Abstract Body (Do not enter title and authors here): Introduction:
Ferric carboxymaltose (FCM) treatment has been shown to alleviate symptoms and enhance the quality of life in individuals with heart failure characterized by reduced ejection fraction and iron deficiency. Despite prior evidence highlighting its benefits, its impact on clinical parameters remains insufficiently investigated. Our study sought to evaluate the impact of ferric carboxymaltose (FCM) treatment on hospital admissions and mortality rates.

Methods and Materials:
In this prospective, multicenter study, consecutive heart failure patients meeting criteria of a left ventricular ejection fraction of 40% or lower and iron deficiency were enrolled. Participants were allocated into two cohorts, one receiving intravenous ferric carboxymaltose alongside standard heart failure therapy, while the other received a placebo. Ferric carboxymaltose or placebo was administered every 6 months as required, guided by iron indices and hemoglobin levels. The primary endpoint consisted of a hierarchical composite, including death within 12 months post-randomization and heart failure-related hospitalizations within the same timeframe. Significance was determined at a p-value of 0.05.

Results:
Out of the 1500 patients enrolled, 830 were allocated to the ferric carboxymaltose group and 670 to the placebo group. By the end of the 12-month period, 78 patients (9.4%) in the ferric carboxymaltose group and 73 (10.8%) in the placebo group had experienced mortality (P = 0.82). Additionally, there were 102 and 193 hospitalizations for heart failure in the ferric carboxymaltose and placebo groups, respectively, by the end of the 12 months (P = <0.001). The repeated administration of ferric carboxymaltose demonstrated a favorable safety profile with acceptable adverse events observed in most patients.

Conclusion:
Among heart failure patients with reduced left ventricular ejection fraction and iron deficiency, intravenous ferric carboxymaltose was linked to a notable decrease in the likelihood of hospitalizations due to heart failure without any observable impact on mortality rates.