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Heart failure in patients treated with bisphosphonates
E L Grove1, B Abrahamsen, P Vestergaard
1Department of Cardiology, Aarhus University Hospital, Aarhus, Denmark.
Journal of Internal Medicine
|May 18, 2013
Summary
Bisphosphonate use increases heart failure risk, but alendronate may offer protection. This study analyzed Danish patient data to assess bisphosphonate and raloxifene effects on heart failure incidence.
Area of Science:
- Pharmacovigilance
- Cardiovascular Epidemiology
- Bone Metabolism Therapeutics
Background:
- Bisphosphonates are widely prescribed for osteoporosis and other bone diseases.
- Concerns exist regarding potential cardiovascular side effects of bisphosphonate therapy.
Purpose of the Study:
- To investigate the association between bisphosphonate use and the risk of developing heart failure.
- To compare the heart failure risk between bisphosphonate users and a matched control group.
Main Methods:
- Nationwide retrospective cohort study in Denmark (1996-2006).
- Inclusion of 102,342 bisphosphonate/raloxifene users and 307,026 matched controls.
- Heart failure risk assessed using Cox proportional hazard analyses.
Main Results:
- An increased risk of heart failure was observed in bisphosphonate users (adjusted HR 1.41).
- Raloxifene use was not associated with an increased heart failure risk (adjusted HR 1.07).
- Alendronate use showed a dose-dependent reduction in heart failure risk, while etidronate showed an increased risk with higher compliance.
Conclusions:
- Bisphosphonate therapy is associated with an elevated risk of heart failure.
- Alendronate may potentially reduce heart failure risk, contrasting with other bisphosphonates like etidronate.
- Individual bisphosphonate profiles warrant further investigation regarding cardiovascular safety.
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