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Cardiovascular Safety and Effectiveness of Bisphosphonates: From Intervention Trials to Real-Life Data

Both osteoporosis with related fragility fractures and cardiovascular diseases are rapidly outspreading worldwide. Since they are often coexistent in elderly patients and may be related to possible common pathogenetic mechanisms, the possible reciprocal effects of drugs employed to treat these disea...

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Autores principales: Delli Poggi, Chiara, Fusaro, Maria, Mereu, Maria Cristina, Brandi, Maria Luisa, Cianferotti, Luisella
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9227734/
https://www.ncbi.nlm.nih.gov/pubmed/35745099
http://dx.doi.org/10.3390/nu14122369
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author Delli Poggi, Chiara
Fusaro, Maria
Mereu, Maria Cristina
Brandi, Maria Luisa
Cianferotti, Luisella
author_facet Delli Poggi, Chiara
Fusaro, Maria
Mereu, Maria Cristina
Brandi, Maria Luisa
Cianferotti, Luisella
author_sort Delli Poggi, Chiara
collection PubMed
description Both osteoporosis with related fragility fractures and cardiovascular diseases are rapidly outspreading worldwide. Since they are often coexistent in elderly patients and may be related to possible common pathogenetic mechanisms, the possible reciprocal effects of drugs employed to treat these diseases have to be considered in clinical practice. Bisphosphonates, the agents most largely employed to decrease bone fragility, have been shown to be overall safe with respect to cardiovascular diseases and even capable of reducing cardiovascular morbidity in some settings, as mainly shown by real life studies. No randomized controlled trials with cardiovascular outcomes as primary endpoints are available. While contradictory results have emerged about a possible BSP-mediated reduction of overall mortality, it is undeniable that these drugs can be employed safely in patients with high fracture risk, since no increased mortality has ever been demonstrated. Although partial reassurance has emerged from meta-analysis assessing the risk of cardiac arrhythmias during bisphosphonates treatment, caution is warranted in administering this class of drugs to patients at risk for atrial fibrillation, possibly preferring other antiresorptives or anabolics, according to osteoporosis guidelines. This paper focuses on the complex relationship between bisphosphonates use and cardiovascular disease and possible co-management issues.
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spelling pubmed-92277342022-06-25 Cardiovascular Safety and Effectiveness of Bisphosphonates: From Intervention Trials to Real-Life Data Delli Poggi, Chiara Fusaro, Maria Mereu, Maria Cristina Brandi, Maria Luisa Cianferotti, Luisella Nutrients Review Both osteoporosis with related fragility fractures and cardiovascular diseases are rapidly outspreading worldwide. Since they are often coexistent in elderly patients and may be related to possible common pathogenetic mechanisms, the possible reciprocal effects of drugs employed to treat these diseases have to be considered in clinical practice. Bisphosphonates, the agents most largely employed to decrease bone fragility, have been shown to be overall safe with respect to cardiovascular diseases and even capable of reducing cardiovascular morbidity in some settings, as mainly shown by real life studies. No randomized controlled trials with cardiovascular outcomes as primary endpoints are available. While contradictory results have emerged about a possible BSP-mediated reduction of overall mortality, it is undeniable that these drugs can be employed safely in patients with high fracture risk, since no increased mortality has ever been demonstrated. Although partial reassurance has emerged from meta-analysis assessing the risk of cardiac arrhythmias during bisphosphonates treatment, caution is warranted in administering this class of drugs to patients at risk for atrial fibrillation, possibly preferring other antiresorptives or anabolics, according to osteoporosis guidelines. This paper focuses on the complex relationship between bisphosphonates use and cardiovascular disease and possible co-management issues. MDPI 2022-06-07 /pmc/articles/PMC9227734/ /pubmed/35745099 http://dx.doi.org/10.3390/nu14122369 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Review
Delli Poggi, Chiara
Fusaro, Maria
Mereu, Maria Cristina
Brandi, Maria Luisa
Cianferotti, Luisella
Cardiovascular Safety and Effectiveness of Bisphosphonates: From Intervention Trials to Real-Life Data
title Cardiovascular Safety and Effectiveness of Bisphosphonates: From Intervention Trials to Real-Life Data
title_full Cardiovascular Safety and Effectiveness of Bisphosphonates: From Intervention Trials to Real-Life Data
title_fullStr Cardiovascular Safety and Effectiveness of Bisphosphonates: From Intervention Trials to Real-Life Data
title_full_unstemmed Cardiovascular Safety and Effectiveness of Bisphosphonates: From Intervention Trials to Real-Life Data
title_short Cardiovascular Safety and Effectiveness of Bisphosphonates: From Intervention Trials to Real-Life Data
title_sort cardiovascular safety and effectiveness of bisphosphonates: from intervention trials to real-life data
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9227734/
https://www.ncbi.nlm.nih.gov/pubmed/35745099
http://dx.doi.org/10.3390/nu14122369
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