The Efficacy Intravenous Iron Supplementation in the Emergency Department on Clinical Outcomes for Patients with Acute Heart Failure and Iron Deficiency: Systematic Review and Meta-Analysis

Safaa Medani; Ali Zain Abden Mohamed Alshammari; Abdullah A. Alhajuj; Mazen Alhejaili; Mohammed Atallah Aljohani; Ammar J. Almutairi; Mohammed Aljohani; Anmar O. Bawazeer; Husam O. Alreheli; Ahmed A. Alnakhli

doi:10.24911/IJMDC.51-1763543792

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Online Published: 02 Jan 2026

IJMDC. 2025; 9(12): 3274-3285

doi: 10.24911/IJMDC.51-1763543792

The efficacy intravenous iron supplementation in the Emergency Department on clinical outcomes for patients with acute heart failure and iron deficiency: systematic review and metaanalysis

Safaa Medani, Ali Zain Abden Mohamed Alshammari, Abdullah A. Alhajuj, Mazen Alhejaili, Mohammed Atallah Aljohani, Ammar J. Almutairi, Mohammed Aljohani, Anmar O. Bawazeer, Husam O. Alreheli, Ahmed A. Alnakhli.

Abstract
Acute heart failure (AHF) represents one of the top causes of admission to emergency departments, and iron deficiency is one of the comorbidities that tend to result in poor clinical outcomes. Iintravenous (IV) iron supplementation is one of the therapies that has been proposed as an intervention to enhance functional recovery and decrease hospitalizations. A detailed search was carried out in accordance with PRISMA 2020 principles. The inclusion criteria were randomized and non-randomized trials that tested IV iron therapy in patients with presentations of AHF and iron deficiency. Random effects models were used to pool data, and the Cochrane Risk of Bias and Methodological Index of Non-Randomized Studies tools were used to evaluate the quality of studies. There were 10 studies that met the inclusion criteria. The overall analysis revealed that IV iron treatment was found to be significant in reducing heart failure (HF) hospitalization by 2% (OR = 0.72, 95% CI 0.56-0.93, p-value = 0.01) and the reduced hospital stay [standardized mean difference (SMD) = -0.81, 95% CI -1.08--0.54, p < 0.00001]. Yet, cardiovascular mortality (OR = 0.86, p-value = 0.31), readmissions/ED revisits (OR = 0.85, p-value = 0.20), and health-related quality of life (SMD = 0.37, p-value = 0.26) did not exhibit any significant effects. Iron-deficient AHF patients receiving intravenous iron therapy, especially ferric carboxylmaltose, show a significant reduction in the length of stay and HF admissions in the hospitals, suggesting that the patients recover better. Nonetheless, its impact on mortality, readmission, and the quality of life is unclear owing to the variability of the study.

Key words: Acute heart failure, iron deficiency, intravenous iron, ferric carboxymaltose, hospitalization, systematic review.

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Pubmed Style

Medani S, Alshammari AZAM, Alhajuj AA, Alhejaili M, Aljohani MA, Almutairi AJ, Aljohani M, Bawazeer AO, Alreheli HO, Alnakhli AA. The efficacy intravenous iron supplementation in the Emergency Department on clinical outcomes for patients with acute heart failure and iron deficiency: systematic review and metaanalysis. IJMDC. 2025; 9(12): 3274-3285. doi:10.24911/IJMDC.51-1763543792

Web Style

Medani S, Alshammari AZAM, Alhajuj AA, Alhejaili M, Aljohani MA, Almutairi AJ, Aljohani M, Bawazeer AO, Alreheli HO, Alnakhli AA. The efficacy intravenous iron supplementation in the Emergency Department on clinical outcomes for patients with acute heart failure and iron deficiency: systematic review and metaanalysis. https://www.ijmdc.com/?mno=297856 [Access: January 16, 2026]. doi:10.24911/IJMDC.51-1763543792

