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Osteoporosis treatment and atrial fibrillation: alendronate versus raloxifene.
Menopause. 2010 Jan-Feb; 17(1):57-63.M

Abstract

OBJECTIVES

Concerns have been raised about bisphosphonate use and risk of atrial fibrillation (AF) in women with osteoporosis. This study compares the risk of AF and of flutter or acute myocardial infarction (AMI) in women with osteoporosis taking alendronate or raloxifene.

METHODS

Using Taiwan's National Health Insurance database to conduct a population-based retrospective cohort study, we reviewed the medical and prescription histories of 27,257 women with osteoporosis (21,037 receiving alendronate and 6,220 receiving raloxifene) between 2001 and 2007. Mean (SD) follow-up was 303.62 (422.87) days. For the main outcome measures, we calculated the adjusted relative risk of AF and AMI using the Cox proportional hazards model, adjusting for various confounders.

RESULTS

Incidence rates (per patient-year) of AF in the alendronate group (1.00%) and the raloxifene group (1.02%) were similar. Alendronate use was not associated with risk of AF (hazard ratio [HR], 1.06; 95% CI, 0.85-1.32) and AMI (HR, 1.02; 95% CI, 0.86-1.19) compared with raloxifene use. However, alendronate users who had previous cardiovascular events and had taken their medications for more than 1 year were at significantly greater risk of AMI than were the group taking raloxifene (HR, 2.24; 95% CI, 1.07-4.71). Users who received 70 mg of alendronate once a week were at significantly lower risk of AF than were those taking 10 mg daily (HR, 0.56; 95% CI, 0.47-0.68).

CONCLUSIONS

Compared with raloxifene, alendronate did not increase the risk of AF and flutter in women with osteoporosis. Medical history contributed most to the development of AF or AMI in the women who received either raloxifene or alendronate. Long-term treatment with alendronate is not suggested for women with a history of cardiovascular events because they are at increased risk of AMI.

Authors+Show Affiliations

Institute of Health and Social Welfare Policy, National Yang-Ming University, Taipei, Taiwan.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

19680161

Citation

Huang, Weng-Foung, et al. "Osteoporosis Treatment and Atrial Fibrillation: Alendronate Versus Raloxifene." Menopause (New York, N.Y.), vol. 17, no. 1, 2010, pp. 57-63.
Huang WF, Tsai YW, Wen YW, et al. Osteoporosis treatment and atrial fibrillation: alendronate versus raloxifene. Menopause. 2010;17(1):57-63.
Huang, W. F., Tsai, Y. W., Wen, Y. W., Hsiao, F. Y., Kuo, K. N., & Tsai, C. R. (2010). Osteoporosis treatment and atrial fibrillation: alendronate versus raloxifene. Menopause (New York, N.Y.), 17(1), 57-63. https://doi.org/10.1097/gme.0b013e3181b34749
Huang WF, et al. Osteoporosis Treatment and Atrial Fibrillation: Alendronate Versus Raloxifene. Menopause. 2010 Jan-Feb;17(1):57-63. PubMed PMID: 19680161.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Osteoporosis treatment and atrial fibrillation: alendronate versus raloxifene. AU - Huang,Weng-Foung, AU - Tsai,Yi-Wen, AU - Wen,Yu-Wen, AU - Hsiao,Fei-Yuan, AU - Kuo,Ken N, AU - Tsai,Chia-Rung, PY - 2009/8/15/entrez PY - 2009/8/15/pubmed PY - 2010/5/18/medline SP - 57 EP - 63 JF - Menopause (New York, N.Y.) JO - Menopause VL - 17 IS - 1 N2 - OBJECTIVES: Concerns have been raised about bisphosphonate use and risk of atrial fibrillation (AF) in women with osteoporosis. This study compares the risk of AF and of flutter or acute myocardial infarction (AMI) in women with osteoporosis taking alendronate or raloxifene. METHODS: Using Taiwan's National Health Insurance database to conduct a population-based retrospective cohort study, we reviewed the medical and prescription histories of 27,257 women with osteoporosis (21,037 receiving alendronate and 6,220 receiving raloxifene) between 2001 and 2007. Mean (SD) follow-up was 303.62 (422.87) days. For the main outcome measures, we calculated the adjusted relative risk of AF and AMI using the Cox proportional hazards model, adjusting for various confounders. RESULTS: Incidence rates (per patient-year) of AF in the alendronate group (1.00%) and the raloxifene group (1.02%) were similar. Alendronate use was not associated with risk of AF (hazard ratio [HR], 1.06; 95% CI, 0.85-1.32) and AMI (HR, 1.02; 95% CI, 0.86-1.19) compared with raloxifene use. However, alendronate users who had previous cardiovascular events and had taken their medications for more than 1 year were at significantly greater risk of AMI than were the group taking raloxifene (HR, 2.24; 95% CI, 1.07-4.71). Users who received 70 mg of alendronate once a week were at significantly lower risk of AF than were those taking 10 mg daily (HR, 0.56; 95% CI, 0.47-0.68). CONCLUSIONS: Compared with raloxifene, alendronate did not increase the risk of AF and flutter in women with osteoporosis. Medical history contributed most to the development of AF or AMI in the women who received either raloxifene or alendronate. Long-term treatment with alendronate is not suggested for women with a history of cardiovascular events because they are at increased risk of AMI. SN - 1530-0374 UR - https://www.unboundmedicine.com/medline/citation/19680161/Osteoporosis_treatment_and_atrial_fibrillation:_alendronate_versus_raloxifene_ L2 - https://doi.org/10.1097/gme.0b013e3181b34749 DB - PRIME DP - Unbound Medicine ER -