{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T20:32:35Z","timestamp":1792096355196,"version":"4.4.0"},"reference-count":25,"publisher":"Oxford University Press (OUP)","issue":"4","license":[{"start":{"date-parts":[[2025,12,5]],"date-time":"2025-12-05T00:00:00Z","timestamp":1764892800000},"content-version":"vor","delay-in-days":1003,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2023,3,8]],"date-time":"2023-03-08T00:00:00Z","timestamp":1678233600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000274","name":"British Heart Foundation","doi-asserted-by":"publisher","award":["RE\/18\/6134217"],"award-info":[{"award-number":["RE\/18\/6134217"]}],"id":[{"id":"10.13039\/501100000274","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000274","name":"British Heart Foundation","doi-asserted-by":"publisher","award":["RE\/18\/6134217"],"award-info":[{"award-number":["RE\/18\/6134217"]}],"id":[{"id":"10.13039\/501100000274","id-type":"DOI","asserted-by":"publisher"}]}],"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>For patients with heart failure (HF) and iron deficiency (ID), randomized trials suggest that intravenous (IV) iron reduces hospitalizations for heart failure (HHF), but uncertainty exists about the effects in subgroups and the impact on mortality. We conducted a meta-analysis of randomized trials investigating the effect of IV iron on clinical outcomes in patients with HF.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and results<\/jats:title>\n                    <jats:p>We identified randomized trials published between 1 January 2000 and 5 November 2022 investigating the effect of IV iron versus standard care\/placebo in patients with HF and ID in any clinical setting, regardless of HF phenotype. Trials of oral iron or not in English were not included. The main outcomes of interest were a composite of HHF and cardiovascular death (CVD), on HHF alone and on cardiovascular and all-cause mortality. Ten trials were identified with 3373 participants, of whom 1759 were assigned to IV iron. IV iron reduced the composite of recurrent HHF and CVD (rate ratio 0.75, 95% confidence interval [CI] 0.61\u20130.93; p\u2009&amp;lt;\u20090.01) and first HHF or CVD (odds ratio [OR] 0.72, 95% CI 0.53\u20130.99; p = 0.04). Effects on cardiovascular (OR 0.86, 95% CI 0.70\u20131.05; p = 0.14) and all-cause mortality (OR 0.93, 95% CI 0.78\u20131.12; p = 0.47) were inconclusive. Results were similar in analyses confined to the first year of follow-up, which was less disrupted by the COVID-19 pandemic. Subgroup analyses found little evidence of heterogeneity for the effect on the primary endpoint, although patients with transferrin saturation &amp;lt;20% (OR 0.67, 95% CI 0.49\u20130.92) may have benefited more than those with values \u226520% (OR 0.99, 95% CI 0.74\u20131.30) (heterogeneity p = 0.07).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>In patients with HF and ID, this meta-analysis suggests that IV iron reduces the risk of HHF but whether this is associated with a reduction in cardiovascular or all-cause mortality remains inconclusive.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ejhf.2810","type":"journal-article","created":{"date-parts":[[2023,2,24]],"date-time":"2023-02-24T01:00:30Z","timestamp":1677200430000},"page":"528-537","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":136,"title":["Intravenous Iron in Patients with Heart Failure and Iron Deficiency: An Updated Meta-Analysis"],"prefix":"10.1093","volume":"25","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7539-9958","authenticated-orcid":false,"given":"Fraser J.","family":"Graham","sequence":"first","affiliation":[{"name":"Robertson Centre for Biostatistics, University of Glasgow , Glasgow ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pierpaolo","family":"Pellicori","sequence":"additional","affiliation":[{"name":"School of Cardiovascular and Metabolic Health, University of Glasgow , Glasgow ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul R.","family":"Kalra","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Portsmouth Hospitals University NHS Trust , Portsmouth ,","place":["UK"]},{"name":"College of Medical, Veterinary & Life Sciences, University of Glasgow , Glasgow ,","place":["UK"]},{"name":"Faculty of Science and Health, University of Portsmouth , Portsmouth ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ian","family":"Ford","sequence":"additional","affiliation":[{"name":"Robertson Centre for Biostatistics, University of Glasgow , Glasgow ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dario","family":"Bruzzese","sequence":"additional","affiliation":[{"name":"Department of Public Health, University of Naples Federico II , Naples ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John G.F.","family":"Cleland","sequence":"additional","affiliation":[{"name":"School of Cardiovascular and Metabolic Health, University of Glasgow , Glasgow ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2023,3,8]]},"reference":[{"key":"2026010913083887300_ejhf2810-bib-0001","doi-asserted-by":"crossref","first-page":"341","DOI":"10.1016\/j.jacc.2021.11.039","article-title":"Criteria for iron deficiency in patients with heart failure","volume":"79","author":"Masini","year":"2021","journal-title":"J Am Coll Cardiol"},{"key":"2026010913083887300_ejhf2810-bib-0002","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":"2026010913083887300_ejhf2810-bib-0003","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","volume":"36","author":"Ponikowski","year":"2015","journal-title":"Eur Heart J"},{"key":"2026010913083887300_ejhf2810-bib-0004","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":"2026010913083887300_ejhf2810-bib-0005","doi-asserted-by":"crossref","first-page":"575","DOI":"10.1016\/j.ahj.2013.01.017","article-title":"Iron deficiency in chronic heart failure: an international pooled analysis","volume":"165","author":"Klip","year":"2013","journal-title":"Am Heart J"},{"key":"2026010913083887300_ejhf2810-bib-0006","doi-asserted-by":"crossref","first-page":"4","DOI":"10.1002\/ejhf.2333","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). 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