Monzo Luca, Cheema Baljash, Ambrosy Andrew P, Girerd Nicolas
Université de Lorraine, Centre d'Investigation Clinique Plurithématique, INSERM 1433 and INSERM U1116, Institut de Recherche et d'Innovation en Santé (I.R.I.S.), CHRU de Nancy, F-CRIN INI-CRCT (Cardiovascular and Renal Clinical Trialists), Rue du Morvan, Nancy, France.
Department of Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA.
Heart Fail Rev. 2025 May 31. doi: 10.1007/s10741-025-10532-z.
Iron is essential for the production of myocardial energy and proteins critical for metabolism. Iron deficiency is common in patients with heart failure and reduced ejection fraction (HFrEF) and is associated with a poor prognosis. However, whether intravenous iron replacement reduces the risk of adverse clinical events in HFrEF patients remains uncertain, despite several outcome trials being conducted. Furthermore, significant uncertainties persist in this setting regarding the most appropriate definition of iron deficiency and the optimal dosing regimen. Here, we critically discuss the findings of the recently published FAIR-HF2 (Ferric Carboxymaltose Assessment of Morbidity and Mortality in Patients with Iron Deficiency and Chronic Heart Failure) trial, which investigated the efficacy and safety of ferric carboxymaltose in patients with HF and iron deficiency, while positioning these results within the broader context of current evidence on intravenous iron supplementation in patients with HFrEF.
铁对于心肌能量生成以及新陈代谢关键蛋白质的合成至关重要。缺铁在射血分数降低的心力衰竭（HFrEF）患者中很常见，且与预后不良相关。然而，尽管已开展多项结局试验，但静脉补铁是否能降低HFrEF患者发生不良临床事件的风险仍不确定。此外，在这方面，关于缺铁的最合适定义和最佳给药方案仍存在重大不确定性。在此，我们批判性地讨论了最近发表的FAIR-HF2（缺铁和慢性心力衰竭患者的羧基麦芽糖铁发病率和死亡率评估）试验的结果，该试验研究了羧基麦芽糖铁在缺铁性心力衰竭患者中的疗效和安全性，同时将这些结果置于目前关于HFrEF患者静脉补铁证据的更广泛背景中。
