Effect of raloxifene on cardiovascular adverse events in postmenopausal women with osteoporosis
| Autor: | Michelle A. Mcnabb, Elizabeth Barrett-Connor, Mary Jane Geiger, Andrea R. Genazzani, Kristine E. Ensrud, David A. Cox, Sherie A. Dowsett |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2006 |
| Předmět: |
medicine.medical_specialty
Osteoporosis Breast Neoplasms Coronary Disease Internal medicine Humans Medicine Raloxifene Adverse effect Osteoporosis Postmenopausal Aged Gynecology Bone Density Conservation Agents business.industry Proportional hazards model Incidence (epidemiology) Hazard ratio medicine.disease Clinical trial Cerebrovascular Disorders Selective estrogen receptor modulator Raloxifene Hydrochloride Cardiology Female Cardiology and Cardiovascular Medicine business Follow-Up Studies medicine.drug |
| Popis: | The impact of selective estrogen receptor modulators on cardiovascular disease outcomes in postmenopausal women remains unclear. This analysis assessed the effect of raloxifene on the incidence of cardiovascular adverse events in postmenopausal women followed foror =8 years as participants in a 4-year osteoporosis treatment trial and a subsequent 4-year follow-up trial. The Continuing Outcomes Relevant to Evista (CORE) trial, designed to determine the effect of raloxifene on the incidence of invasive breast cancer, was a 4-year follow-up study to the 4-year Multiple Outcomes of Raloxifene Evaluation (MORE) osteoporosis treatment trial. Of the 7,705 participants originally enrolled in MORE, 4,011 were enrolled in CORE and thus participated in both trials (MORE-CORE participants). The incidence of serious cardiovascular (i.e., coronary and cerebrovascular) adverse events during 8 years, confirmed by external adjudication in the 2 trials, was compared between treatment groups using Cox proportional hazards models. The 8-year incidence of serious cardiovascular adverse events did not differ significantly between the raloxifene (5.5%) and placebo (4.7%) groups (hazard ratio [HR] 1.16, 95% confidence interval [CI] 0.86 to 1.56). Similar results were obtained when coronary (HR 1.22, 95% CI 0.82 to 1.83) or cerebrovascular (HR 1.19, 95% CI 0.78 to 1.84) events were analyzed separately, and when cardiovascular events were analyzed in the 459 MORE-CORE participants who were at increased risk of cardiovascular events by previously established criteria (HR 1.03, 95% CI 0.58 to 1.82). In conclusion, we found no evidence of a beneficial or harmful effect of raloxifene on the incidence of cardiovascular events overall, or coronary or cerebrovascular events, in postmenopausal osteoporotic women at relatively low risk of cardiovascular events. |
| Databáze: | OpenAIRE |
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