Bisphosphonate Use and Prevalence of Valvular and Vascular Calcification in Women MESA (The Multi-Ethnic Study of Atherosclerosis).
OBJECTIVE
the aim of this study was to determine whether nitrogen-containing bisphosphonate (NCBP) therapy is associated with the prevalence of cardiovascular calcification.


BACKGROUND
cardiovascular calcification correlates with atherosclerotic disease burden. Experimental data suggest that NCBP might limit cardiovascular calcification, which has implications for disease prevention.


METHODS
the relationship of NCBP use to the prevalence of aortic valve, aortic valve ring, mitral annulus, thoracic aorta, and coronary artery calcification (AVC, AVRC, MAC, TAC, and CAC, respectively) detected by computed tomography was assessed in 3,710 women within the MESA (Multi-Ethnic Study of Atherosclerosis) with regression modeling.


RESULTS
Analyses were age-stratified, because of a significant interaction between age and NCBP use (interaction p values: AVC p < 0.0001; AVRC p < 0.0001; MAC p = 0.002; TAC p < 0.0001; CAC p = 0.046). After adjusting for age; body mass index; demographic data; diabetes; smoking; blood pressure; cholesterol levels; and statin, hormone replacement, and renin-angiotensin inhibitor therapy, NCBP use was associated with a lower prevalence of cardiovascular calcification in women ≥ 65 years of age (prevalence ratio: AVC 0.68 [95% confidence interval (CI): 0.41 to 1.13]; AVRC 0.65 [95% CI: 0.51 to 0.84]; MAC 0.54 [95% CI: 0.33 to 0.93]; TAC 0.69 [95% CI: 0.54 to 0.88]; CAC 0.89 [95% CI: 0.78 to 1.02]), whereas calcification was more prevalent in NCBP users among the 2,181 women <65 years of age (AVC 4.00 [95% CI: 2.33 to 6.89]; AVRC 1.92 [95% CI: 1.42 to 2.61]; MAC 2.35 [95% CI: 1.12 to 4.84]; TAC 2.17 [95% CI: 1.49 to 3.15]; CAC 1.23 [95% CI: 0.97 to 1.57]).


CONCLUSIONS
among women in the diverse MESA cohort, NCBPs were associated with decreased prevalence of cardiovascular calcification in older subjects but more prevalent cardiovascular calcification in younger ones. Further study is warranted to clarify these age-dependent NCBP effects.
Zena and Michael A. Wiener Cardiovascular Institute, The Mount Sinai School of Medicine, New York, New York, USA. selmariah@partners.org
Sammy
S
Elmariah
Joseph A C
JA
Delaney
Kevin D
KD
O'Brien
Matthew J
MJ
Budoff
Jens
J
Vogel-Claussen
Valentin
V
Fuster
Richard A
RA
Kronmal
Jonathan L
JL
Halperin
D001741:Black or African American; D000368:Aged; D000369:Aged, 80 and over; D001213:Asian; D050197:Atherosclerosis / Q000139:chemically induced / Q000000981:diagnostic imaging / Q000208:ethnology*; D050071:Bone Density Conservation Agents / Q000009:adverse effects; D002114:Calcinosis / Q000139:chemically induced / Q000000981:diagnostic imaging / Q000208:ethnology*; D004164:Diphosphonates / Q000009:adverse effects*; D005260:Female; D005500:Follow-Up Studies; D006349:Heart Valve Diseases / Q000139:chemically induced / Q000208:ethnology*; D006630:Hispanic or Latino; D006801:Humans; D008875:Middle Aged; D015995:Prevalence; D011379:Prognosis; D011859:Radiography; D012189:Retrospective Studies; D012307:Risk Factors; D014481:United States / Q000453:epidemiology; D014652:Vascular Diseases / Q000139:chemically induced / Q000000981:diagnostic imaging / Q000208:ethnology*; D044465:White People
D050071:Bone Density Conservation Agents; D004164:Diphosphonates