Iron supplementation may reduce hospitalization due to heart failure

China: Iron therapy can reduce heart failure (HF) hospitalization but not mortality in patients with heart failure, finds a recent study published in The American Journal of Medicine.

The study further found that in Heart failure patients iron treatment increased cardiac function, exercise capacity and improved quality of life and decreased serum levels of N-terminal pro-B-type natriuretic peptide (NT-proBNP) and C-reactive protein (CRP) -- a biomarker of myocardial strain, independently predict adverse outcomes in HF patients.

According to the Mayo Clinic, heart failure occurs when the heart is unable to pump the required amount of blood. Certain conditions, such as narrowed arteries in the heart (coronary artery disease) or high blood pressure, gradually leave the heart too weak or stiff to fill and pump efficiently.

Iron deficiency is prevalent in up to 50% of patients with heart failure and is associated with the severity of the disease. Iron deficiency in heart failure patients may contribute to reduced exercise capacity, impaired quality of life, and increased cardiac mortality, irrespective of the presence of anaemia. Several small randomized controlled trials (RCTs) have been performed to evaluate the effects of iron therapy in patients with heart failure. However, no firm conclusions could be drawn from these studies.

Xiang Zhou, The Second Affiliated Hospital of Soochow University, Suzhou, China, and colleagues performed this meta-analysis to evaluate the therapeutic effects of iron in patients with systolic heart failure and iron deficiency.

For the purpose, the researchers searched the online databases through h March 2018 and included 10 randomized controlled trials involving 1404 heart failure patients who underwent iron or placebo treatment.

Key findings of the study include:

• Iron supplementation significantly reduced hospitalization for worsening heart failure (OR 0.39) and the combined endpoint of death and heart failure hospitalization (OR 0.47).


• Iron treatment was found to improve New York Heart Association class, 6-minute walk distance, left ventricular ejection fraction, and peak oxygen consumption.


• Iron therapy was also associated with improvements in Patient Global Assessment, Kansas City Cardiomyopathy Questionnaire score, European Quality of Life-5 Dimensions score, and Minnesota Living with Heart Failure Questionnaire score.


• Serum levels of N-terminal pro-B-type natriuretic peptide (NT-proBNP) and C-reactive protein (CRP) were markedly decreased in patients with iron repletion compared with placebo treatment (WMD: -332.48 pg/mL; WMD: -4.64 mg/L respectively).

Our meta-analysis suggests that iron therapy can reduce heart failure hospitalization, increase cardiac function, improve quality of life, and decrease serum levels of NT-proBNP and CRP in patients with heart failure.

More Information: "Iron Supplementation Improves Cardiovascular Outcomes in Patients with Heart Failure" published in The American Journal of Medicine.