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Once-yearly zoledronic acid and change in abdominal aortic calcification over 3 years in postmenopausal women with osteoporosis: results from the HORIZON Pivotal Fracture Trial

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Cai, G ORCID: 0000-0002-6481-704X, Keen, HI, Host, LV, Aitken, D ORCID: 0000-0001-5685-7634, Laslett, LL ORCID: 0000-0002-4336-0095, Winzenberg, T ORCID: 0000-0002-4112-3491, Wluka, AE, Black, D and Jones, G ORCID: 0000-0002-9814-0006 2020 , 'Once-yearly zoledronic acid and change in abdominal aortic calcification over 3 years in postmenopausal women with osteoporosis: results from the HORIZON Pivotal Fracture Trial' , Osteoporosis International, no. May , pp. 1-7 , doi: 10.1007/s00198-020-05430-z.

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Abstract

Summary: This study evaluated whether zoledronic acid (ZA) inhibited the progression of abdominal aortic calcification (AAC) over 3 years in 502 postmenopausal women with osteoporosis. AAC progressed in a similar proportion of participants in the ZA (29%) and placebo (31%) groups, suggesting no effect of ZA on AAC progression. Introduction: Bisphosphonate use is associated with reduced risk of all-cause mortality and cardiovascular events. The underlying mechanisms are uncertain but may include effects on vascular calcification. This study aimed to evaluate the effect of zoledronic acid (ZA) on abdominal aortic calcification (AAC) in postmenopausal women with osteoporosis. Methods: This was a post hoc analysis of the HORIZON Pivotal Fracture Trial that included 502 postmenopausal women (mean age 72.5 years) with osteoporosis (234 received ZA and 268 placebo). AAC scores (range, 0-8) were assessed from paired spine X-rays at baseline and after 3 years. Progression of AAC was defined as any increase in AAC score. The association between change in hip and femoral neck bone mineral density and change in AAC score was also assessed. Results: At baseline, 292 (58.2%) participants had AAC (i.e., AAC score > 0), with AAC scores similar in the two intervention groups (median [interquartile range], 1 [0 to 2] for both; p = 0.98). Over 3 years, AAC progressed in a similar proportion of participants in both groups (ZA 29% and placebo 31%; p = 0.64). Change in bone mineral density and change in AAC score were not correlated. Conclusion: Once-yearly zoledronic acid did not affect progression of AAC over 3 years in postmenopausal women with osteoporosis.

Item Type: Article
Authors/Creators:Cai, G and Keen, HI and Host, LV and Aitken, D and Laslett, LL and Winzenberg, T and Wluka, AE and Black, D and Jones, G
Keywords: aortic calcification, bisphosphonates, cardiovascular, osteoporosis, zoledronic acid
Journal or Publication Title: Osteoporosis International
Publisher: Springer-Verlag London Ltd
ISSN: 0937-941X
DOI / ID Number: 10.1007/s00198-020-05430-z
Copyright Information:

Copyright 2020 International Osteoporosis Foundation and National Osteoporosis Foundation. This is a post-peer-review, pre-copyedit version of an article published in Osteoporosis International. The final authenticated version is available online at: http://dx.doi.org/10.1007/s00198-020-05430-z

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