{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,28]],"date-time":"2026-08-28T23:37:33Z","timestamp":1787960253170,"version":"build-2784847793"},"reference-count":18,"publisher":"Oxford University Press (OUP)","issue":"2","license":[{"start":{"date-parts":[[2025,11,12]],"date-time":"2025-11-12T00:00:00Z","timestamp":1762905600000},"content-version":"vor","delay-in-days":1014,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2023,2,2]],"date-time":"2023-02-02T00:00:00Z","timestamp":1675296000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2023,4,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>There is considerable variability in the effect of intravenous iron on hard cardiovascular (CV)-related outcomes in patients with heart failure (HF) in randomized controlled trials (RCTs). We use a meta-analytic approach to analyse data from existing RCTs to derive a more robust estimate of the effect size of intravenous iron infusion on CV-related outcomes in patients with HF.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Method and results<\/jats:title>\n                    <jats:p>PubMed\/Medline was searched using the following terms: (\u2018intravenous\u2019 and \u2018iron\u2019 and \u2018heart failure\u2019) from inception till 6 November 2022 for RCTs comparing intravenous iron infusion with placebo or standard of care in patients with HF and iron deficiency. Outcomes were the composite of CV mortality and first hospitalization for HF; all-cause mortality; CV mortality; first hospitalization for HF; and total hospitalizations for HF. Random effects risk ratio (RR) with 95% confidence intervals (CIs) were calculated. Ten RCTs with a total of 3438 patients were included. Intravenous iron resulted in a significant reduction in the composite of CV mortality and first hospitalization for HF [RR 0.0.85; 95% CI (0.77, 0.95)], first hospitalization for HF [RR 0.82; 95% CI (0.67, 0.99)], and total hospitalizations for HF [RR 0.74; 95% CI (0.60, 0.91)] but no statistically significant difference in all-cause mortality [RR 0.95; 95% CI. (0.83, 1.09)] or CV mortality [OR 0.89; 95% CI (0.75, 1.05)].<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Intravenous iron infusion in patients with HF reduces the composite risk of first hospitalization for HF and CV mortality as well as the risks of first and recurrent hospitalizations for HF, with no effect on all-cause mortality or CV mortality alone.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ehf2.14310","type":"journal-article","created":{"date-parts":[[2023,2,3]],"date-time":"2023-02-03T02:39:17Z","timestamp":1675391957000},"page":"1473-1480","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":47,"title":["Intravenous Iron Infusion in Patients with Heart Failure: A Systematic Review and Study-Level Meta-Analysis"],"prefix":"10.1093","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9549-7907","authenticated-orcid":false,"given":"Husam M.","family":"Salah","sequence":"first","affiliation":[{"name":"Department of Internal Medicine, University of Arkansas for Medical Sciences , Little Rock, AR ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gianluigi","family":"Savarese","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Medicine, Karolinska Institutet; Heart and Vascular Theme, Karolinska University Hospital , Stockholm ,","place":["Sweden"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giuseppe M.C.","family":"Rosano","sequence":"additional","affiliation":[{"name":"St George's Hospitals NHS Trust University of London , London ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew P.","family":"Ambrosy","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Kaiser Permanente San Francisco Medical Center , San Francisco, CA ,","place":["USA"]},{"name":"Division of Research, Kaiser Permanente Northern California , Oakland, CA ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert J.","family":"Mentz","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Duke University Medical Center , Durham, NC ,","place":["USA"]},{"name":"Duke Clinical Research Institute, Duke