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In a recent randomized trial, zoledronic acid administered intravenously once yearly increased hip and lumbar spine bone density and reduced hip and vertebral fracture risk. However, IV zoledronic acid also increased risk for serious atrial fibrillation (Journal Watch May 2 2007). Do oral bisphosphonates increase risk for atrial fibrillation and flutter (AF)?
To answer this question, Danish investigators conducted a population-based case-control study involving 13,586 case patients with AF and 68,054 control patients without AF matched for age, sex, and county of residence. Overall, 435 case patients (3.2%) and 1958 control patients (2.9%) were current users of oral bisphosphonates (mostly etidronate and alendronate). In analyses that were a…