Another study confirmed that the use of bisphosphonates, drugs for the treatment of osteoporosis, significantly increases the risk of atrial fibrillation, as reported by the Internet publication for girls and women from 14 to 35 years Pannochka. net A systematic review of randomized placebo-controlled and observational studies has shown that the use of bisphosphonates increases the risk of atrial fibrillation by 27% (95% CI 1.16-1.39) in observational studies and 40% in controlled studies (95% CI 1.02-1.93).

This was reported by the author of the survey Dr. Abhishek Sharma, an employee of the Maimonides Medical Center in Brooklyn (USA).

In the October issue of Chest magazine, Dr. Sharma reports that in comparison patients who did not take bisphosphonates, there was no increase in the risk of stroke and cardiovascular mortality.

Recall that earlier studies have suggested a link between atrial fibrillation (MA) and bisphosphonate administration, but the data were not enough. Bisphosphonates are successfully used to treat osteoporosis, but therapy with these drugs, among other things, is associated with a risk of atypical fractures.

The authors of the new work carried out a systematic review of a large number of studies that evaluated the risk of atrial fibrillation and other cardiovascular events with the use of bisphosphonates. The review included 6 observational studies with a total of 149,856 participants, and 6 randomized controlled trials in which 41,375 patients participated.

Observational studies have shown that oral administration of bisphosphonates "significantly increases" the risk of atrial fibrillation among patients who had a history of MA. In patients with cancer who received bisphosphonates intravenously but did not have a history of MA, the risk was also "increased compared to patients who coincide by sex, age and type of disease but who do not take bisphosphonates".

There was no association between drug use and atrial fibrillation in the population retrospective cohort of women with osteoporosis who participated in two major studies.

The authors noted that the parenteral use of bisphosphonates "induces the release of TNF-alpha tumor necrosis factor, interleukin-6, and also inhibits farnesyl pyrophosphate synthase in the mevalonate pathway, resulting in accumulation of pyrophosphate". The result is an activation of the inflammatory cascade and a violation of the expression of proteins that control intracellular calcium. This, in the opinion of scientists, explains the risk of arrhythmia in patients on bisphosphonates.

They warned that the fuzzy link between stroke and bisphosphonate may be due to too short patient monitoring, which lasted on average from 2 to 6 years - this is not enough to reliably assess the risk of stroke, which "increases as the patients continue to take these drugs".

Scientists also wrote that patients with osteoporosis have an increased cardiovascular risk, which is "proportional to the degree of severity of osteoporosis," and this should be paid special attention.

The study may be limited by the fact that scientists in the analysis of cardiovascular events did not distinguish between primary and secondary events. The authors of the work did not report any conflicts of interest.

medbe. en.