Iron deficiency has been observed in a large proportion of patients with chronic heart failure. Most importantly, the presence of iron deficiency has been shown to impair exercise capacity, to increase symptoms and to decrease quality of life.

In this systematic review with meta-analysis, the authors assessed the relationship between intravenous iron therapy and outcome in patients with heart failure and iron deficiency. Among the five trials included in this meta-analysis, intravenous iron therapy reduced the risk of the combined endpoint of all-cause death or cardiovascular hospitalisation and the combined endpoint of cardiovascular death or hospitalisation for worsening heart failure. Iron therapy also improved functional capacity and quality of life.

In conclusion, patients with systolic heart failure and iron deficiency (with or without anemia) may benefit from intravenous iron supplementation.

– David Faraoni