Intravenous bisphosphonate therapy and atrial fibrillation/flutter risk in cancer patients: a nationwide cohort study
2011

Intravenous bisphosphonates and atrial fibrillation risk in cancer patients

Sample size: 11887 publication Evidence: moderate

Author Information

Author(s): Erichsen R, Christiansen C F, Frøslev T, Jacobsen J, Sørensen H T

Primary Institution: Department of Clinical Epidemiology, Aarhus University Hospital

Hypothesis

Do intravenous bisphosphonates increase the risk of atrial fibrillation in cancer patients?

Conclusion

Intravenous bisphosphonates may increase AF/flutter risk in cancer patients.

Supporting Evidence

  • 3981 cancer patients exposed to IV bisphosphonates were followed for a total of 22,642 years.
  • 128 (3.2%) of exposed patients developed AF/flutter compared to 192 (2.4%) of non-exposed patients.
  • The adjusted hazard ratio for AF/flutter in exposed patients was 1.7.

Takeaway

Cancer patients who receive a treatment called bisphosphonates might have a higher chance of getting a heart problem called atrial fibrillation.

Methodology

A nationwide population-based cohort study using Danish databases matched bisphosphonate-exposed cancer patients with non-exposed patients.

Potential Biases

Residual confounding may exist, and patients at higher risk of AF/flutter might be more likely to receive bisphosphonates.

Limitations

Potential misclassification of bisphosphonate exposure and lack of specific subtype or dose information.

Participant Demographics

Median age was 65 years, 61% were women, and 23% had distant metastasis at diagnosis.

Statistical Information

P-Value

1.7

Confidence Interval

95% CI: 1.2–2.4

Statistical Significance

p<0.05

Digital Object Identifier (DOI)

10.1038/bjc.2011.338

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