University School of Medicine , Durham, NC ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marat","family":"Fudim","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Duke University Medical Center , Durham, NC ,","place":["USA"]},{"name":"Duke Clinical Research Institute, Duke University School of Medicine , Durham, NC ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2023,2,2]]},"reference":[{"key":"2026012114113474100_ehf214310-bib-0001","doi-asserted-by":"crossref","first-page":"125","DOI":"10.3390\/jcm11010125","article-title":"Iron deficiency in heart failure: mechanisms and pathophysiology","volume":"11","author":"Alnuwaysir","year":"2021","journal-title":"J Clin Med"},{"key":"2026012114113474100_ehf214310-bib-0002","doi-asserted-by":"crossref","first-page":"14","DOI":"10.1093\/eurheartj\/ehac569","article-title":"Iron deficiency and cardiovascular disease","volume":"44","author":"Savarese","year":"2022","journal-title":"Eur Heart J"},{"key":"2026012114113474100_ehf214310-bib-0003","doi-asserted-by":"crossref","first-page":"125","DOI":"10.1002\/ejhf.823","article-title":"Effects of ferric carboxymaltose on hospitalisations and mortality rates in iron-deficient heart failure patients: an individual patient data meta-analysis","volume":"20","author":"Anker","year":"2018","journal-title":"Eur J Heart Fail"},{"key":"2026012114113474100_ehf214310-bib-0004","doi-asserted-by":"crossref","first-page":"2199","DOI":"10.1016\/S0140-6736(22)02083-9","article-title":"Intravenous ferric derisomaltose in patients with heart failure and iron deficiency in the UK (IRONMAN): an investigator-initiated, prospective, randomised, open-label, blinded-endpoint trial","volume":"400","author":"Kalra","year":"2022","journal-title":"Lancet"},{"key":"2026012114113474100_ehf214310-bib-0005","doi-asserted-by":"crossref","first-page":"344","DOI":"10.1002\/ehf2.12250","article-title":"Single-dose intravenous iron in Southeast Asian heart failure patients: a pilot randomized placebo-controlled study (PRACTICE-ASIA-HF)","volume":"5","author":"Yeo","year":"2018","journal-title":"ESC Heart Fail"},{"key":"2026012114113474100_ehf214310-bib-0006","doi-asserted-by":"crossref","first-page":"657","DOI":"10.1093\/eurheartj\/ehu385","article-title":"Beneficial effects of long-term intravenous iron therapy with ferric carboxymaltose in patients with symptomatic heart failure and iron deficiency\u2020","volume":"36","author":"Ponikowski","year":"2015","journal-title":"Eur Heart J"},{"key":"2026012114113474100_ehf214310-bib-0007","doi-asserted-by":"crossref","first-page":"2436","DOI":"10.1056\/NEJMoa0908355","article-title":"Ferric carboxymaltose in patients with heart failure and iron deficiency","volume":"361","author":"Anker","year":"2009","journal-title":"N Engl J Med"},{"key":"2026012114113474100_ehf214310-bib-0008","doi-asserted-by":"crossref","first-page":"103","DOI":"10.1016\/j.jacc.2007.09.036","article-title":"Effect of intravenous iron sucrose on exercise tolerance in anemic and nonanemic patients with symptomatic chronic heart failure and iron deficiency FERRIC-HF: a randomized, controlled, observer-blinded trial","volume":"51","author":"Okonko","year":"2008","journal-title":"J Am Coll Cardiol"},{"key":"2026012114113474100_ehf214310-bib-0009","doi-asserted-by":"crossref","first-page":"194","DOI":"10.1097\/FJC.0000000000001287","article-title":"IV sodium ferric gluconate complex in patients with iron deficiency hospitalized due to acute heart failure-investigator initiated, randomized controlled trial","volume":"80","author":"Marcusohn","year":"2022","journal-title":"J Cardiovasc Pharmacol"},{"key":"2026012114113474100_ehf214310-bib-0010","doi-asserted-by":"crossref","first-page":"4905","DOI":"10.1093\/eurheartj\/ehab411","article-title":"The effect of intravenous ferric carboxymaltose on cardiac reverse remodelling following cardiac resynchronization therapy-the IRON-CRT trial","volume":"42","author":"Martens","year":"2021","journal-title":"Eur Heart J"},{"key":"2026012114113474100_ehf214310-bib-0011","doi-asserted-by":"crossref","first-page":"1895","DOI":"10.1016\/S0140-6736(20)32339-4","article-title":"Ferric