Breast cancer: bisphosponates offer cardioprotective benefit in older survivors

  • Breast
  • 1 Jul 2019

  • curated by Emily Willingham, PhD
  • Univadis Clinical Summaries
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Takeaway

  • Population-based data suggest that bisphosphonates offer protection from cardiovascular disease (CVD) events among older survivors of early-stage breast cancer.

Why this matters

  • Some studies have suggested a CVD-protective benefit of bisphosphonates in this population, in which CVD is a leading cause of death.

Key results

  • Freedom from CVD events at 36 months postdiagnosis was higher among bisphosphonate users than nonusers (87.0% vs 76.6%; P<.001>
  • Bisphosphonate use reduced CVD risk by about half: HR, 0.51 (95% CI, 0.44-0.59).
  • Incidences of specific CVD events for bisphosphonate users vs nonusers: 
    • Angina: 6.3% vs 11.8% 
      • HR, 0.50 (95% CI, 0.41-0.62);
    • Afib: 4.1% vs 6.2%
      • HR, 0.61 (95% CI, 0.47-0.78);
    • Heart failure: 4.5% vs 6.9%
      • HR, 0.61 (95% CI, 0.47-0.78);
    • Myocardial infarction: 1.1% vs 3.1% 
      • HR, 0.35 (95% CI, 0.22-0.57); and
    • Stroke: 3.4% vs 6.5%
      • HR, 0.53 (95% CI, 0.40-0.71).

Study design

  • Longitudinal, population-based cohort study using Medicare claims-linked registry data for 10,115 women (2314  bisphosphonate users) aged >65 (median age, 72; interquartile range, 68-78) years without CVD.
  • 2178 bisphosphonate users were propensity-score matched with 2178 nonusers.
  • Funding: None disclosed.

Limitations

  • Potential residual confounding.
  • Over-the-counter use of supplements such as vitamin D or calcium not captured.

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