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Experimental Biology 2010: Bisphosphonate Use And The Prevalence Of Cardiovascular Calcification In Women: The Multi-Ethnic Study Of Atherosclerosis
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Bisphosphonate Use And The Prevalence Of Cardiovascular Calcification In Women: The Multi-Ethnic Study Of Atherosclerosis
S. Elmariah1, J.A. Delaney2, K.D. O'Brien2, M.J. Budoff3, J. Vogel-Claussen4, V. Fuster1,5, R.A. Kronmal2, J.L. Halperin1 1Cardiovascular Institute, The Mount Sinai School of Medicine, New York, NY 2University of Washington, Seattle, WA 3Harbour-UCLA Medical Center, Torrance, CA 4Johns Hopkins University School of Medicine, Baltimore, MD 5Centro Nacional de Investigaciones Cardiovasculares (CNIC), Madrid, Spain.
Purpose of Study: Vascular and valvular calcification correlate with atherosclerotic disease burden. Experimental data suggest that nitrogen-containing bisphosphonates (NCBP) may limit cardiovascular calcification, which has implications for disease prevention. We examine the relationship of NCBP therapy with prevalence of cardiovascular calcification in women. Methods Used: 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 3,636 women within the Multi-Ethnic Study of Atherosclerosis (MESA) using relative risk regression modeling. Summary of 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<0.005; TAC p<0.0001; CAC p<0.05). After adjusting for age, body mass index, demographics, antihypertensive and lipid-lowering therapy, diabetes, smoking, blood pressure and cholesterol levels, NCBP use was associated with a lower prevalence of cardiovascular calcification in women =65 years old (prevalence ratio [95% confidence interval]: AVC 0.68 [0.41, 1.13]; AVRC 0.65 [0.51, 0.84]; MAC 0.54 [0.32, 0.92]; TAC 0.68 [0.53, 0.88]; CAC 0.89 [0.78, 1.02]), whereas calcification was more prevalent in NCBP users among the 2,181 women <65 years old (AVC 4.01 [2.33, 6.91]; AVRC 1.89 [1.40, 2.56]; MAC 2.35 [1.13, 4.88]; TAC 2.16 [1.49, 3.14]; CAC 1.24 [0.97, 1.58]). Grouping by finer age strata demonstrated a gradual reduction in NCBP-associated calcification with increasing age. Conclusions: Among women in the diverse MESA cohort, NCBPs were associated with decreased prevalence of cardiovascular calcification in older subjects, but more prevalent calcification in younger ones. Further study is warranted to clarify these age-dependent NCBP effects.
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