Abstract 2159: Use of Bisphosphonate is Associated with a Higher Risk of Serious Atrial Fibrillation in Postmenopausal Women: A Meta-Analysis
The association of serious atrial fibrillation (defined as events resulting in hospitalization or disability or judged to be life-threatening) with the use of bisphosphonates is uncertain. We analyzed evidence for the risk of serious atrial fibrillation with the use of bisphosphonates. We performed a systematic literature search for randomized placebo controlled clinical trials using bisphosphonates and providing data on the outcome of serious atrial fibrillation. The studies were homogenous; therefore the Mantel-Haenszel fixed-effect model was used to calculate combined relative risk. A two-sided alpha error of less than 0.05 was considered to be statistically significant (p<0.05). Four studies with 26126 postmenopausal women were included. Meta-analysis revealed that serious atrial fibrillation occurred more frequently in the bisphosphonate group compared to the placebo group (relative risk, 1.525; 95% CI, 1.166 to 1.997; p = 0.002). The results are shown in the figure⇓ below. Bisphosphonate use may be associated with a significant increase in the risk of serious atrial fibrillation in postmenopausal women. This increased risk might be due to bisphosphonate induced release of inflammatory cytokines or shifts of calcium within atrial cells.