Intravenous Iron Repletion for Patients With Heart Failure and Iron Deficiency: JACC State-of-the-Art Review,Journal of the American College of Cardiology

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Intravenous Iron Repletion for Patients With Heart Failure and Iron Deficiency: JACC State-of-the-Art Review
Journal of the American College of Cardiology ( IF 21.7 ) Pub Date : 2024-06-17 , DOI: 10.1016/j.jacc.2024.03.431
Baljash Cheema ₁ , Anuj Chokshi ₂ , Olusola Orimoloye ₂ , Hossein Ardehali ₃

Affiliation

Iron deficiency and heart failure frequently co-occur, sparking clinical research into the role of iron repletion in this condition over the last 20 years. Although early nonrandomized studies and subsequent moderate-sized randomized controlled trials showed an improvement in symptoms and functional metrics with the use of intravenous iron, 3 recent larger trials powered to detect a difference in hard cardiovascular outcomes failed to meet their primary endpoints. Additionally, there are potential concerns related to side effects from intravenous iron, both in the short and long term. This review discusses the basics of iron biology and regulation, the diagnostic criteria for iron deficiency and the clinical evidence for intravenous iron in heart failure, safety concerns, and alternative therapies. We also make practical suggestions for the management of patients with iron deficiency and heart failure and outline key areas in need of future research.

中文翻译：

心力衰竭和缺铁患者的静脉补铁：JACC 最先进的综述

缺铁和心力衰竭经常同时发生，这引发了过去 20 年对补充铁在这种情况下的作用的临床研究。尽管早期的非随机研究和随后的中等规模的随机对照试验表明，使用静脉补铁可改善症状和功能指标，但最近 3 项旨在检测硬心血管结局差异的大型试验未能达到其主要终点。此外，静脉注射铁剂的短期和长期副作用也存在潜在的担忧。这篇综述讨论了铁生物学和调节的基础知识、缺铁的诊断标准以及静脉注射铁剂治疗心力衰竭的临床证据、安全问题和替代疗法。我们还为缺铁和心力衰竭患者的治疗提出了实用建议，并概述了未来需要研究的关键领域。

更新日期：2024-06-17

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