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The effect of intravenous iron-carbohydrate complexes on quality of life in patients with acute vs chronic heart failure – a systematic review and meta-analysis
Session:
Sessão de Posters 39 - Insuficiência cardíaca: abordagem a longo prazo
Speaker:
Mauro Moreira
Congress:
CPC 2024
Topic:
D. Heart Failure
Theme:
10. Chronic Heart Failure
Subtheme:
10.6 Chronic Heart Failure - Clinical
Session Type:
Cartazes
FP Number:
---
Authors:
Mauro Moreira; Rafaela G. Lopes; Inês Gomes Campos; Aurora Andrade; Bruno Bragança
Abstract
<p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><u>Introduction:</u> Intravenous iron supplementation in iron deficient patients with symptomatic heart failure (HF) with reduced or mildly reduced left ventricular ejection fraction demonstrated to improve quality of life (QoL). However, a comparison of this supplementation between acute and chronic HF is lacking.</span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><u>Aim:</u> To review and summarize the effect of intravenous iron-carbohydrate complexes on QoL in patients with acute vs chronic HF.</span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><u>Methods:</u> We performed a systematic review on MEDLINE and SCOPUS for articles that assessed the effect of intravenous iron-carbohydrate complexes on QoL in patients with HF published until October of 2023. Two investigators screened the literature, extracted data, and assessed the risk of bias. Treatment effects were measured by Cohen's d effect-size (EZ) with 95% confidence interval (CI), using fixed-effects inverse variance model. Improvement of QoL was the prespecified endpoint. </span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><u>Results:</u> From 1369 publications screened, 9 randomized controlled trials (RCT) that fulfilled our criteria were included, comprising a total of 3193 patients. Ferric carboxymaltose (FCM) was studied in 5 RCT, while other 4 RCT analysed iron sucrose, iron isomaltoside or ferric derisomaltose. Meta-analysis demonstrated that intravenous iron-carbohydrate complexes improve QoL in patients with HF (EZ= 0.12, CI 0.04-0.19; I<sup>2</sup>=58.51%). Subgroup analysis showed benefit on QoL in chronic HF patients (EZ 0.11, CI 0.03-0.18; I<sup>2</sup>=54.03%), whereas the effect in acute HF was neutral (EZ=0.21, 95% CI -0.04-0.46; I<sup>2</sup>=82.36%). There was no evidence of publication bias on Funnel plot analysis.</span></span></p> <p><u><span style="font-size:11.0pt"><span style="font-family:"Calibri",sans-serif">Conclusions:</span></span></u><span style="font-size:11.0pt"><span style="font-family:"Calibri",sans-serif"> Despite heterogeneity among these studies, this meta-analysis demonstrates that intravenous iron-carbohydrate complexes improve QoL in patients with HF. Subgroups analysis showed that this benefit on QoL might be limited to chronic HF patients.</span></span></p>
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