Evidence map›Paper›PMID 32662036›Full record

ArticleOsteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA2020

Risk of acute myocardial infarction among new users of bisphosphonates: a nested case-control study.

R Mazzucchelli, S Rodríguez-Martín, A García-Vadillo, N Crespí-Villarías, M Gil, A Rodriguez-Miguel, D Barreira, A Garcia-Lledó, F J de Abajo

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In one paragraph

Article in Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed, 1 pooled it
–field-weighted citation impact, top 90% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed, 1 synthesis or guideline pooled it, 1 citations in OpenAlex.

  1. Effect of osteoporosis medications on vascular and valvular calcification: a systematic review and meta-analysis.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2025
    Pooled it
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors at 5 institutions in 1 country.

R MazzucchelliRheumatology Unit, Hospital Universitario Fundación Alcorcón, 28922, Alcorcón, Madrid, Spain.
S Rodríguez-MartínClinical Pharmacology Unit, Hospital Universitario Príncipe de Asturias, 28805, Alcalá de Henares, Madrid, Spain.
A García-VadilloRheumatology Department, Hospital Universitario La Princesa, 28006, Madrid, Madrid, Spain.
N Crespí-VillaríasCentro de Salud La Rivota, 28922, Alcorcón, Madrid, Spain.
M GilDivision of Pharmacoepidemiology and Pharmacovigilance of the Spanish Agency on Medicines and Medical Devices (AEMPS), 28022, Madrid, Spain.
A Rodriguez-MiguelClinical Pharmacology Unit, Hospital Universitario Príncipe de Asturias, 28805, Alcalá de Henares, Madrid, Spain.
D BarreiraClinical Pharmacology Unit, Hospital Universitario Príncipe de Asturias, 28805, Alcalá de Henares, Madrid, Spain.
A Garcia-LledóDepartment of Cardiology, Hospital Universitario Príncipe de Asturias, 28805, Alcalá de Henares, Madrid, Spain.
F J de AbajoClinical Pharmacology Unit, Hospital Universitario Príncipe de Asturias, 28805, Alcalá de Henares, Madrid, Spain. francisco.abajo@uah.es.
Universidad de Alcalá · ESAgencia Española de Medicamentos y Productos Sanitarios · ESHospital Universitario de La Princesa · ESHospital Universitario Fundación Alcorcón · ESHospital Universitario Príncipe de Asturias · ES

Funding

Instituto de Salud Carlos III PI16/01353
6 · The paper itself

Abstract

objectiveTo test the hypothesis that bisphosphonates reduce AMI risk among new users and to assess whether the effect depends on the duration of treatment.

methodsCase-control study nested in a primary cohort composed of patients aged 40 to 99 years, with at least 1-year registry in the BIFAP database throughout the study period 2002-2015. Out of this cohort, incident AMI cases were identified and five controls per case were randomly selected, matched by exact age, sex, and index date. The association of AMI with current, recent and past use of bisphosphonates was assessed by computing adjusted odds ratios (AOR) and their corresponding 95% confidence interval (CI) through an unconditional logistic regression. Only initiators of bisphosphonates were considered.

resultsA total of 23,590 cases of AMI and 117,612 controls were included. The mean age was 66.8 (SD 13.4) years, and 72.52% was male, in both groups. About 276 (1.17%) cases and 1458 (1.24%) controls were current users of bisphosphonates yielding an AOR of 0.98 (95% CI 0.854-1.14). Recent and past use were not associated with a reduced risk, either, nor was it found a reduction with treatment duration (AOR less than 1 year = 0.92; 95% CI 0.73-1.15; AOR more than 1 year = 1.03; 95% CI 0.86-1.23). Stratified analysis by age, sex and background cardiovascular risk did not show an effect modification by these variables.

conclusionThe results do not support a cardioprotective effect of bisphosphonates regardless of the duration of treatment, age, sex or background cardiovascular risk. However, a small protective effect could have been masked if patients with osteoporosis have had a background higher risk of AMI.

Indexed as

Myocardial InfarctionOsteoporosisAdultAgedAged, 80 and overBone Density Conservation AgentsCase-Control StudiesDiphosphonatesHumansMaleMiddle AgedOdds RatioRisk FactorsBone Density Conservation AgentsDiphosphonatesAcute myocardial infarctionAntiresorptive agents, osteoporosisBisphosphonates

Identifiers

PMID32662036
OpenAlexW3043756317

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.