铁剂治疗射血分数保留的心力衰竭伴缺铁患者的荟萃分析方案。
Iron therapy in iron-deficiency patients with heart failure with preserved ejection fraction: A protocol for meta-analysis.
机构信息
Core Laboratory, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan.
Department of Medical Innovation, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan.
出版信息
Medicine (Baltimore). 2021 Aug 13;100(32):e26919. doi: 10.1097/MD.0000000000026919.
BACKGROUND
Nearly half of patients with heart failure (HF) have preserved ejection fraction (EF) and the mortality and morbidity of patients with HF with preserved EF (HFpEF) are high. However, there is no established therapy to improve survival in these patients. HFpEF patients are often elderly and their primary chronic symptom is severe exercise intolerance. Thus, improvement of exercise capacity presents another important clinical outcome in HFpEF patients. Iron deficiency is common in HF patients, and the presence of iron deficiency, regardless of concomitant anemia, is associated with worse symptoms, impaired exercise capacity, and higher mortality and hospitalization in these patients. Several meta-analyses of randomized controlled trials reported that iron administration improved HF symptoms, exercise capacity, and clinical outcomes in iron-deficiency patients with HF with reduced EF. However, there is insufficient evidence as to the effect of iron administration in iron-deficiency HFpEF patients.
METHODS AND RESULTS
This meta-analysis will include randomized controlled trials on the effects of iron administration on HF symptoms, exercise capacity, and health-related quality of life in iron-deficiency HFpEF patients. Information of studies will be collected from PubMed, Web of Science, Cochrane Library, and ClinicalTrials.gov. The primary outcome will be exercise capacity (6-minute walking distance). The secondary outcomes will be HF symptoms, health-related quality of life, and mortality and hospitalization rates.
CONCLUSION
This meta-analysis will evaluate the effect of iron therapy in iron-deficiency HFpEF patients, providing evidence as to the iron administration in these patients.
SYSTEMATIC REVIEW REGISTRATION
PROSPERO CRD42020205297.
背景
近半数心力衰竭（HF）患者射血分数保留（EF），HF 伴射血分数保留（HFpEF）患者的死亡率和发病率较高。然而，目前尚无改善此类患者生存的既定疗法。HFpEF 患者通常为老年人，其主要慢性症状为严重运动不耐受。因此，改善运动能力是 HFpEF 患者的另一个重要临床转归。铁缺乏在 HF 患者中很常见，无论是否同时伴有贫血，铁缺乏的存在与这些患者的症状恶化、运动能力受损以及死亡率和住院率升高相关。几项随机对照试验的荟萃分析报告称，铁剂治疗可改善铁缺乏的射血分数降低型心力衰竭患者的 HF 症状、运动能力和临床结局。然而，关于铁剂治疗铁缺乏的 HFpEF 患者的疗效，目前证据不足。
方法和结果
本次荟萃分析将纳入关于铁剂治疗对铁缺乏的 HFpEF 患者 HF 症状、运动能力和健康相关生活质量影响的随机对照试验。将从 PubMed、Web of Science、Cochrane Library 和 ClinicalTrials.gov 收集研究信息。主要结局为运动能力（6 分钟步行距离）。次要结局为 HF 症状、健康相关生活质量以及死亡率和住院率。
结论
本次荟萃分析将评估铁治疗对铁缺乏的 HFpEF 患者的疗效，为这些患者的铁剂治疗提供证据。
系统评价注册
PROSPERO CRD42020205297。
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