Evidence mapPaperPMID 29133976Full record

SynthesisClinical interventions in aging2017

Bisphosphonates, atherosclerosis and vascular calcification: update and systematic review of clinical studies.

Carla Caffarelli, Andrea Montagnani, Ranuccio Nuti, Stefano Gonnelli

Open access · goldAbstract readSystematic Review
In one paragraph

Synthesis in Clinical interventions in aging, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 37 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
37citing papers in PubMed, 3 pooled it
3.7field-weighted citation impact, top 5% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

37 citing papers in PubMed, 3 syntheses or guidelines pooled it, 83 citations in OpenAlex.

  1. Effect of osteoporosis medications on vascular and valvular calcification: a systematic review and meta-analysis.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2025
    Pooled it
  2. Pooled it
  3. Association between bisphosphonate use and stroke risk: a meta-analysis.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2023
    Pooled it
  4. Trial
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  6. Article
  7. Review
  8. Review
  9. Review
  10. Review
  11. From Bone Health to Lifespan: Pleiotropic Effects of Antiresorptive Agents.Endocrinology and metabolism (Seoul, Korea) · 2025
    Review
  12. Article
  13. Review
  14. Frontiers in cardiovascular medicine · 2025
    Article
  15. Quantitative aortic Na[European journal of nuclear medicine and molecular imaging · 2025
    Article
  16. Review
  17. Review
  18. Article
  19. Article
  20. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors at 2 institutions in 1 country.

Carla CaffarelliDepartment of Medicine, Surgery and Neuroscience, University of Siena, Italy.
Andrea MontagnaniDivision of Internal Medicine, General Hospital Misericordia, Grosseto, Italy.
Ranuccio NutiDepartment of Medicine, Surgery and Neuroscience, University of Siena, Italy.
Stefano GonnelliDepartment of Medicine, Surgery and Neuroscience, University of Siena, Italy.
University of Siena · ITOspedale Misericordia - Grosseto · IT

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundEpidemiologic and clinical data have suggested the existence of a biologic linkage between the bone system and the vascular system. Bisphosphonates (BPs) are effective inhibitors of bone resorption and are currently considered the drugs of choice for the prevention and treatment of osteoporosis and related fractures. Data from several publications have suggested that BPs may also be effective in reducing the atherosclerotic process and vascular calcification, but the results of these studies are contrasting. This review aimed to allow a better understanding of the relationships between BPs and atherosclerosis in humans. MATERIALS AND

methodsElectronic databases of Pubmed-Medline, Cochrane Library and SCOPUS from inception to June 30, 2016 were searched. The full texts of the articles potentially eligible were carefully assessed and reviewed. Finally, 20 studies were found to be eligible and were included in the systematic review. All included studies were published between 2000 and 2014.

resultsIn several studies, etidronate limited the progression of aortic and coronary calcification in hemodialysis patients, whereas the nitrogen-containing-BPs given orally did not significantly reduce vascular calcifications in patients with chronic kidney disease, kidney trasplant or in those with osteoporosis. Nitrogen-containing-BPs present favorable effects both on vessel wall thickness and on arterial elasticity due to both a reduction in serum lipids and the interaction of BPs with the bone tissue, with the consequent release of bone turnover markers and cytokines into the bloodstream.

conclusionTo sum up, the BPs seem to have the potential of influencing atherosclerosis and calcium homeostasis at the level of vascular walls with several possible mechanisms which may differ according to the type, potency, dosage and administration route of BPs. Additional studies are needed to specifically address the mechanism by which BP use could influence cardiovascular morbidity and mortality.

Indexed as

AtherosclerosisBone and BonesBone Density Conservation AgentsDiphosphonatesHumansOsteoporosisVascular CalcificationBone Density Conservation AgentsDiphosphonatesatherosclerosisbisphosphonateshuman studiesvascular calcification

Identifiers

PMID29133976
PMCPMC5669782
OpenAlexW2766624685

What Socratic holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.