Table 1 Open in new tab Summary of...

Study (year), country	Cohort (sex, diagnosis, mean age [years] [±SD])	Total population (n)	Bisphosphonate	Dose	Electrolytes reported (before/after infusion)	Inclusion (I)/exclusion (E) criteria
Zhuang et al. (2021), China	100% women, OP, 69.6 ± 9.5	116	ZA	5 mg	Yes/no	I: primary osteoporosis, aged ≥50 years E: secondary osteoporosis, bone metastases, severe arrhythmias, antiarrhythmic therapy, severe ischemic heart disease
Aktas et al. (2016), Turkey	91% women, OP, 70.5 ± 11.6	100	ZA	N/A	Yes/no	I: N/A E: chronic AF, valvular heart disease, chronic renal failure, serious electrolyte imbalance, thyroid disease, antiarrhythmic therapy, previous IV bisphosphonate therapy, oral bisphosphonates within past 3 months
Güzelant et al. (2016), Turkey	100% women, OP, 73.3 ± 6.9	33	ZA	5 mg	Yes/yes	I: osteoporosis, aged ≥65 years E: male, history of treatment with bisphosphonate, cardiac pathology, undefinable P waves in baseline ECG, primary biliary cirrhosis, renal pathology, anemia
Cipriani et al. (2015), Italy	100% women, OP or fragility fractures, 70.7 ± 6.9	15	ZA	5 mg	Yes/yes	I: osteoporosis, fragility fractures E: history of paroxysmal or permanent AF, left bundle branch block, pacemakers, ventricular pre‐excitation, hypertrophic cardiomyopathy, severe valvular disease
Rothenbuhler et al. (2010), France	50% girls, children with OP secondary to cerebral palsy, 13.0 (9.0–15.7)	34	Pamidronate	3 mg/kg/year	Yes/yes	N/A
Demirtas et al. (2017), Turkey	57% women, cancer with new bone metastases, 53.70 ± 14.1	37	ZA	N/A	Yes/no	I: diagnosis of cancer and new bone metastases E: malignant hypercalcemia requiring dialysis, hyperkalemia, previous antiarrhythmic or antihypertensive therapy, uncontrolled diabetes mellitus, ischemic heart disease.

Study (year), country

Cohort (sex, diagnosis, mean age [years] [±SD])

Total population (n)

Bisphosphonate

Dose

Electrolytes reported (before/after infusion)

Inclusion (I)/exclusion (E) criteria

Zhuang et al. (2021), China

100% women, OP, 69.6 ± 9.5

116

5 mg

Yes/no

I: primary osteoporosis, aged ≥50 years
E: secondary osteoporosis, bone metastases, severe arrhythmias, antiarrhythmic therapy, severe ischemic heart disease

Aktas et al. (2016), Turkey

91% women, OP, 70.5 ± 11.6

100

N/A

Yes/no

I: N/A
E: chronic AF, valvular heart disease, chronic renal failure, serious electrolyte imbalance, thyroid disease, antiarrhythmic therapy, previous IV bisphosphonate therapy, oral bisphosphonates within past 3 months

Güzelant et al. (2016), Turkey

100% women, OP, 73.3 ± 6.9

5 mg

Yes/yes

I: osteoporosis, aged ≥65 years
E: male, history of treatment with bisphosphonate, cardiac pathology, undefinable P waves in baseline ECG, primary biliary cirrhosis, renal pathology, anemia

Cipriani et al. (2015), Italy

100% women, OP or fragility fractures, 70.7 ± 6.9

5 mg

Yes/yes

I: osteoporosis, fragility fractures
E: history of paroxysmal or permanent AF, left bundle branch block, pacemakers, ventricular pre‐excitation, hypertrophic cardiomyopathy, severe valvular disease

Rothenbuhler et al. (2010), France

50% girls, children with OP secondary to cerebral palsy, 13.0 (9.0–15.7)

Pamidronate

3 mg/kg/year

Yes/yes

N/A

Demirtas et al. (2017), Turkey

57% women, cancer with new bone metastases, 53.70 ± 14.1

N/A

Yes/no

I: diagnosis of cancer and new bone metastases
E: malignant hypercalcemia requiring dialysis, hyperkalemia, previous antiarrhythmic or antihypertensive therapy, uncontrolled diabetes mellitus, ischemic heart disease.

Study (year), country	Cohort (sex, diagnosis, mean age [years] [±SD])	Total population (n)	Bisphosphonate	Dose	Electrolytes reported (before/after infusion)	Inclusion (I)/exclusion (E) criteria
Zhuang et al. (2021), China	100% women, OP, 69.6 ± 9.5	116	ZA	5 mg	Yes/no	I: primary osteoporosis, aged ≥50 years E: secondary osteoporosis, bone metastases, severe arrhythmias, antiarrhythmic therapy, severe ischemic heart disease
Aktas et al. (2016), Turkey	91% women, OP, 70.5 ± 11.6	100	ZA	N/A	Yes/no	I: N/A E: chronic AF, valvular heart disease, chronic renal failure, serious electrolyte imbalance, thyroid disease, antiarrhythmic therapy, previous IV bisphosphonate therapy, oral bisphosphonates within past 3 months
Güzelant et al. (2016), Turkey	100% women, OP, 73.3 ± 6.9	33	ZA	5 mg	Yes/yes	I: osteoporosis, aged ≥65 years E: male, history of treatment with bisphosphonate, cardiac pathology, undefinable P waves in baseline ECG, primary biliary cirrhosis, renal pathology, anemia
Cipriani et al. (2015), Italy	100% women, OP or fragility fractures, 70.7 ± 6.9	15	ZA	5 mg	Yes/yes	I: osteoporosis, fragility fractures E: history of paroxysmal or permanent AF, left bundle branch block, pacemakers, ventricular pre‐excitation, hypertrophic cardiomyopathy, severe valvular disease
Rothenbuhler et al. (2010), France	50% girls, children with OP secondary to cerebral palsy, 13.0 (9.0–15.7)	34	Pamidronate	3 mg/kg/year	Yes/yes	N/A
Demirtas et al. (2017), Turkey	57% women, cancer with new bone metastases, 53.70 ± 14.1	37	ZA	N/A	Yes/no	I: diagnosis of cancer and new bone metastases E: malignant hypercalcemia requiring dialysis, hyperkalemia, previous antiarrhythmic or antihypertensive therapy, uncontrolled diabetes mellitus, ischemic heart disease.

