Ischaemic cardiac events and use of strontium ranelate in postmenopausal osteoporosis: a nested case–control study in the CPRDReportar como inadecuado




Ischaemic cardiac events and use of strontium ranelate in postmenopausal osteoporosis: a nested case–control study in the CPRD - Descarga este documento en PDF. Documentación en PDF para descargar gratis. Disponible también para leer online.

Osteoporosis International

, Volume 25, Issue 2, pp 737–745

First Online: 10 December 2013Received: 11 October 2013Accepted: 15 November 2013

Abstract

SummaryWe explored the cardiac safety of the osteoporosis treatment strontium ranelate in the UK Clinical Practice Research Datalink. While known cardiovascular risk factors like obesity and smoking were associated with increased cardiac risk, use of strontium ranelate was not associated with any increase in myocardial infarction or cardiovascular death.

IntroductionIt has been suggested that strontium ranelate may increase risk for cardiac events in postmenopausal osteoporosis. We set out to explore the cardiac safety of strontium ranelate in the Clinical Practice Research Datalink CPRD and linked datasets.

MethodsWe performed a nested case–control study. Primary outcomes were first definite myocardial infarction, hospitalisation with myocardial infarction, and cardiovascular death. Cases and matched controls were nested in a cohort of women treated for osteoporosis. The association with exposure to strontium ranelate was analysed by multivariate conditional logistic regression.

ResultsOf the 112,445 women with treated postmenopausal osteoporosis, 6,487 received strontium ranelate. Annual incidence rates for first definite myocardial infarction 1,352 cases, myocardial infarction with hospitalisation 1,465 cases, and cardiovascular death 3,619 cases were 3.24, 6.13, and 14.66 per 1,000 patient-years, respectively. Obesity, smoking, and cardiovascular treatments were associated with significant increases in risk for cardiac events. Current or past use of strontium ranelate was not associated with increased risk for first definite myocardial infarction odds ratio OR 1.05, 95 % confidence interval CI 0.68–1.61 and OR 1.12, 95 % CI 0.79–1.58, respectively, hospitalisation with myocardial infarction OR 0.84, 95 % CI 0.54–1.30 and OR 1.17, 95 % CI 0.83–1.66, or cardiovascular death OR 0.96, 95 % CI 0.76–1.21 and OR 1.16, 95 % CI 0.94–1.43 versus patients who had never used strontium ranelate.

ConclusionsAnalysis in the CPRD did not find evidence for a higher risk for cardiac events associated with the use of strontium ranelate in postmenopausal osteoporosis.

KeywordsCardiac safety CPRD Nested case–control study Postmenopausal osteoporosis Strontium ranelate A related article can be found at DOI 10.1007-s00198-013-2469-4; a related editorial at DOI 10.1007-s00198-013-2583-3.

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Autor: C. Cooper - K. M. Fox - J. S. Borer

Fuente: https://link.springer.com/







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