What is the Simplified Ironman trial?

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Last updated: March 20, 2025View editorial policy

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From the Research

The Simplified Ironman trial refers to a randomized trial of intravenous ferric derisomaltose (FDI) versus usual care in patients with symptomatic heart failure, left ventricular ejection fraction (LVEF) ≤45%, and transferrin saturation (TSAT) <20% or ferritin <100 μg/L, as investigated in the IRONMAN trial 1. The IRONMAN trial aimed to investigate whether giving IV FDI to patients with heart failure and iron deficiency alters the rate of hospitalization or death due to infections.

  • The primary analysis of interest was infection as the main reason for hospitalization or death, using first and recurrent events analyses.
  • The composite primary event of interest tended to be lower in those randomized to FDI when analysed as first or recurrent event.
  • The results suggested that correction of iron deficiency is not associated with an increased risk of hospitalization or death from infection, and may reduce such events, especially when TSAT is <20% 1. The trial provided insights into the relationship between blood tests for iron deficiency and the response to intravenous iron in patients with heart failure, as well as the effectiveness of different iron deficiency definitions and clinical responses 2. However, it is essential to note that the IRONMAN trial is a medical study and not related to the Ironman triathlon, which is an endurance race consisting of three consecutive events: a 2.4-mile swim, a 112-mile bicycle ride, and a 26.22-mile marathon run.
  • The Ironman triathlon requires careful management of nutrition, hydration, and energy expenditure to avoid exhaustion and tests both physical endurance and mental fortitude 3.
  • A meta-analysis found that the Ironman event led to a moderate state of dehydration in comparison to baseline values, highlighting the importance of hydration status after an Ironman triathlon 3. In contrast, the IRONMAN trial focused on the medical aspects of iron deficiency and its correction in patients with heart failure, rather than the athletic event.
  • The study found that dietary intervention with iron and vitamin C administered separately may be effective in improving iron status in young women to prevent iron deficiency anemia, especially in those with lower baseline vitamin C intake 4. Overall, the Simplified Ironman trial refers to a medical study investigating the effects of intravenous iron on patients with heart failure and iron deficiency, rather than the athletic event.

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