Abstract 12515: Effect of Intravenous Iron Therapy in Patients With Heart Failure and Iron Deficiency: A Meta-Analysis of Randomized Controlled Trials

Background: Iron deficiency is a frequently observed comorbidity in patients with chronic heart failure (HF). Present guidelines strongly advocate for the routine screening of iron deficiency anemia in all HF patients. Numerous randomized controlled trials (RCTs) have examined the efficacy and safety of intravenous iron-carbohydrate complexes as a supplementation approach for patients with HF with reduced ejection fraction (HFrEF). Nevertheless, there exists a necessity to systematically synthesize the evidence derived from these RCTs through a comprehensive meta-analysis. Methods: A comprehensive search was conducted in major electronic databases to identify relevant RCTs. Studies published from inception to April 2023 were scrutinized. Results: A total of 14 RCTs with 3597 patients were included in the analysis. The pooled analysis demonstrated a significant reduction in the composite outcome of cardiovascular death or hospitalization for worsening HF (OR 0.55, 95% CI= 0.45, 0.67; p < 0.001). Similarly, the composite outcome of all-cause death or cardiovascular hospitalization showed a significant benefit with intravenous iron supplementation (OR 0.42, 95% CI= 0.28, 0.62; p < 0.001). Moreover, the analysis indicated a significant decrease in hospitalizations for HF among patients receiving IV iron (OR 0.49, 95% CI= 0.32, 0.75; p < 0.001). However, no statistically significant difference was observed in all-cause mortality (OR 0.90, 95% CI= 0.74, 1.10; p = 0.31) and cardiovascular mortality (OR 0.85, 95% CI= 0.68, 1.05; p = 0.14) between the two groups. Conclusion: The evidence from this meta-analysis underscores the significance of incorporating IV iron therapy in iron-deficient patients with systolic HF as it demonstrates significant improvements in patient outcomes.