心力衰竭和铁缺乏症患者的静脉铁疗法:随机对照试验的更新元分析
Mohamed Hamed1, Sheref A Elseidy2, Asmaa Ahmed2
1Department of Internal Medicine, Florida Atlantic University, Boca Raton, FL, USA.
Heliyon
|June 29, 2023
概括
静脉注射铁可以减少铁缺乏症患者的心力衰竭住院的情况. 这项对12个RCT的元分析发现,静脉注射铁降低了复合结果和住院治疗,改善了心力衰竭症状.
科学领域:
- 心脏病学 心脏病学
- 血液学 血液学 血液学
- 临床研究 临床研究
背景情况:
- 心力衰竭 (HF) 和缺铁 (ID) 经常同时存在.
- 静脉注射 (IV) 铁是HF患者ID的潜在治疗方法.
- 之前对IV铁的随机临床试验 (RCT) 对于HF和ID显示了不一致的结果.
研究的目的:
- 为了评估IV铁的有效性和安全性,在患有HF和ID的患者.
- 综合来自RCT的证据,以确定IV铁对HF住院和死亡率的影响.
主要方法:
- 在MEDLINE,EMBASE和OVID数据库中进行了系统的电子搜索,直到2022年11月.
- 包括RCT专注于ID的HF患者的IV铁.
- 主要结局是HF住院或心血管死亡率的组合,以及单独的HF住院. 随机效应模型被用于分析.
主要成果:
- 分析了12个涉及3,492名患者的RCT.
- 静脉注射铁显著降低了HF住院或心血管死亡率 (RR 0.72;95% CI 0.59-0.88) 和HF住院 (RR 0.69;95% CI 0.57-0.85) 的复合.
- 在心血管或全因死亡率方面没有发现显著差异. 静脉注射铁改善了纽约心脏协会的排名和左心室喷射率 (LVEF).
结论:
- 静脉注射铁与HF住院和HF和ID患者综合结局的减少有关.
- 这些好处主要来自于HF住院病例的减少.
- 进一步的研究可能会证实对死亡率和生活质量的长期影响.
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