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Iron deficiency in patients with cardiogenic shock: protocol for a scoping review
Lorenzo Germinario1,2, Daniel Catena3,2, Sascha Ott3,2,4,5
1Department of Cardiac Anesthesiology and Intensive Care Medicine, Deutsches Herzzentrum der Charité - Medical Heart Center of Charité and German Heart Institute Berlin, Berlin, Germany lorenzo.germinario@dhzc-charite.de.
Insights
This scoping review investigates the link between iron deficiency and cardiogenic shock (CS). Understanding this association is crucial for improving outcomes in patients with this severe heart condition.
Area of Science:
- Cardiology
- Intensive Care Medicine
- Hematology
Background:
- Cardiogenic shock (CS) is a critical condition of cardiac failure leading to organ hypoperfusion.
- Iron deficiency is known to worsen chronic and acute heart failure, impacting quality of life and survival.
- The relationship between iron deficiency and cardiogenic shock remains largely unexplored.
Purpose of the Study:
- To conduct a scoping review on the significance of iron deficiency in patients with cardiogenic shock.
- To determine the current state of knowledge regarding iron deficiency in CS.
- To analyze the incidence and clinical significance of iron deficiency in CS.
Main Methods:
- Systematic literature review using MEDLINE, EMBASE, and Web of Science databases.
- Inclusion of basic research, observational studies, randomized controlled trials, systematic reviews, and meta-analyses.
- Comprehensive search strategy using terms related to iron status and cardiogenic shock, from inception to January 2025.
Main Results:
- This section is to be filled after the study is completed.
Conclusions:
- This section is to be filled after the study is completed.
Introduction:
Cardiogenic shock (CS) is a severe condition characterised by low cardiac output and often hypotension, which results in organ hypoperfusion due to cardiac failure. As a form of acute heart failure, this condition seems to share similar underlying pathological mechanisms. It is well established that iron deficiency is correlated with chronic and acute heart failure, causing worsening of the symptoms, reduction of quality of life and survival and simultaneously increasing the rehospitalisation rates for all causes in these patients. It remains unclear whether there is an association between iron deficiency and CS. The objective of this scoping review will be to determine the actual state of the art regarding the significance of iron deficiency in patients affected by CS.
Methods And Analysis:
We will conduct a systematic review of the literature using MEDLINE and EMBASE via 'Ovid' (Elsevier) and Web of Science (2024 Clarivate). The goal is to analyse the incidence and clinical significance of iron deficiency in patients affected by cardiogenic shock. To gain a deeper insight into the underlying pathophysiological mechanisms, the review will include basic research conducted on both human subjects and on animal models as well as observational, randomised controlled studies and systematic reviews and meta-analysis. To maximise the identification of relevant reports and reduce loss of information, a systematic search of the literature will be performed from inception until January 2025 using the terms "iron deficiency" as well as "iron", "ferritin", "transferrin", "transferrin saturation", "hepcidin" and "soluble transferrin receptor" matching these terms with the keywords "cardiogenic shock", "acute heart failure", "advanced heart failure", "decompensated heart failure", "lvad", "left ventricular assist device", "mechanical circulatory support", "VA-ECMO" and "Extracorporeal Life Support". We will also use the corresponding MeSH and Emtree terms. In order to find grey literature, we will use the OADT.org internet-based database.
Ethics And Dissemination:
No additional ethics approval is required, as this review is based on existing research without new data collection. Only studies with ethics approval will be included. We plan to publish our findings in a peer-reviewed journal and present them at international conferences on cardiology, intensive and acute cardiovascular care, cardiac surgery and cardioanaesthesiology.
