Study Examines Link Between Treatment Choice, Osteoporosis, Atrial Fibrillation

A population-based study in Taiwan examined whether or not vitamin D or bisphosphonates affect the risk of atrial fibrillation (AF) in postmenopausal women with osteoporosis.

Vitamin D and bisphosphonates are used to treat osteoporosis, and these may have different effects on the risk of AF, the researchers said. The study noted that osteoporosis and AF are both diseases associated with the aging process. Researchers did the study due to issues with current treatment for osteoporosis, and because vitamin D deficiency is a cause of osteoporosis and induces several cardiovascular morbidities, which are expected to increase the risk of AF.

Using the Taiwan National Health Insurance nationwide database, researchers identified 20,788 female patients with osteoporosis who were or were not treated with vitamin D or bisphosphonates. The data came from the years 2000 to 2008, and the patients were followed for up to 5 consecutive years to determine if they had a new diagnosis of AF after the diagnosis of osteoporosis.

There were 14 (2.67%) new AF diagnoses in osteoporosis patients treated with bisphosphonates, 1 (0.28%) new AF diagnosis in patients treated with vitamin D, and 279 (1.40%) new AF diagnoses in patients who were not treated with vitamin D or bisphosphonates (neither group).

Patients who received bisphosphonates showed a higher incidence of AF occurrence than those that were not treated with bisphosphonates (P =.015). One patient who received vitamin D had a new diagnosis of AF during the study period; the incidence was significantly lower than that in the patients treated with bisphosphonates (P =.007).

Patients who were treated with vitamin D had a lower incidence of AF than did those who were not treated with either vitamin D or bisphosphonates (P =.074). Kaplan—Meier analysis also showed a significant difference in AF occurrence in different groups during the 5-year follow-up (P = .010).

The study found that patients who were treated with vitamin D had more comorbidities than those without treatment. This study also found that the incidences of comorbidities in patients with osteoporosis with AF were higher than those among patients with osteoporosis without AF. The incidence of comorbidities was higher in the vitamin D group than in the neither group, which suggests that the beneficial effects of vitamin D on reducing AF may be underestimated.

Additional research is needed to confirm the findings, the study said.

Reference

Yang HY, Huang JH, Chiu HW, Lin YK, Hsu CY, Chen YJ. Vitamin D and bisphosphonates therapies for osteoporosis are associated with different risks of atrial fibrillation in women. Medicine. 2018; 97(43):e12947. doi: 10.1097/MD.0000000000012947.