医学
缺铁
静脉注射铁
心力衰竭
临床试验
随机对照试验
内科学
重症监护医学
贫血
作者
Baljash Cheema,Anuj K. Chokshi,Olusola A. Orimoloye,Hossein Ardehali
标识
DOI:10.1016/j.jacc.2024.03.431
摘要
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.
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