Department of Physical Medicine and Rehabilitation, Taipei Medical University Hospital, Taipei, Taiwan.
Osteoporos Int. 2013 Jan;24(1):271-7. doi: 10.1007/s00198-012-2213-5. Epub 2012 Nov 14.
UNLABELLED: This population-based matched cohort analysis explored the effects of bisphosphonate treatment on acute myocardial infarction (AMI). We found that patients who received bisphosphonate therapy had a lower risk of AMI during a 2-year follow-up period (hazard ratio (HR) = 0.35). Our data support that bisphosphonates may provide protective effects against cardiovascular events. INTRODUCTION: Although bisphosphonates have been suggested to have anti-atherosclerotic effects in animal models, evidence in human subjects is still conflicting. Therefore, this study aimed to explore the effects of bisphosphonate treatment on AMI using a population-based cohort study. METHODS: We identified 1,548 patients who received bisphosphonate therapy for osteoporotic fractures and randomly extracted 4,644 subjects with vertebral or hip fractures as a comparison cohort. Each patient was individually tracked for 2 years to identify those who subsequently suffered an AMI. Stratified Cox proportional hazards regressions were performed to assess the effect of bisphosphonate treatment on the risk of AMI. RESULTS: Six (0.4 %) of the patients who received bisphosphonate therapy and 49 (1.1 %) of the comparison subjects suffered an AMI during the 2-year follow-up period. The incidence rate of AMI was 1.94 (95 % CI = 0.79-4.03) per 1,000 person-years in patients who received bisphosphonate therapy and 5.28 (95 % CI = 3.95-6.92) per 1,000 person-years in comparison patients. Regression analysis revealed that patients who received bisphosphonate therapy had a lower hazard of AMI during the 2-year follow-up period than comparison patients (HR = 0.37, 95 % CI = 0.16-0.85, p = 0.020). After censoring cases that died from non-AMI causes and adjusting for both demographic and risk factors, the HR of AMI for patients who received bisphosphonate therapy was 0.35 (95 % CI = 0.14-0.84, p = 0.020) than that of comparison patients. CONCLUSIONS: Patients who received bisphosphonate therapy had a lower risk of AMI during the 2-year follow-up period. Our data support that bisphosphonates may provide protective effects against cardiovascular events.
目的：本基于人群的匹配队列分析探讨了双膦酸盐治疗对急性心肌梗死（AMI）的影响。我们发现，在 2 年的随访期间，接受双膦酸盐治疗的患者发生 AMI 的风险较低（风险比（HR）=0.35）。我们的数据支持双膦酸盐可能对心血管事件具有保护作用。
背景：尽管双膦酸盐在动物模型中已被证明具有抗动脉粥样硬化作用，但在人体中的证据仍存在争议。因此，本研究旨在通过基于人群的队列研究探讨双膦酸盐治疗对 AMI 的影响。
方法：我们确定了 1548 例因骨质疏松性骨折而接受双膦酸盐治疗的患者，并随机抽取了 4644 例椎体或髋部骨折的患者作为对照队列。对每位患者进行了 2 年的单独随访，以确定随后发生 AMI 的患者。采用分层 Cox 比例风险回归评估双膦酸盐治疗对 AMI 风险的影响。
结果：在 2 年的随访期间，接受双膦酸盐治疗的患者中有 6 例（0.4%）和对照患者中有 49 例（1.1%）发生 AMI。接受双膦酸盐治疗的患者中 AMI 的发生率为 1.94（95%CI=0.79-4.03）/1000 人年，而对照患者中为 5.28（95%CI=3.95-6.92）/1000 人年。回归分析显示，在 2 年的随访期间，接受双膦酸盐治疗的患者发生 AMI 的风险低于对照患者（HR=0.37，95%CI=0.16-0.85，p=0.020）。在排除因非 AMI 原因死亡的病例并调整人口统计学和危险因素后，接受双膦酸盐治疗的患者发生 AMI 的 HR 为 0.35（95%CI=0.14-0.84，p=0.020），低于对照患者。
结论：在 2 年的随访期间，接受双膦酸盐治疗的患者发生 AMI 的风险较低。我们的数据支持双膦酸盐可能对心血管事件具有保护作用。
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