Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2013 May;28(5):984-91.
doi: 10.1002/jbmr.1792.

Bisphosphonate use is associated with reduced risk of myocardial infarction in patients with rheumatoid arthritis

Frederick Wolfe  1 , Marcy B Bolster, Christopher M O'Connor, Kaleb Michaud, Kenneth W Lyles, Cathleen S Colón-Emeric
Affiliations

Bisphosphonate use is associated with reduced risk of myocardial infarction in patients with rheumatoid arthritis

Frederick Wolfe et al. J Bone Miner Res. 2013 May.

Abstract

Bisphosphonates have been shown to reduce mortality in patients with osteoporotic fractures, but the mechanism is unclear. Bisphosphonates have immunomodulatory effects that may influence the development of vascular disease. We sought to determine if bisphosphonate use is associated with a reduced risk of myocardial infarction (MI) in a rheumatoid arthritis (RA) population with high prevalence of bisphosphonate use and vascular disease. Adult patients with RA enrolled in the National Data Bank for Rheumatic Diseases, a longitudinal study of RA patients enrolled continuously from U.S. rheumatology practices between 2003 and 2011, were included in the analysis (n = 19,281). Patients completed questionnaires every 6 months. including questions on medication use, demographic information, clinical information, and health status. MIs were confirmed by a central adjudicator. Among the 5689 patients who were treated with bisphosphonates at some time during the study period, the risk of MI while on bisphosphonate compared to when not on bisphosphonate was 0.56 (95% confidence interval [CI], 0.37-0.86; p < 0.01) after adjustment for multiple confounders. In models including all 19,281 treated and untreated patients, the adjusted risk of first MI was 0.72 (95% CI, 0.54-0.96; p = 0.02) and of all MIs it was 0.72 (95% CI, 0.53-0.97; p = 0.03) in bisphosphonate users compared to nonusers. This finding suggests a potential mechanism for the mortality reduction observed with bisphosphonate medications.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Forest plot of the relative risk of myocardial infarction associated with combinations of calcium, vitamin D, and bisphosphonate therapy (subgroup analyses).
Figure 2
Figure 2
Survival function for risk of myocardial infarction among groups not treated and variously treated with bisphosphonates.
See this image and copyright information in PMC

Comment in

References

    1. Cauley J, Thompson D, Ensrud K, Scott J, Black D. Risk of mortality following clinical fractures. Osteoporos Int. 2000;11:556–561. - PubMed
    1. Johnell O, Kanis J. Epidemiology of osteoporotic fractures. Osteoporos Int. 2005 Mar;16(Suppl 2):S3–S7. - PubMed
    1. Haentjens P, Magaziner J, Colón-Emeric CS, Vanderschueren D, Milisen K, Velkeniers B, Boonen S. Meta-analysis: excess mortality after hip fracture among older women and men. Ann Intern Med. 2010;152(6):380–390. - PMC - PubMed
    1. Kado DM, Browner WS, Palermo L, Nevitt MC, Genant HK, Cummings SR. Vertebral fractures and mortality in older women: a prospective study. Arch Intern Med. 1999;159(11):1215–1220. - PubMed
    1. Center JR, Nguyen TV, Schneider D, Sambrook PN, Eisman JA. Mortality after all major types of osteoporotic fracture in men and women: an observational study. Lancet. 1999;353(9156):878–882. - PubMed

Publication types

Substances