Table 1

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Summary of Prospective Cohort Studies Included in Meta‐Analysis

Study (year), country	Cohort (sex, diagnosis, mean age [years] [±SD])	Total population (n)	Bisphosphonate	Dose	Electrolytes reported (before/after infusion)	Inclusion (I)/exclusion (E) criteria
Zhuang et al. (2021), China	100% women, OP, 69.6 ± 9.5	116	ZA	5 mg	Yes/no	I: primary osteoporosis, aged ≥50 years E: secondary osteoporosis, bone metastases, severe arrhythmias, antiarrhythmic therapy, severe ischemic heart disease
Aktas et al. (2016), Turkey	91% women, OP, 70.5 ± 11.6	100	ZA	N/A	Yes/no	I: N/A E: chronic AF, valvular heart disease, chronic renal failure, serious electrolyte imbalance, thyroid disease, antiarrhythmic therapy, previous IV bisphosphonate therapy, oral bisphosphonates within past 3 months
Güzelant et al. (2016), Turkey	100% women, OP, 73.3 ± 6.9	33	ZA	5 mg	Yes/yes	I: osteoporosis, aged ≥65 years E: male, history of treatment with bisphosphonate, cardiac pathology, undefinable P waves in baseline ECG, primary biliary cirrhosis, renal pathology, anemia
Cipriani et al. (2015), Italy	100% women, OP or fragility fractures, 70.7 ± 6.9	15	ZA	5 mg	Yes/yes	I: osteoporosis, fragility fractures E: history of paroxysmal or permanent AF, left bundle branch block, pacemakers, ventricular pre‐excitation, hypertrophic cardiomyopathy, severe valvular disease
Rothenbuhler et al. (2010), France	50% girls, children with OP secondary to cerebral palsy, 13.0 (9.0–15.7)	34	Pamidronate	3 mg/kg/year	Yes/yes	N/A
Demirtas et al. (2017), Turkey	57% women, cancer with new bone metastases, 53.70 ± 14.1	37	ZA	N/A	Yes/no	I: diagnosis of cancer and new bone metastases E: malignant hypercalcemia requiring dialysis, hyperkalemia, previous antiarrhythmic or antihypertensive therapy, uncontrolled diabetes mellitus, ischemic heart disease.

Study (year), country	Cohort (sex, diagnosis, mean age [years] [±SD])	Total population (n)	Bisphosphonate	Dose	Electrolytes reported (before/after infusion)	Inclusion (I)/exclusion (E) criteria
Zhuang et al. (2021), China	100% women, OP, 69.6 ± 9.5	116	ZA	5 mg	Yes/no	I: primary osteoporosis, aged ≥50 years E: secondary osteoporosis, bone metastases, severe arrhythmias, antiarrhythmic therapy, severe ischemic heart disease
Aktas et al. (2016), Turkey	91% women, OP, 70.5 ± 11.6	100	ZA	N/A	Yes/no	I: N/A E: chronic AF, valvular heart disease, chronic renal failure, serious electrolyte imbalance, thyroid disease, antiarrhythmic therapy, previous IV bisphosphonate therapy, oral bisphosphonates within past 3 months
Güzelant et al. (2016), Turkey	100% women, OP, 73.3 ± 6.9	33	ZA	5 mg	Yes/yes	I: osteoporosis, aged ≥65 years E: male, history of treatment with bisphosphonate, cardiac pathology, undefinable P waves in baseline ECG, primary biliary cirrhosis, renal pathology, anemia
Cipriani et al. (2015), Italy	100% women, OP or fragility fractures, 70.7 ± 6.9	15	ZA	5 mg	Yes/yes	I: osteoporosis, fragility fractures E: history of paroxysmal or permanent AF, left bundle branch block, pacemakers, ventricular pre‐excitation, hypertrophic cardiomyopathy, severe valvular disease
Rothenbuhler et al. (2010), France	50% girls, children with OP secondary to cerebral palsy, 13.0 (9.0–15.7)	34	Pamidronate	3 mg/kg/year	Yes/yes	N/A
Demirtas et al. (2017), Turkey	57% women, cancer with new bone metastases, 53.70 ± 14.1	37	ZA	N/A	Yes/no	I: diagnosis of cancer and new bone metastases E: malignant hypercalcemia requiring dialysis, hyperkalemia, previous antiarrhythmic or antihypertensive therapy, uncontrolled diabetes mellitus, ischemic heart disease.

Abbreviations: AF = atrial fibrillation; OP = osteoporosis; ZA = zoledronic acid.

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