AMA (American Medical Association) Style

Medani S, Alshammari AZAM, Alhajuj AA, Alhejaili M, Aljohani MA, Almutairi AJ, Aljohani M, Bawazeer AO, Alreheli HO, Alnakhli AA. The efficacy intravenous iron supplementation in the Emergency Department on clinical outcomes for patients with acute heart failure and iron deficiency: systematic review and metaanalysis. IJMDC. 2025; 9(12): 3274-3285. doi:10.24911/IJMDC.51-1763543792

Vancouver/ICMJE Style

Medani S, Alshammari AZAM, Alhajuj AA, Alhejaili M, Aljohani MA, Almutairi AJ, Aljohani M, Bawazeer AO, Alreheli HO, Alnakhli AA. The efficacy intravenous iron supplementation in the Emergency Department on clinical outcomes for patients with acute heart failure and iron deficiency: systematic review and metaanalysis. IJMDC. (2025), [cited January 16, 2026]; 9(12): 3274-3285. doi:10.24911/IJMDC.51-1763543792

Harvard Style

Medani, S., Alshammari, . A. Z. A. M., Alhajuj, . A. A., Alhejaili, . M., Aljohani, . M. A., Almutairi, . A. J., Aljohani, . M., Bawazeer, . A. O., Alreheli, . H. O. & Alnakhli, . A. A. (2025) The efficacy intravenous iron supplementation in the Emergency Department on clinical outcomes for patients with acute heart failure and iron deficiency: systematic review and metaanalysis. IJMDC, 9 (12), 3274-3285. doi:10.24911/IJMDC.51-1763543792

Turabian Style

Medani, Safaa, Ali Zain Abden Mohamed Alshammari, Abdullah A. Alhajuj, Mazen Alhejaili, Mohammed Atallah Aljohani, Ammar J. Almutairi, Mohammed Aljohani, Anmar O. Bawazeer, Husam O. Alreheli, and Ahmed A. Alnakhli. 2025. The efficacy intravenous iron supplementation in the Emergency Department on clinical outcomes for patients with acute heart failure and iron deficiency: systematic review and metaanalysis. International Journal of Medicine in Developing Countries, 9 (12), 3274-3285. doi:10.24911/IJMDC.51-1763543792

Chicago Style

Medani, Safaa, Ali Zain Abden Mohamed Alshammari, Abdullah A. Alhajuj, Mazen Alhejaili, Mohammed Atallah Aljohani, Ammar J. Almutairi, Mohammed Aljohani, Anmar O. Bawazeer, Husam O. Alreheli, and Ahmed A. Alnakhli. "The efficacy intravenous iron supplementation in the Emergency Department on clinical outcomes for patients with acute heart failure and iron deficiency: systematic review and metaanalysis." International Journal of Medicine in Developing Countries 9 (2025), 3274-3285. doi:10.24911/IJMDC.51-1763543792

MLA (The Modern Language Association) Style

Medani, Safaa, Ali Zain Abden Mohamed Alshammari, Abdullah A. Alhajuj, Mazen Alhejaili, Mohammed Atallah Aljohani, Ammar J. Almutairi, Mohammed Aljohani, Anmar O. Bawazeer, Husam O. Alreheli, and Ahmed A. Alnakhli. "The efficacy intravenous iron supplementation in the Emergency Department on clinical outcomes for patients with acute heart failure and iron deficiency: systematic review and metaanalysis." International Journal of Medicine in Developing Countries 9.12 (2025), 3274-3285. Print. doi:10.24911/IJMDC.51-1763543792

APA (American Psychological Association) Style

Medani, S., Alshammari, . A. Z. A. M., Alhajuj, . A. A., Alhejaili, . M., Aljohani, . M. A., Almutairi, . A. J., Aljohani, . M., Bawazeer, . A. O., Alreheli, . H. O. & Alnakhli, . A. A. (2025) The efficacy intravenous iron supplementation in the Emergency Department on clinical outcomes for patients with acute heart failure and iron deficiency: systematic review and metaanalysis. International Journal of Medicine in Developing Countries, 9 (12), 3274-3285. doi:10.24911/IJMDC.51-1763543792

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