ORLANDO — Bisphosphonate use was linked with an unexpected, increased risk for aortic valve calcification in women aged 55–64 years in an analysis of about 3,700 women.
The analysis also showed the more expected finding that among older women, aged at least 75, bisphosphonate treatment was linked to a significantly reduced risk for aortic valve calcification, Dr. Sammy Elmariah said while presenting a poster at the annual meeting of the American College of Cardiology.
The significantly increased risk for calcification among younger women has no clear explanation. “In my opinion it's due to confounding,” Dr. Elmariah said in an interview. Women younger than 65 who go on bisphosphonate treatment often have a special risk for osteoporosis that may somehow relate to a high level of valve calcification.
He and his associates used data collected in the Multi-Ethnic Study of Atherosclerosis (MESA), a longitudinal cohort study of about 6,800 men and women aged 45–85 that is sponsored by the National Heart, Lung, and Blood Institute. Among the 3,710 women in MESA, 214 were treated with a nitrogen-containing bisphosphonate and the other 3,496 were not receiving a bisphosphonate. The bisphosphonate group included 100 women aged younger than 65.
Among women younger than age 65 years, CT imaging showed aortic valve calcification in 18% of those on a bisphosphonate and in 4% of those not on the drug. In women aged 65 or older, imaging showed a rate of 13% with calcification in the bisphosphonate group and 20% in those not on the drug, reported Dr. Elmariah, a cardiologist at Mount Sinai Medical Center in New York.
In a model that adjusted for age, body mass index, ethnicity, study site, education, income, health insurance, diabetes, smoking, blood pressure, and cholesterol level, bisphosphonate use was linked with a 3.9-fold increased risk for aortic valve calcification in women younger than 65, a statistically significant association. The vast majority of these women were aged 55–64.
In contrast, among women aged 65 or older, bisphosphonate use was associated with a nonsignificant 30% reduction in valve calcification. In those aged 75 or older, bisphosphonate use was linked with a significant 50% relative risk reduction in the prevalence of valve calcification, compared with women not on a bisphosphonate.
Dr. Elmariah reported no financial relationships for this study.