Author + information
Clinical studies have suggested an association between bisphosphonate use and the onset of atrial fibrillation. However, data on the risk of developing atrial fibrillation, stroke and cardiovascular mortality with use of bisphosphonate is conflicting.
To evaluate the risk of serious atrial fibrillation (AF events that required hospital admission), stroke and cardiovascular mortality with use of bisphosphonates through a systematic review of the literature.
We searched the Pub Med, CENTRAL and EMBASE databases for observational studies and randomized controlled trials (RCT) on the use of bisphosphonates from 1966 to April 2012 that reported the number of patients who developed serious atrial fibrillation, stroke and cardiovascular mortality at follow up. The random effects Mantel-Haenszel test was used to evaluate relative risk adverse cardiovascular outcomes with use of bisphosphonates.
Six observational studies (N=149,856) and six RCTs (N=41, 375) were included for analysis. On pooling observational studies, there was an increased risk of atrial fibrillation (OR 1.27 95% CI 1.16-1.39) among bisphosphonate users. Further, analysis of RCTs revealed statistically significant increase in risk of serious atrial fibrillation (OR 1.40 95%CI 1.02-1.93) and no increase in risk of stroke (OR 1.07 95%CI 0.85-1.34) and cardiovascular mortality (OR 0.92 95%CI 0.68-1.26) with use of bisphosphonates.
Evidence from RCTs and observational studies suggests significantly increased risk of serious atrial fibrillation, but no increase in risk of stroke or cardiovascular mortality with use of bisphosphonates. Additional prospective studies are required to further investigate and assess this association.
Poster Sessions, Expo North
Sunday, March 10, 2013, 3:45 p.m.-4:30 p.m.
Session Title: Arrhythmia Outcomes and Quality Assessment
Abstract Category: 28. Quality of Care and Outcomes Assessment
Presentation Number: 1245-111
- 2013 American College of Cardiology Foundation