{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,31]],"date-time":"2026-03-31T16:51:03Z","timestamp":1774975863037,"version":"3.50.1"},"reference-count":18,"publisher":"Springer Science and Business Media LLC","license":[{"start":{"date-parts":[[2024,10,21]],"date-time":"2024-10-21T00:00:00Z","timestamp":1729468800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2024,10,21]],"date-time":"2024-10-21T00:00:00Z","timestamp":1729468800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100006752","name":"Universidade do Porto","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100006752","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Clin Res Cardiol"],"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n              <jats:title>Background<\/jats:title>\n              <jats:p>Intravenous iron improves symptoms in heart failure (HF) with iron deficiency (ID) but failed to consistently show a benefit in cardiovascular outcomes. The ID definition used may influence the response to intravenous iron. The aim of this meta-analysis is to assess the influence of ID definition on the intravenous iron effect in HF.<\/jats:p>\n            <\/jats:sec><jats:sec>\n              <jats:title>Methods\/Results<\/jats:title>\n              <jats:p>We performed a random-effects meta-analysis of randomized controlled trials (RCT) on intravenous iron (vs. placebo or standard of care) in patients with HF and ID that provided data on transferrin saturation (TSAT) and ferritin subgroups on the composite outcome of cardiovascular death (CVD) or HF hospitalizations (HFH). The risk ratio (RR) and 95% confidence intervals (95% CI) were extracted on the TSAT (&lt;\u200920% and\u2009\u2265\u200920%) and ferritin (&lt;\u2009100\u00a0ng\/mL and\u2009\u2265\u2009100\u00a0ng\/mL) subgroups. Data from four major RCT was collected including a total of more than 5500 patients. In patients with a TSAT\u2009&lt;\u200920%, intravenous iron reduced the composite outcome of CVD or HFH: RR 0.81, 95%CI 0.69\u20130.94, while in patients with a TSAT\u2009\u2265\u200920% the effect was neutral: RR 0.98, 95%CI 0.79\u20131.21, interaction, <jats:italic>P<\/jats:italic>\u2009=\u20090.05. On the other hand, ferritin levels did not modify the effect of IV iron: ferritin\u2009\u2265\u2009100\u00a0ng\/mL RR 0.84, 95%CI 0.65\u20131.09, and ferritin\u2009&lt;\u2009100\u00a0ng\/mL RR 0.85, 95%CI 0.74\u20130.97; interaction, <jats:italic>P<\/jats:italic>\u2009=\u20090.96.<\/jats:p>\n            <\/jats:sec><jats:sec>\n              <jats:title>Conclusions<\/jats:title>\n              <jats:p>Our meta-analysis suggests that the benefit of intravenous iron may be restricted to patients with TSAT\u2009&lt;\u200920% regardless of ferritin levels and supports the single use of TSAT\u2009&lt;\u200920% to identify patients with ID who may benefit from intravenous iron therapy.<\/jats:p>\n            <\/jats:sec><jats:sec>\n              <jats:title>Graphical abstract<\/jats:title>\n              <jats:p>In this meta-analysis of\u2009&gt;\u20095500 patients, intravenous iron reduced the composite outcome of CVD or HFH in those with a transferrin saturation (TSAT)\u2009&lt;\u200920%, while for TSAT\u2009\u2265\u200920%, treatment effect was neutral. Ferritin, however, had no impact on intravenous iron response. This analysis suggests that the benefit from intravenous iron may be limited to patients with TSAT\u2009&lt;\u200920%, irrespective of ferritin levels. Utilizing a TSAT\u2009&lt;\u200920% to identify patients with ID who may benefit from intravenous iron therapy should be considered.<\/jats:p>\n              \n            <\/jats:sec>","DOI":"10.1007\/s00392-024-02557-5","type":"journal-article","created":{"date-parts":[[2024,10,21]],"date-time":"2024-10-21T10:02:38Z","timestamp":1729504958000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Influence of iron deficiency definition on the efficacy of intravenous iron in heart failure: a meta-analysis of randomized trials"],"prefix":"10.1007","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1120-5461","authenticated-orcid":false,"given":"Pedro","family":"Marques","sequence":"first","affiliation":[]},{"given":"Francisco","family":"Vasques-N\u00f3voa","sequence":"additional","affiliation":[]},{"given":"Paula","family":"Matias","sequence":"additional","affiliation":[]},{"given":"Joana T.","family":"Vieira","sequence":"additional","affiliation":[]},{"given":"Thomas A.","family":"Mavrakanas","sequence":"additional","affiliation":[]},{"given":"Abhinav","family":"Sharma","sequence":"additional","affiliation":[]},{"given":"Fernando","family":"Fri\u00f5es","sequence":"additional","affiliation":[]},{"given":"Jo\u00e3o Pedro","family":"Ferreira","sequence":"additional","affiliation":[]}],"member":"297","published-online":{"date-parts":[[2024,10,21]]},"reference":[{"issue":"1","key":"2557_CR1","doi-asserted-by":"publisher","first-page":"80","DOI":"10.1161\/CIRCULATIONAHA.118.030099","volume":"138","author":"IS Anand","year":"2018","unstructured":"Anand IS, Gupta P (2018) Anemia and iron deficiency in heart failure: current concepts and emerging therapies. 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AS has received support from the Fonds de Recherche Sant\u00e9 Quebec (FRSQ) Junior 1 clinician scholars\u2019 program, Canadian Institute of Health Research (Grant #175095), Roche Diagnostics, Boehringer-Ingelheim, Novartis, Janssen, Novo-Nordisk, Servier, AstraZeneca, and Takeda. TAM received speaker honoraria from Daiichi Sankyo, BMS Canada, Janssen, Astra Zeneca, and Pfizer and has served on advisory boards for B\u00f6hringer Ingelheim, Bayer, GSK, and Servier outside the submitted work. He has also received an unrestricted research grant from Astra Zeneca and operational grants from the Kidney Foundation of Canada, the Heart & Stroke foundation of Canada and the Canadian Institute of Health Research. He is receiving salary support from the Fonds de Recherche Quebec Sant\u00e9 (Junior 1 Clinician Scholar Award # 298742) and is supported by a KRESCENT New Investigator Award. JPF has received research support from Boehringer-Ingelheim, AstraZeneca and Novartis, through his institution, the University of Porto. The reminder authors report not having relevant conflicts of interest regarding the content of this manuscript.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}}]}}