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

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

BMJ 2008; 336 doi: https://doi.org/10.1136/bmj.39507.551644.BE (Published 10 April 2008) Cite this as: BMJ 2008;336:813
  1. Henrik Toft Sørensen, professor1,
  2. Steffen Christensen, clinical research fellow1,
  3. Frank Mehnert, biostatistician1,
  4. Lars Pedersen, chief statistician1,
  5. Roland D Chapurlat, professor2,
  6. Steven R Cummings, director3,
  7. John A Baron, professor4
  1. 1Department of Clinical Epidemiology, Aarhus University Hospital, 8000 Aarhus C, Denmark
  2. 2INSERM Research Unit 831, Université de Lyon, Department of Orthopedics and Rheumatology, Hôpital E Herriot, Lyon, France
  3. 3San Francisco Coordinating Center, San Francisco, CA, USA
  4. 4Departments of Medicine and Community and Family Medicine, Dartmouth Medical School, Hanover, NH, USA
  1. 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
  • Accepted 28 February 2008

Abstract

Objective To assess the association between atrial fibrillation and flutter and use of bisphosphonates for osteoporosis among women.

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

Setting Northern Denmark.

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

Main outcome measure Adjusted relative risk of atrial fibrillation and flutter.

Results 435 cases (3.2%) and 1958 population controls (2.9%) were current users of bisphosphonates for osteoporosis. Etidronate and alendronate were used with almost the same frequency among cases and controls. The adjusted relative risk of current use of bisphosphonates compared with non-use was 0.95 (95% confidence interval 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 the estimate for continuing users (relative risk 0.96, 95% confidence interval 0.85 to 1.09). The relative risk estimates were independent of number of prescriptions and the position of the atrial fibrillation and flutter diagnosis in the discharge record, and were similar for inpatients and outpatients.

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

Footnotes

  • Contributors: HTS and SRC conceived the study. HTS, SC, FM, LP, and JAB designed the study and collected and analysed the data. All authors interpreted the findings. HTS, RDC, and SRC reviewed the literature. HTS wrote the first draft and all authors edited the manuscript. HTS is the guarantor.

  • Funding: Western Danish Research Forum for Health Sciences. The funder had no role in the design, conduct, analysis, or reporting of this study.

  • Competing interests: RDC has received consulting fees, speaker honorariums, or research funding from several pharmaceutical companies marketing drugs for osteoporosis: Novartis, Merck-Sharpe and Dohme, Roche, Eli Lilly, Procter and Gamble, Sanofi-Aventis, Nycomed, and Servier. SRC has received consulting or advisory board fees and grant support from Amgen, Eli Lilly, Pfizer, and Novartis, and lecture fees from Merck and Eli Lilly. JAB has been a consultant to Merck and to Novartis.

  • Ethical approval: This study was approved by the Danish Data Protection Agency (record No 2004-41-4693) and the Aarhus University Hospital registry board.

  • Provenance and peer review: Not commissioned; externally peer reviewed.

  • Accepted 28 February 2008
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