Cardiovascular risk is increased in patients with Paget's disease of bone: Insights from the CARTaGENE cohort.

INTRODUCTION

We aimed to assess whether Paget's disease of bone (PD) increases the risk of major adverse cardiovascular events (MACE) and arterial stiffness in middle-aged men and women.

METHODS

We analyzed data from the CARTaGENE cohort, including individuals aged 40-69 years, recruited in the province of Quebec, Canada in 2009/2010, linked to healthcare administrative databases to identify PD and MACE (both before and after recruitment, 1997-2021). Comorbidities and arterial stiffness parameters (augmentation index, estimated pulse wave velocity) were measured at recruitment. Cardiovascular risk factors were compared in an age-standardized population. MACE was defined as 3-component (myocardial infarction, stroke, cardiovascular death) or 5- component (3-point + heart failure, unstable angina) variables. Time-to-event analyses (from birth) used Cox and Fine-Gray models in a 1:3 propensity-score matched population, and associations with arterial stiffness were tested with linear and logistic regressions.

RESULTS

Among 19,990 participants, 101 (0.5%) had PD. PD participants were older (57.5 ± 7.7 vs 54.2 ± 7.9 years) and had a higher prevalence of diabetes (22.4% vs 9.9%) than participants without PD. Ten (10%) MACE-3 and 15 (15%) MACE-5 occurred in the PD group versus 18 (6%) and 24 (8%) in the matched sample (n = 303). Hazard ratios were 1.86 (95%CI 0.80-4.34) for MACE-3 and 2.06 (95%CI 1.06-4.04) for MACE-5. Competing risk models yielded similar results. No significant associations were observed with arterial stiffness parameters.

CONCLUSION

PD was associated with an independently increased risk of MACE, but not with arterial stiffness.