The potential impact of bisphosphonates on major adverse cardiovascular events: a study of 1,097,406 patients
Abstract
Up to 19.7% of adults worldwide suffer from osteoporosis, and the risk of acquiring the disease increases with age.1 A common therapy for osteoporosis is the bisphosphonate class of drugs. These drugs act in part by inhibiting osteoclasts, cells that resorb bone and experience increased activity relative to bone-forming osteoblasts with aging.2 As adults age, the risk of developing atherosclerosis increases, putting patients at an increased risk of major adverse cardiovascular events (MACE).3 Atherosclerotic plaques become calcified as they mature, which is the basis of CT coronary artery calcium score, a tool used to aid cardiovascular risk assessment and help guide clinical treatment in patients with coronary artery disease. One possible mechanism which could contribute to the calcification of atherosclerotic plaques involves the presence of arterial osteoblast and osteoclast-like cells, a phenomenon which has been described in a growing body of research4–7 The goal of this study was to use the TriNetX medical database to evaluate the effect of bisphosphonate use on the development of major adverse cardiovascular events in patients with osteoporosis.
The TriNetX research network was used for this study, with cohorts created via International Classification of Disease 10 (ICD-10) codes and medication codes in the TriNetX system. Both cohorts consisted of adult patients with a diagnosis of osteoporosis (M81). One cohort of patients was receiving treatment with alendronate,…
How strong is the evidence?
Evidence Hub reads this as a cohort study, done in people. Its evidence level is 3 of 5 (Moderate · trial / cohort / secondary analysis). Trials without a large randomized design, cohorts and secondary analyses give moderate evidence. Reported size: 548,703 participants or records.
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