Takeaway
- Population-based data suggest that bisphosphonates offer protection from cardiovascular disease (CVD) events among older survivors of early-stage breast cancer.
Why this matters
- Some studies have suggested a CVD-protective benefit of bisphosphonates in this population, in which CVD is a leading cause of death.
Key results
- Freedom from CVD events at 36 months postdiagnosis was higher among bisphosphonate users than nonusers (87.0% vs 76.6%; P<.001>
- Bisphosphonate use reduced CVD risk by about half: HR, 0.51 (95% CI, 0.44-0.59).
- Incidences of specific CVD events for bisphosphonate users vs nonusers:
- Angina: 6.3% vs 11.8%
- HR, 0.50 (95% CI, 0.41-0.62);
- Afib: 4.1% vs 6.2%
- HR, 0.61 (95% CI, 0.47-0.78);
- Heart failure: 4.5% vs 6.9%
- HR, 0.61 (95% CI, 0.47-0.78);
- Myocardial infarction: 1.1% vs 3.1%
- HR, 0.35 (95% CI, 0.22-0.57); and
- Stroke: 3.4% vs 6.5%
- HR, 0.53 (95% CI, 0.40-0.71).
- Angina: 6.3% vs 11.8%
Study design
- Longitudinal, population-based cohort study using Medicare claims-linked registry data for 10,115 women (2314 bisphosphonate users) aged >65 (median age, 72; interquartile range, 68-78) years without CVD.
- 2178 bisphosphonate users were propensity-score matched with 2178 nonusers.
- Funding: None disclosed.
Limitations
- Potential residual confounding.
- Over-the-counter use of supplements such as vitamin D or calcium not captured.
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