Use of bisphosphonates among women and risk of atrial fibrillation and flutter: population based case-control study

doi:10.1136/bmj.39507.551644.BE

BMJ 2008;336:813-816 (12 April), doi:10.1136/bmj.39507.551644.BE (published 11 March 2008)

Research

Use of bisphosphonates among women and risk of atrial fibrillation and flutter: population based case-control study

Henrik Toft Sørensen, professor¹, Steffen Christensen, clinical research fellow¹, Frank Mehnert, biostatistician¹, Lars Pedersen, chief statistician¹, Roland D Chapurlat, professor², Steven R Cummings, director³, John A Baron, professor⁴

¹ Department of Clinical Epidemiology, Aarhus University Hospital, 8000 Aarhus C, Denmark, ² INSERM Research Unit 831, Université de Lyon, Department of Orthopedics and Rheumatology, Hôpital E Herriot, Lyon, France, ³ San Francisco Coordinating Center, San Francisco, CA, USA, ⁴ Departments of Medicine and Community and Family Medicine, Dartmouth Medical School, Hanover, NH, USA

Correspondence to: H T Sørensen, Department of Clinical Epidemiology, Aarhus University Hospital, Olof Palmes Allé 43-45, DK-8200 Aarhus N, Denmark hts{at}dce.au.dk

Objective To assess the association between atrial fibrillationand flutter and use of bisphosphonates for osteoporosis amongwomen.

Design Population based case-control study, using medical databasesfrom Denmark.

Setting Northern Denmark.

Participants 13 586 patients with atrial fibrillation and flutterand 68 054 population controls, all with complete hospital andprescription history.

Main outcome measure Adjusted relative risk of atrial fibrillationand flutter.

Results 435 cases (3.2%) and 1958 population controls (2.9%)were current users of bisphosphonates for osteoporosis. Etidronateand alendronate were used with almost the same frequency amongcases and controls. The adjusted relative risk of current useof bisphosphonates compared with non-use was 0.95 (95% confidenceinterval 0.84 to 1.07). New users had a relative risk of 0.75(95% confidence interval 0.49 to 1.16), broadly similar to theestimate for continuing users (relative risk 0.96, 95% confidenceinterval 0.85 to 1.09). The relative risk estimates were independentof number of prescriptions and the position of the atrial fibrillationand flutter diagnosis in the discharge record, and were similarfor inpatients and outpatients.

Conclusion No evidence was found that use of bisphosphonatesincreases the risk of atrial fibrillation and flutter.

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