{"id":"469d7afe6552","type":"article","url":"https://hartvaat.nl/2025/02/01/iv-ijzer-bij-hartfalen-en-ijzerdeficientie-geactualiseerde-meta-analyse-van-rct-/","title":"IV-ijzer bij hartfalen en ijzerdeficiëntie: geactualiseerde meta-analyse van RCT's","title_en":"Intravenous iron therapy for heart failure and iron deficiency: An updated meta-analysis of randomized clinical trials.","category":"hartfalen","category_label":"Hartfalen","professions":["apotheker","cardioloog","internist"],"tags":["ijzersuppletie","ivabradine"],"journal":"ESC heart failure","doi":"10.1002/ehf2.14905","source_url":"https://doi.org/10.1002/ehf2.14905","authors":["Mushood Ahmed","Aimen Shafiq","Hira Javaid","Priyansha Singh","Haania Shahbaz","Muhammad Talha Maniya","Hritvik Jain","Najwa Shakir","Huzaifa Ahmad Cheema","Adeel Ahmad","Wajeeh Ur Rehman","Gabriel Yeap","Abdulqadir J Nashwan","Abdul Mannan Khan Minhas","Raheel Ahmed","Marat Fudim","Gregg C Fonarow"],"significance":8,"published":"2025-02-01","source_date":"2025-02-01","image":"","kennis":["https://hartvaat.nl/kennis/farmacologie/betablokkers-cardiale-indicaties/"],"congress":"","summary_en":"This updated meta-analysis of all randomized trials confirmed that intravenous iron in heart failure with iron deficiency significantly reduces heart failure hospitalization without increasing adverse events. The comprehensive evidence supports IV iron as a standard of care in iron-deficient heart failure.","created":"2026-07-03T10:31:27Z","updated":"2026-07-03T13:30:28Z","licence":"Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.","body_markdown":"Geactualiseerde meta-analyse van alle RCT's bevestigde dat IV-ijzer bij hartfalen met ijzerdeficiëntie hartfalenhospitalisaties vermindert. Het bewijs is nu robuust en definitief.","abstract_original":"Heart failure (HF) patients frequently exhibit iron deficiency, which is associated with a poor prognosis. Although various trials have been conducted, it is uncertain if intravenous (IV) iron replenishment improves clinical outcomes in HF patients with iron deficiency. A comprehensive literature search was conducted using PubMed/MEDLINE, Embase, and the Cochrane Library from inception till 15 September 2023 to retrieve randomized controlled trials (RCTs) that compared IV iron therapy with placebo or standard of care in patients with HF and iron deficiency. Clinical outcomes were assessed by generating forest plots using the random-effects model and pooling odds ratios (ORs) or weighted mean differences (WMDs). Fourteen RCTs with 6651 patients were included. IV iron therapy showed a significantly reduced incidence of the composite of first heart failure hospitalization (HHF) or cardiovascular (CV) mortality as compared with the control group (OR = 0.73, 95% CI: 0.58 to 0.92). The IV iron therapy resulted in a trend towards lower CV mortality (OR = 0.88, 95% CI: 0.76 to 1.01), 1-year all-cause mortality (OR = 0.85, 95% CI: 0.71 to 1.02), and first HHF (OR = 0.73, 95% CI: 0.51 to 1.05), and an improved left ventricular ejection fraction (LVEF) (MD = 4.54, 95% CI: -0.13 to 9.21). Meta-regression showed a significant inverse moderating effect of baseline LVEF on the first HHF or CV death. In patients with HF and iron deficiency, IV iron therapy reduced the incidence of composite of first HHF or CV mortality. There was a trend of lower overall CV and 1-year all-cause mortality, first HHF, and improved LVEF with IV iron therapy."}