{
  "abstract": "Introduction: Iron deficiency affects up to 50% of patients with chronic heart failure (HF) and is associated with worse outcomes, including reduced exercise capacity, poorer quality of life, and increased risk of hospitalization and mortality. As a prevalent comorbidity, several trials have investigated the effects of intravenous (IV) iron therapy in this population, showing positive results. However, its impact on mortality remains uncertain and it is unclear whether the observed benefits are driven by hemoglobin increases or by iron itself. These factors highlight the need for a comprehensive synthesis of the available evidence. Objectives: The aim of this study was to evaluate the effect of IV iron therapy on clinical outcomes in patients with heart failure and iron deficiency. Methods: This systematic review followed PRISMA guidelines and was registered in PROSPERO (CRD420261361606). PubMed, Cochrane and Embase databases were systematically searched using MeSH and DeCS terms, with no time restrictions up to March 2026. Randomized, non-randomized, and cohort studies including adults with heart failure and iron deficiency treated with intravenous iron were included. Comparators included placebo, standard therapy, or oral iron. Selection was performed by two reviewers with a third resolving disagreements. Results and Conclusion: A total of 10 studies were included after screening, comprising over 2,500 participants. Most studies were randomized controlled trials, evaluating patients with HF and iron deficiency, mainly with reduced ejection fraction. IV iron therapy was associated with improvements in functional capacity and quality of life in trials such as FAIR-HF and FERRIC-HF. A reduction in heart failure-related hospitalizations was also observed, notably in larger trials such as AFFIRM-AHF and IRONMAN. Regarding mortality, results were heterogeneous. While studies such as AFFIRM-AHF and IRONMAN suggested a trend toward reduction in cardiovascular outcomes, no consistent statistically significant reduction in all-cause mortality was observed across all included studies. Overall, IV iron therapy in patients with HF and iron deficiency is associated with improvements in functional status and a reduction in hospitalizations, particularly as demonstrated in trials such as AFFIRM-AHF and FAIR-HF, with a favorable safety profile. However, its impact on mortality remains uncertain. Further large-scale trials are needed to clarify long-term outcomes.",
  "abstract_shown": true,
  "affiliations": [
    "Universidade de Fortaleza (UNIFOR), Fortaleza, CE, Brazil"
  ],
  "article_type": null,
  "arxiv": null,
  "author_total": 11,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Beatriz BARSI CUNHA"
    },
    {
      "affs": [
        0
      ],
      "name": "Lara DAMASCENO DUARTE"
    },
    {
      "affs": [
        0
      ],
      "name": "Maria Eduarda SANTOS DE OLIVEIRA"
    },
    {
      "affs": [
        0
      ],
      "name": "Clarissa FREIRE COUTINHO"
    },
    {
      "affs": [
        0
      ],
      "name": "Arthur BARROS MIRANDA CILIÃO LUCENA"
    },
    {
      "affs": [
        0
      ],
      "name": "Thaís FACÓ DE CASTRO"
    },
    {
      "affs": [
        0
      ],
      "name": "Fernanda DE CARVALHO SALES CAVALCANTE"
    },
    {
      "affs": [
        0
      ],
      "name": "Beatriz BARSI CUNHA"
    },
    {
      "affs": [
        0
      ],
      "name": "Letícia MATOS LEANDRO"
    },
    {
      "affs": [
        0
      ],
      "name": "Maria Beatriz MAGALHÃES PINTO"
    },
    {
      "affs": [
        0
      ],
      "name": "Victoria Stephane TESSARO"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/3aefdbq9rwve6.bib",
  "cited_by": 0,
  "doi": "10.1016/j.htct.2026.108488",
  "fulltext_url": "http://www.sciencedirect.com/science/article/pii/S2531137926022352",
  "id": "3aefdbq9rwve6",
  "issns": [
    "2531-1379",
    "2531-1387"
  ],
  "landing_url": "https://doi.org/10.1016/j.htct.2026.108488",
  "language": "en",
  "licence": "CC-BY",
  "licence_label": "CC BY",
  "licence_source": "journal",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "lcc",
      "RC633-647.5"
    ],
    [
      "openalex",
      "2720|Erythropoietin and Anemia Treatment"
    ]
  ],
  "openalex": "W7223563973",
  "pdf_url": null,
  "pmcid": null,
  "pmid": null,
  "published": "2026-10-23",
  "publisher": "Elsevier",
  "ris": "https://research.draconitic.com/paper/3aefdbq9rwve6.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T13:43:26Z",
      "native_id": "6faa8e63b3d84e408067bcebcece3fc2",
      "source": "doaj",
      "url": "https://doi.org/10.1016/j.htct.2026.108488"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "lcc:RC633-647.5",
      "subfield": "endocrinology-metabolism"
    }
  ],
  "title": "IMPACT OF INTRAVENOUS IRON THERAPY IN PATIENTS WITH HEART FAILURE AND IRON DEFICIENCY: A SYSTEMATIC REVIEW",
  "title_text": "IMPACT OF INTRAVENOUS IRON THERAPY IN PATIENTS WITH HEART FAILURE AND IRON DEFICIENCY: A SYSTEMATIC REVIEW",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T13:43:26Z",
  "url": "https://research.draconitic.com/paper/3aefdbq9rwve6",
  "venue": "Hematology, Transfusion and Cell Therapy",
  "versions": []
}