Outcomes of Patients with Chronic Heart Failure and Iron Deficiency Treated with Intravenous Iron: A Meta-analysis

Kapoor, Mahim; Schleinitz, Mark D.; Gemignani, Anthony; Wu, Wen‐Chih

doi:10.2174/1871529x11313010004

Cited by 39 publications

(34 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Conclusive evidence from a large number of studies has confirmed that adequate treatment of iron deficiency significantly improves rates of mortality and morbidity in patients suffering from a wide range of conditions, including chronic heart failure [29, 30], coronary heart disease [31], chronic kidney disease [32, 33], cancer [34, 35], and rheumatoid arthritis [36, 37]. Nevertheless, screening and treatment of ID continue to be widely neglected in the routine management of geriatric patients.…”

Section: Discussionmentioning

confidence: 99%

An Etiologic Profile of Anemia in 405 Geriatric Patients

Geisel

Martin

Schulze

et al. 2014

Anemia

View full text Add to dashboard Cite

Background. Anemia is a common condition in the elderly and a significant risk factor for increased morbidity and mortality, reducing not only functional capacity and mobility but also quality of life. Currently, few data are available regarding anemia in hospitalized geriatric patients. Our retrospective study investigated epidemiology and causes of anemia in 405 hospitalized geriatric patients. Methods. Data analysis was performed using laboratory parameters determined during routine hospital admission procedures (hemoglobin, ferritin, transferrin saturation, C-reactive protein, vitamin B12, folic acid, and creatinine) in addition to medical history and demographics. Results. Anemia affected approximately two-thirds of subjects. Of 386 patients with recorded hemoglobin values, 66.3% were anemic according to WHO criteria, mostly (85.1%) in a mild form. Anemia was primarily due to iron deficiency (65%), frequently due to underlying chronic infection (62.1%), or of mixed etiology involving a combination of chronic disease and iron deficiency, with absolute iron deficiency playing a comparatively minor role. Conclusion. Greater awareness of anemia in the elderly is warranted due to its high prevalence and negative effect on outcomes, hospitalization duration, and mortality. Geriatric patients should be routinely screened for anemia and etiological causes of anemia individually assessed to allow timely initiation of appropriate therapy.

show abstract

Section: Discussionmentioning

confidence: 99%

An Etiologic Profile of Anemia in 405 Geriatric Patients

Geisel

Martin

Schulze

et al. 2014

Anemia

View full text Add to dashboard Cite

show abstract

“…About half of all patients with HF have either absolute iron deficiency or functional iron deficiency defined as ferritin <100 µg/L or TSAT <20% and serum ferritin 100–300 μg/L [11,21,22], respectively. This finding is only partly associated with the presence of anaemia.…”

Section: Iron Deficiency In Patients With Heart Failurementioning

confidence: 99%

Iron Deficiency in Heart Failure: A Practical Guide

Ebner

Haehling

2013

Nutrients

View full text Add to dashboard Cite

Iron is an element necessary for cells due to its capacity of transporting oxygen and electrons. One of the important co-morbidities in heart failure is iron deficiency. Iron has relevant biological functions, for example, the formation of haemoglobin, myoglobin and numerous enzymatic groups. The prevalence of iron deficiency increases with the severity of heart failure. For a long time, the influence of iron deficiency was underestimated especially in terms of worsening of cardiovascular diseases and of developing anaemia. In recent years, studies with intravenous iron agents in patients with iron deficiency and cardiovascular diseases indicated new insights in the improvement of therapy. Experimental studies support the understanding of iron metabolism. Many physicians remain doubtful of the use of intravenous iron due to reports of side effects. The aim of this review is to describe iron metabolism in humans, to highlight the influence of iron deficiency on the course and symptoms of heart failure, discuss diagnostic tools of iron deficiency and provide guidance on the use of intravenous iron.

show abstract

“…27,28 Although our study additionally included only one large and well-designed RCT published recently, the sample size of our meta-analysis increased by about half. Moreover, the most recent meta-analysis enrolled patients were treated in combination with ESAs and lost the significance of prognostic endpoints after exclusion of some trials.…”

Section: Discussionmentioning

confidence: 99%

“…Moreover, the most recent meta-analysis enrolled patients were treated in combination with ESAs and lost the significance of prognostic endpoints after exclusion of some trials. 28 Conversely, we conducted a reliable sensitivity analysis and evaluated more endpoints (eg, the combined outcomes of death and HF hospitalization). The above points increase accuracy and robustness of our findings.…”

Section: Discussionmentioning

confidence: 99%