{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T16:47:26Z","timestamp":1791478046809,"version":"4.3.4"},"reference-count":30,"publisher":"Springer Science and Business Media LLC","issue":"7","license":[{"start":{"date-parts":[[2023,4,19]],"date-time":"2023-04-19T00:00:00Z","timestamp":1681862400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2023,4,19]],"date-time":"2023-04-19T00:00:00Z","timestamp":1681862400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"Universit\u00e4tsklinikum des Saarlandes und Medizinische Fakult\u00e4t der Universit\u00e4t des Saarlandes"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Clin Res Cardiol"],"published-print":{"date-parts":[[2023,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Introduction<\/jats:title>\n                <jats:p>AFFIRM-AHF and IRONMAN demonstrated lower rates of the combined endpoint recurrent heart failure (HF) hospitalizations and cardiovascular death (CVD) using intravenous (IV) ferric carboxymaltose (FCM) and ferric derisomaltose (FDI), respectively in patients with HF and iron deficiency (ID) utilizing prespecified COVID-19 analyses.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Material and methods<\/jats:title>\n                <jats:p>We meta-analyzed efficacy, between trial heterogeneity and data robustness for the primary endpoint and CVD in AFFIRM-AHF and IRONMAN. As sensitivity analysis, we analyzed data from all eligible exploratory trials investigating FCM\/FDI in HF.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>FCM\/FDI reduced the primary endpoint (RR\u2009=\u20090.81, 95% CI 0.69\u20130.95, <jats:italic>p<\/jats:italic>\u2009=\u20090.01, <jats:italic>I<\/jats:italic><jats:sup>2<\/jats:sup>\u2009=\u20090%), with the number needed to treat (NNT) being 7. Power was 73% and findings were robust with fragility index (FI) of 94 and fragility quotient (FQ) of 0.041. Effects of FCM\/FDI were neutral concerning CVD (OR\u2009=\u20090.88, 95% CI 0.71\u20131.09, <jats:italic>p<\/jats:italic>\u2009=\u20090.24, <jats:italic>I<\/jats:italic><jats:sup>2<\/jats:sup>\u2009=\u20090%). Power was 21% while findings were fragile with reverse FI of 14 and reversed FQ of 0.006. The sensitivity analysis from all eligible trials (<jats:italic>n<\/jats:italic>\u2009=\u20093258) confirmed positive effects of FCM\/FDI on the primary endpoint (RR\u2009=\u20090.77, 95% CI 0.66\u20130.90, <jats:italic>p<\/jats:italic>\u2009=\u20090.0008, <jats:italic>I<\/jats:italic><jats:sup>2<\/jats:sup>\u2009=\u20090%), with NNT being 6. Power was 91% while findings were robust (FI of 147 and FQ of 0.045). Effect on CVD was neutral (RR\u2009=\u20090.87, 95% CI 0.71\u20131.07, <jats:italic>p<\/jats:italic>\u2009=\u20090.18, <jats:italic>I<\/jats:italic><jats:sup>2<\/jats:sup>\u2009=\u20090%). Power was 10% while findings were fragile (reverse FI of 7 and reverse FQ of 0.002). Rate of infections (OR\u2009=\u20090.85, 95% CI 0.71\u20131.02, <jats:italic>p<\/jats:italic>\u2009=\u20090.09, <jats:italic>I<\/jats:italic><jats:sup>2<\/jats:sup>\u2009=\u20090%), vascular disorder (OR\u2009=\u20090.84, 95% CI 0.57\u20131.25, <jats:italic>p<\/jats:italic>\u2009=\u20090.34, <jats:italic>I<\/jats:italic><jats:sup>2<\/jats:sup>\u2009=\u20090%) and general or injection-site related disorders (OR\u2009=\u20091.39, 95% CI 0.88\u20131.29, <jats:italic>p<\/jats:italic>\u2009=\u20090.16, <jats:italic>I<\/jats:italic><jats:sup>2<\/jats:sup>\u2009=\u200930%) were comparable between groups. There was no relevant heterogeneity (<jats:italic>I<\/jats:italic><jats:sup>2<\/jats:sup>\u2009&gt;\u200950%) between the trials for any of the analyzed outcomes.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>Use of FCM\/FDI is safe and reduces the composite of recurrent HF hospitalizations and CVD, while effects on CVD alone are based on available level of data indeterminate. Findings concerning composite outcomes exhibit a high level of robustness without heterogeneity between trials with FCM and FDI.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Graphical Abstract<\/jats:title>\n                \n              <\/jats:sec>","DOI":"10.1007\/s00392-023-02207-2","type":"journal-article","created":{"date-parts":[[2023,4,19]],"date-time":"2023-04-19T15:04:16Z","timestamp":1681916656000},"page":"954-966","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":24,"title":["Efficacy and safety of intravenous iron repletion in patients with heart failure: a systematic review and meta-analysis"],"prefix":"10.1007","volume":"112","author":[{"given":"Davor","family":"Vukadinovi\u0107","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amr","family":"Abdin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Insa","family":"Emrich","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P. 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Drug Saf 45(10):1019\u20131036. https:\/\/doi.org\/10.1007\/s40264-022-01216-w","journal-title":"Drug Saf"}],"container-title":["Clinical Research in Cardiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00392-023-02207-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00392-023-02207-2\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00392-023-02207-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,6,26]],"date-time":"2023-06-26T19:04:18Z","timestamp":1687806258000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s00392-023-02207-2"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,4,19]]},"references-count":30,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2023,7]]}},"alternative-id":["2207"],"URL":"https:\/\/doi.org\/10.1007\/s00392-023-02207-2","relation":{},"ISSN":["1861-0684","1861-0692"],"issn-type":[{"value":"1861-0684","type":"print"},{"value":"1861-0692","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,4,19]]},"assertion":[{"value":"19 February 2023","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"24 March 2023","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"19 April 2023","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"D.V. and A.A. have no conflict of interest to declare; I.E.E. received advisory board and speaker honoraria from Pharmacosmos and Astellas. C.S. received honoraria and travel support from Bayer, Astra Zeneca, Daiichi Sankyo, Novartis, Actelion, Roche, Sanofi Aventis, Pharmacosmos, Medtronic, Thoratec, Boehringer Ingelheim, HeartWare, Coronus, Abbott, Edwards Inc, Boston Scientific, St Jude Medical, Abiomed, and the German Cardiac Society; research support from the National Institutes of Health, the German Research Foundation, the Else Kr\u00f6ner Fresenius Foundation, the German Heart Foundation, the European Society of Cardiology, Actelion, Medtronic, BMBF, Abiomed, Boehringer Ingelheim, and Boston Scientific; and served on advisory boards for the German Research Council, Eurotransplant, Novartis, Bayer, Pharmacosmos, Astra Zeneca, Boehringer Ingelheim Inc, the German Cardiac Society, and the European Society of Cardiology; S.v.H. has been a paid consultant for and\/or received honoraria payments from AstraZeneca, Bayer, Boehringer Ingelheim, BRAHMS, Chugai, Gr\u00fcnenthal, Helsinn, Hexal, Novartis, Pharmacosmos, Respicardia, Roche, Servier, Sorin, and Vifor. S.v.H. reports research support from Amgen, Boehringer Ingelheim, IMI, and the German Center for Cardiovascular Research (DZHK); M.B. is supported by the Deutsche Forschungsgemeinschaft (German Research Foundation; TTR 219, project number 322900939) and reports personal fees from Abbott, Amgen, Astra Zeneca, Bayer, Boehringer Ingelheim, Cytokinetics, Edwards, Medtronic, Novartis, Recor, Servier and Vifor.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interests"}}]}}