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Use of strontium ranelate and risk of acute coronary syndrome: cohort study.
MedLine Citation:
PMID:  24651624     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
BACKGROUND: A recent pooled analysis of randomised trials found an increased risk of myocardial infarction with use of the antiosteoporotic drug strontium ranelate. We conducted a nationwide cohort study in Denmark, 2005-2011, to investigate the risk of acute coronary syndrome among postmenopausal women treated with strontium ranelate.
METHODS: The study involved two analytic setups. The first analysis included new users of either strontium ranelate (n=1798) or one of the two first-line bisphosphonates in Denmark (alendronate and risedronate; n=65 236). The second analysis included patients who had first been treated with a first-line bisphosphonate and subsequently switched to either strontium ranelate (n=1219) or ibandronate (n=2290). The primary outcome was acute coronary syndrome (unstable angina or myocardial infarction). The secondary outcome was any-cause mortality. Cox regression was used to estimate HRs, with adjustment using a disease risk score.
RESULTS: Compared with use of alendronate/risedronate, use of strontium was not associated with significantly increased risk of acute coronary syndrome (rate per 1000 person-years 5.7 for strontium vs 6.3 for alendronate/risedronate; adjusted HR 0.89, 95% CI 0.52 to 1.55) or any-cause mortality (adjusted HR 0.96, 95% CI 0.76 to 1.21). In the analysis of switchers, strontium was not associated with significantly increased risk of acute coronary syndrome (rate per 1000 person-years 9.9 for strontium vs 9.9 for ibandronate; adjusted HR 1.00, 95% CI 0.49 to 2.05) or of any-cause mortality (adjusted HR 1.45, 95% CI 0.95 to 2.21).
INTERPRETATION: These real-world data of antiosteoporotic drug users do not support a significant association between use of strontium ranelate and acute coronary syndrome.
Authors:
Henrik Svanström; Björn Pasternak; Anders Hviid
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2014-3-20
Journal Detail:
Title:  Annals of the rheumatic diseases     Volume:  -     ISSN:  1468-2060     ISO Abbreviation:  Ann. Rheum. Dis.     Publication Date:  2014 Mar 
Date Detail:
Created Date:  2014-3-21     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0372355     Medline TA:  Ann Rheum Dis     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
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