carboxymaltose for iron deficiency at discharge after acute heart failure: a multicentre, double-blind, randomised, controlled trial","volume":"396","author":"Ponikowski","year":"2020","journal-title":"Lancet"},{"key":"2026012114113474100_ehf214310-bib-0012","doi-asserted-by":"crossref","first-page":"1374","DOI":"10.1161\/CIRCULATIONAHA.117.027497","article-title":"Effect of ferric carboxymaltose on exercise capacity in patients with chronic heart failure and iron deficiency","volume":"136","author":"van Veldhuisen","year":"2017","journal-title":"Circulation"},{"key":"2026012114113474100_ehf214310-bib-0013","doi-asserted-by":"crossref","first-page":"1657","DOI":"10.1016\/j.jacc.2007.07.029","article-title":"Intravenous iron reduces NT-pro-brain natriuretic peptide in anemic patients with chronic heart failure and renal insufficiency","volume":"50","author":"Toblli","year":"2007","journal-title":"J Am Coll Cardiol"},{"key":"2026012114113474100_ehf214310-bib-0014","doi-asserted-by":"crossref","first-page":"3011","DOI":"10.1093\/eurheartj\/ehab234","article-title":"The effect of intravenous ferric carboxymaltose on health-related quality of life in iron-deficient patients with acute heart failure: the results of the AFFIRM-AHF study","volume":"42","author":"Jankowska","year":"2011","journal-title":"Eur Heart J"},{"key":"2026012114113474100_ehf214310-bib-0015","doi-asserted-by":"crossref","first-page":"e263","DOI":"10.1016\/j.jacc.2021.12.012","article-title":"2022 AHA\/ACC\/HFSA guideline for the management of heart failure","volume":"79","author":"Heidenreich","year":"2022","journal-title":"J Am Coll Cardiol"},{"key":"2026012114113474100_ehf214310-bib-0016","doi-asserted-by":"crossref","first-page":"3599","DOI":"10.1093\/eurheartj\/ehab368","article-title":"2021 ESC guidelines for the diagnosis and treatment of acute and chronic heart failure: developed by the task force for the diagnosis and treatment of acute and chronic heart failure of the European Society of Cardiology (ESC) with the special contribution of the Heart Failure Association (HFA) of the ESC","volume":"42","author":"McDonagh","year":"2021","journal-title":"Eur Heart J"},{"key":"2026012114113474100_ehf214310-bib-0017","doi-asserted-by":"crossref","first-page":"947","DOI":"10.1002\/ehf2.13823","article-title":"Trends and characteristics of hospitalizations for heart failure in the United States from 2004 to 2018","volume":"9","author":"Salah","year":"2022","journal-title":"ESC Heart Failure"},{"key":"2026012114113474100_ehf214310-bib-0018","doi-asserted-by":"crossref","DOI":"10.1186\/cc11919","article-title":"Small studies may overestimate the effect sizes in critical care meta-analyses: a meta-epidemiological study","volume":"17","author":"Zhang","year":"2013","journal-title":"Crit Care"}],"container-title":["ESC Heart Failure"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ehf2.14310","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/ehf2.14310","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/academic.oup.com\/eschf\/article-pdf\/10\/2\/1473\/65051267\/eschf_10_2_1473.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/eschf\/article-pdf\/10\/2\/1473\/65051267\/eschf_10_2_1473.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,21]],"date-time":"2026-01-21T19:12:47Z","timestamp":1769022767000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/eschf\/article\/10\/2\/1473\/8304895"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,2,2]]},"references-count":18,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2023,2,2]]},"published-print":{"date-parts":[[2023,4,1]]}},"URL":"https:\/\/doi.org\/10.1002\/ehf2.14310","relation":{},"ISSN":["2055-5822"],"issn-type":[{"value":"2055-5822","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2023,4]]},"published":{"date-parts":[[2023,2,2]]},"assertion":[{"value":"2022-12-05","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-01-16","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-02-02","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}