Iron supplementation may be beneficial in patients with heart failure and iron deficiency

Référence

Zhou X, Xu W, Xu Y, Qian Z. Iron supplementation improves cardiovascular outcomes in patients with heart failure. Am J Med 2019;132:955-961. https://doi.org/10.1016/j.amjmed.2019.02.018

Sommaire

Iron deficiency is common in patients with heart failure and increases in likelihood with severity of disease. The authors searched three databases, including Cochrane CENTRAL, identifying 10 English-language randomized trials enrolling a total of 1404 patients. Two authors independently selected studies for inclusion and extracted data. Most of the studies used weekly intravenous iron supplementation and ranged in duration from 2 weeks to one year. In 5 studies of 1007 patients, hospitalization rates were significantly lower with iron supplementation (odds ratio [OR] .39; 95% CI .19 - .80) though mortality was not. Quality of life scores were higher with treatment. Cardiac output and peak oxygen consumption were also increased. There was no significant heterogeneity among the studies or evidence of publication bias. However, we need more research into the role of iron; many of these studies had a high risk of bias and were of a short duration. Note the more aggressive approach used in these studies -- many of the studies used weekly intravenous iron supplementation.