Effects and Safety of Oral Iron for Heart Failure with Iron Deficiency: A Systematic Review and Meta-Analysis with Trial Sequential Analysis.
Study Goal
The researchers aimed to evaluate the effects of oral iron supplementation on cardiac function, exercise capacity, and iron stores in heart failure patients with iron deficiency.
Results Summary
Oral iron improved left ventricular ejection fraction (LVEF) and serum ferritin levels but did not significantly affect exercise capacity (6 MWT) or hemoglobin levels. The study noted poor methodological and evidence quality, urging cautious interpretation of findings.
Population
Heart failure patients with iron deficiency (582 participants across four studies).
Effective Dosage
Not specified in the abstract.
Duration
Not specified in the abstract.
Interactions
None mentioned.
| Intervention | Direction | Endpoint | Population | Dosage | Impact | Claim # |
|---|---|---|---|---|---|---|
oral iron treatment | increase | left ventricular ejection fraction (LVEF) | patients with heart failure and iron deficiency | MD = 1.52%, 95% CI: 0.69 to 2.36 | could improve | #1 |
oral iron treatment | increase | iron stores measured serum ferritin | patients with heart failure and iron deficiency | MD = 15.39 ng/mL, 95% CI: 8.42 to 22.36 | could improve | #2 |
oral iron treatment | no change | exercise capacity measured by 6 MWT | patients with heart failure and iron deficiency | MD = 0.00 m, 95% CI: -9.56 to 9.56 | lack of effect on | #3 |
oral iron treatment | no change | iron stores measured by hemoglobin | patients with heart failure and iron deficiency | MD = 0.00 g/dL, 95% CI: -0.12 to 0.12 | lack of effect on | #4 |
BACKGROUND: Oral iron supplement is commonly prescribed to heart failure patients with iron deficiency. However, the effects of oral iron for heart failure remain controversial. This study included randomized controlled trials (RCTs) for meta-analysis to evaluate the effects of oral iron for heart failure patients. METHODS: Nine databases (The Cochrane Library, Embase, PubMed, CINAHL, Web of science, CNKI, SinoMed, VIP, and Wanfang) were searched for RCTs of oral iron for heart failure from inception to October 2021. The effects were assessed with a meta-analysis using Revman 5.3 software. The trial sequential analysis was performed by TSA 0.9.5.10 beta software. The risk of bias of trials was evaluated via Risk of Bias tool. The evidence quality was assessed through GRADE tool. RESULTS: Four studies including 582 patients with heart failure and iron deficiency were enrolled. The results indicated that oral iron treatment could improve left ventricular ejection fraction (LVEF, MD = 1.52%, 95% CI: 0.69 to 2.36, CONCLUSION: This analysis showed that oral iron could improve cardiac function measured by LVEF, and iron stores measured serum ferritin, but lack of effect on exercise capacity measured by 6 MWT, and iron stores measured by hemoglobin. Given the overall poor methodological quality and evidence quality, these findings should be treated cautiously.