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Effects and Safety of Oral Iron for Heart Failure with Iron Deficiency: A Systematic Review and Meta-Analysis with

Nannan Tan1,2,3, Yiqing Cai1, Junjie Liu4

  • 1School of Traditional Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China.

Cardiovascular Therapeutics
|October 3, 2022
PubMed

Insights

Oral iron supplements may improve cardiac function (left ventricular ejection fraction) and ferritin levels in heart failure patients with iron deficiency. However, effects on exercise capacity and hemoglobin remain unclear, warranting cautious interpretation due to study quality.

Area of Science:

  • Cardiology
  • Hematology
  • Internal Medicine

Background:

  • Oral iron supplementation is a common treatment for iron deficiency in heart failure (HF) patients.
  • The efficacy of oral iron in improving outcomes for HF patients remains a subject of ongoing debate and research.

Purpose of the Study:

  • To conduct a meta-analysis of randomized controlled trials (RCTs).
  • To evaluate the effects of oral iron supplementation on heart failure patients with iron deficiency.

Main Methods:

  • Systematic literature search across nine databases for RCTs up to October 2021.
  • Meta-analysis using Revman 5.3, trial sequential analysis (TSA) with TSA 0.9.5.10 beta software.
  • Risk of bias and evidence quality assessed using the Risk of Bias tool and GRADE tool, respectively.

Main Results:

  • Four RCTs involving 582 patients indicated oral iron improved left ventricular ejection fraction (LVEF) and serum ferritin.
  • No significant differences were observed in 6-minute walk distance (6MWT), NT-proBNP, or hemoglobin levels.
  • Trial sequential analysis for LVEF and serum ferritin did not reach the required information size, suggesting inconclusive results.

Conclusions:

  • Oral iron may enhance cardiac function (LVEF) and iron stores (serum ferritin) in HF patients.
  • The treatment showed no significant impact on exercise capacity (6MWT) or hemoglobin levels.
  • Findings should be interpreted with caution due to the generally low methodological and evidence quality of the included studies.
Abstract

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