Author + information
- Brian Griffin, MD⁎ ( and )
- Olcay Aksoy, MD
- ↵⁎Department of Cardiovascular Medicine, J1-5 Cleveland Clinic, Cleveland Clinic Foundation, 9500 Euclid Avenue, Cleveland, Ohio 44195
We thank the correspondents for their interesting comment on our recent paper (1). We would like to point out, however, that none of the authors of the present paper have been associated with the papers that they referenced. The calcification paradox whereby vascular calcification is more prevalent in those with reduced bone density or increased bone turnover has been well described. Increased valvular calcification has also been described in patients with osteoporosis, but specific data on whether osteoporosis accelerates aortic stenosis progression has not to our knowledge been reported. Additionally, we have no way of knowing whether the elderly women in our study who did not receive bisphosphonates had some degree of osteoporosis. The fact that many were receiving vitamin D and calcium supplementation suggests that a proportion at least were considered at risk for osteoporosis. The correspondents' contention that bisphosphonates in our study may have normalized an acceleration of aortic stenosis associated with osteoporosis is therefore interesting but still hypothetical. We agree with the correspondents and stated in our conclusions to the paper that prospective clinical trials of specific bisphosphonates will be needed to fully answer the question of the impact of this class of drugs on aortic stenosis progression.
- American College of Cardiology Foundation