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Risk of acute myocardial infarction among new users of chondroitin sulfate: A nested case-control study
Ramón Mazzucchelli1, Sara Rodríguez-Martín2,3, Alberto García-Vadillo4
1Rheumatology Unit, Hospital Universitario Fundación Alcorcón, Alcorcón, Madrid, Spain.
Insights
Chondroitin sulfate (CS) use was associated with a reduced risk of acute myocardial infarction (AMI). Glucosamine showed no significant effect on AMI risk, suggesting a potential cardioprotective role for CS.
Area of Science:
- Cardiovascular Research
- Pharmacology
- Epidemiology
Background:
- Acute myocardial infarction (AMI) remains a leading cause of mortality worldwide.
- Understanding the role of dietary supplements like chondroitin sulfate (CS) and glucosamine in cardiovascular health is crucial.
- Previous research on these supplements' impact on AMI risk has yielded mixed results.
Purpose of the Study:
- To investigate the association between the use of chondroitin sulfate (CS) and glucosamine and the risk of acute myocardial infarction (AMI).
- To evaluate potential differences in risk reduction based on duration of use, sex, age, and cardiovascular risk level.
Main Methods:
- A case-control study was conducted using the BIFAP database (2002-2015).
- Incident AMI cases were identified and matched with five controls based on age, gender, and index date.
- Conditional logistic regression was employed to calculate adjusted odds ratios (AOR) and 95% confidence intervals (CI) for new users of CS or glucosamine.
Main Results:
- A total of 23,585 AMI cases and 117,405 controls were analyzed.
- Current use of CS was associated with a significantly reduced risk of AMI (AOR = 0.57; 95%CI: 0.46-0.72).
- This protective effect of CS was consistent across short-term and long-term users, both sexes, different age groups, and individuals with intermediate to high cardiovascular risk. Glucosamine use showed no significant association with AMI risk (AOR = 0.86; 95%CI: 0.66-1.08).
Conclusions:
- Chondroitin sulfate (CS) demonstrates a cardioprotective effect, significantly reducing the risk of acute myocardial infarction (AMI).
- Glucosamine appears to have a neutral effect on AMI risk.
- The cardioprotective benefits of CS were particularly notable in individuals with higher cardiovascular risk.
Objective:
To test the hypothesis that the use of chondroitin sulfate (CS) or glucosamine reduces the risk of acute myocardial infarction (AMI).
Design:
Case-control study nested in a primary cohort of patients aged 40 to 99 years, using the database BIFAP during the 2002-2015 study period. From this cohort, we identified incident cases of AMI and randomly selected five controls per case, matched by exact age, gender, and index date. Adjusted odds ratios (AOR) and 95% confidence interval (CI) were computed through a conditional logistic regression. Only new users of CS or glucosamine were considered.
Results:
A total of 23,585 incident cases of AMI and 117,405 controls were included. Of them, 89 cases (0.38%) and 757 controls (0.64%) were current users of CS at index date, yielding an AOR of 0.57 (95%CI: 0.46-0.72). The reduced risk among current users was observed in both short-term (<365 days, AOR = 0.58; 95%CI: 0.45-0.75) and long-term users (>364 days AOR = 0.56; 95%CI:0.36-0.87), in both sexes (men, AOR = 0.52; 95%CI:0.38-0.70; women, AOR = 0.65; 95%CI:0.46-0.91), in individuals over or under 70 years of age (AOR = 0.54; 95%CI:0.38-0.77, and AOR = 0.61; 95%CI:0.45-0.82, respectively) and in individuals at intermediate (AOR = 0.65; 95%CI:0.48-0.91) and high cardiovascular risk (AOR = 0.48; 95%CI:0.27-0.83), but not in those at low risk (AOR = 1.11; 95%CI:0.48-2.56). In contrast, the current use of glucosamine was not associated with either increased or decreased risk of AMI (AOR = 0.86; 95%CI:0.66-1.08).
Conclusions:
Our results support a cardioprotective effect of CS, while glucosamine seems to be neutral. The protection was remarkable among subgroups at high cardiovascular risk.
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