Undefined indicates that there were no AF events in the placebo arm of the study, although there may have been an event in the alendronate arm Other endpoints The endpoints of CA, CVA, and CHF were examined in the meta-analysis using the same studies and the find more same patient populations as were used for the atrial fibrillation endpoint: 32 Metabolism inhibitor trials including 9,518 participants on alendronate and 7,773 on placebo. Cardiac arrhythmias The estimated relative risk for all AEs of cardiac arrhythmia (including AF) was 0.92 (95% CI = 0.79, 1.07; p = 0.31), and

the estimated odds ratio was 0.91 (95% CI = 0.78, 1.06; p = 0.23). The estimated relative risk for SAEs was 1.18 (95% CI = 0.87, 1.61; p = 0.31), and the estimated odds ratio was 1.17 (95% CI = 0.87, 1.59; p = 0.30). There were 360 AEs and 98 SAEs of cardiac arrhythmia for alendronate, occurring in 26 trials (Online Table A). There were 346 AEs and 78 SAEs of cardiac arrhythmia for placebo, occurring in 24 trials. Thirty trials had at least one event in either treatment group; two trials had no events. As seen with the AF endpoint, FIT accounted for two thirds of selleckchem the arrhythmia events (study 51.1—alendronate = 85, placebo = 78, RR = 1.06; study 51.2—alendronate = 159, placebo = 162, RR = 0.99). Non-hemorrhagic cerebrovascular accidents (CVA) The estimated relative risk for all CVA AEs was

0.85 (95% CI = 0.65, 1.11; p = 0.25), and the estimated odds ratio was 0.84 (95% CI = 0.65, 1.10; p = 0.21). There were 108 CVA AEs for alendronate occurring in 11 trials, compared with 122 CVA AEs for placebo occurring in nine trials (Online Table A). Thirteen trials

had CVA AEs; 19 trials had no CVA events. Congestive heart failure (CHF) The estimated relative risk for all CHF AEs was 0.96 (95% CI = 0.71, 1.30; p = 0.84), Protein kinase N1 and the estimated odds ratio was 0.95 (95% CI = 0.71, 1.28; p = 0.75). There were 91 CHF AEs for alendronate occurring in 11 trials compared with 91 AEs for placebo occurring in eight trials (Online Table A). Thirteen trials had an AE in one or both treatment groups; 19 trials had no CHF events. Myocardial infarctions and cardiovascular deaths in FIT As FIT was the largest trial included in this meta-analysis and as it was the only trial to adjudicate CV AEs, only MIs and CV deaths from FIT are summarized. An analysis of the adjudicated results of all FIT SAEs attributed to coronary heart disease (CHD) in the combined cohort did not demonstrate a significant increase in risk of MI with alendronate compared with placebo (1.4% vs. 1.1%, RR 1.28, 95% CI = 0.82, 2.00). All CV deaths that occurred during FIT, as well as all deaths reported with the term “sudden death,” were included in the adjudication. There were 23 CV deaths in the placebo group and 28 in the alendronate group [RR = 1.22 (95% CI = 0.68, 2.21), p = 0.578 for alendronate vs.