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COMMENTS AND OPINIONS
Alendronate, Osteoporosis, and Atherosclerosis—Reply
Susan R. Heckbert, MD, PhD;
Guo Li, MS;
Steven R. Cummings, MD;
Nicholas L. Smith, PhD;
Bruce M. Psaty, MD, PhD
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In reply
We recently reported an increased risk of newly recognized AF in women who had ever used alendronate compared with women who had never used a bisphosphonate in a clinical practice setting.1 This finding is consistent with recent adverse event reports from both the HORIZON Pivotal Fracture Trial2 and the Fracture Intervention Trial.3 Strandberg notes that the association of alendronate use with AF may be confounded by atherosclerosis because osteoporosis and AF may share common pathogenetic factors.
In our data, advanced age was associated with both alendronate use and AF. However, in many other respects (history of angina, myocardial infarction, heart failure, or diabetes), the alendronate users appeared to be at slightly lower risk of atherosclerotic disease than the never users. Because of our concern about confounding, our . . . [Full Text of this Article]
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RELATED ARTICLE
Use of Alendronate and Risk of Incident Atrial Fibrillation in Women
Susan R. Heckbert, Guo Li, Steven R. Cummings, Nicholas L. Smith, and Bruce M. Psaty
Arch Intern Med. 2008;168(8):826-831.
ABSTRACT
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RELATED LETTER
Alendronate, Osteoporosis, and Atherosclerosis
Timo E. Strandberg
Arch Intern Med. 2008;168(21):2386-2387.
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