{"id":"642aca88-50b2-52ad-93fa-68c3165b54c1","stable_key":"1ff3a29f-ef80-5bff-9300-30b98c60b90d:strontium-cardiovascular-null-ami","predicate":"not_associated_with_increased","statement":"In a five-country study restricted to patients without ranelate contraindications, current ranelate versus current bisphosphonate use had an acute-MI odds ratio of 0.89, 95% CI 0.70–1.12.","claim_class":"observational","status":"source_derived_draft","evidence_grade":"ungraded","direction":"neutral","is_public":true,"mechanism_event_id":"9ed17af9-b24d-54a3-8338-45d13d8432ad","mechanism_event_label":"This observational comparison did not detect excess myocardial infarction.","subject":{"id":"a319eca8-b0ed-5a8c-8659-e7f106bed73a","slug":"strontium-ranelate","display_name":"Strontium ranelate","entity_type_key":"chemical_species"},"object":{"id":"786c2d86-a0c1-5426-944c-b7442a077381","slug":"human-ranelate-acute-mi","display_name":"Acute myocardial infarction in ranelate observational cohorts","entity_type_key":"cellular_process"},"evidence_count":1,"mechanism_event":{"id":"9ed17af9-b24d-54a3-8338-45d13d8432ad","stable_key":"1ff3a29f-ef80-5bff-9300-30b98c60b90d:strontium-cardiovascular-null-ami-event","event_type":"observed_relationship","label":"This observational comparison did not detect excess myocardial infarction.","description":"In a five-country study restricted to patients without ranelate contraindications, current ranelate versus current bisphosphonate use had an acute-MI odds ratio of 0.89, 95% CI 0.70–1.12.","status":"provisional","compartment":null,"participants":[{"entity":{"id":"a319eca8-b0ed-5a8c-8659-e7f106bed73a","slug":"strontium-ranelate","display_name":"Strontium ranelate","entity_type_key":"chemical_species"},"role":"subject","stoichiometry":null,"state_label":"","sequence_order":0,"notes":""},{"entity":{"id":"786c2d86-a0c1-5426-944c-b7442a077381","slug":"human-ranelate-acute-mi","display_name":"Acute myocardial infarction in ranelate observational cohorts","entity_type_key":"cellular_process"},"role":"target","stoichiometry":null,"state_label":"","sequence_order":1,"notes":""},{"entity":{"id":"2ca2864b-1ef0-54e4-8397-1dbe7207a0d2","slug":"strontium","display_name":"Strontium","entity_type_key":"nutrient_element"},"role":"context_participant","stoichiometry":null,"state_label":"","sequence_order":2,"notes":""}]},"contexts":[{"dimension":"evidence_access","value_text":"Primary abstract","comparator":null,"unit":null,"notes":"","entity":null},{"dimension":"experimental_model","value_text":"Nested case-control studies in healthcare databases.","comparator":null,"unit":null,"notes":"","entity":null},{"dimension":"limitations","value_text":"Selected eligible patients and residual confounding; not proof of cardiovascular safety or a vascular mechanism.","comparator":null,"unit":null,"notes":"","entity":null},{"dimension":"nutrient_topic","value_text":"Strontium collection; molecular form, preparation, species, exposure and manipulation remain explicit.","comparator":null,"unit":null,"notes":"","entity":{"slug":"strontium","display_name":"Strontium","entity_type_key":"nutrient_element"}},{"dimension":"plain_language","value_text":"This observational comparison did not detect excess myocardial infarction.","comparator":null,"unit":null,"notes":"","entity":null},{"dimension":"primary_references","value_text":"Comparative cardiovascular safety of strontium ranelate and bisphosphonates: a multi-database study in 5 EU countries by the EU-ADR Alliance. · 2020 · https://pubmed.ncbi.nlm.nih.gov/32757044/ · DOI 10.1007/s00198-020-05580-0","comparator":null,"unit":null,"notes":"","entity":null}],"evidence":[{"id":"0d654fca-8222-5467-a12c-4672266d82f6","evidence_kind":"source_excerpt","locator":"Lines 438-444","start_line":438,"end_line":444,"excerpt":"## strontium-cardiovascular-null-ami\nThis observational comparison did not detect excess myocardial infarction.\nIn a five-country study restricted to patients without ranelate contraindications, current ranelate versus current bisphosphonate use had an acute-MI odds ratio of 0.89, 95% CI 0.70–1.12.\nModel: Nested case-control studies in healthcare databases.\nLimitations: Selected eligible patients and residual confounding; not proof of cardiovascular safety or a vascular mechanism.\nEvidence access: Primary abstract\nComparative cardiovascular safety of strontium ranelate and bisphosphonates: a multi-database study in 5 EU countries by the EU-ADR Alliance. · 2020 · https://pubmed.ncbi.nlm.nih.gov/32757044/ · DOI 10.1007/s00198-020-05580-0","model_system":"Nested case-control studies in healthcare databases.","directness":"reported_statement","verification_status":"source_derived_draft","notes":"Original curation paraphrase; evidence access and experimental limitations specified.","relationship":"supports","weight":1.0,"link_notes":"","source":{"id":"43ef0fe7-eb6c-5346-8381-f7694733b4dc","stable_key":"import-1ff3a29f-ef80-5bff-9300-30b98c60b90d","title":"Strontium: calcium interactions, cellular mechanisms and mineralization (2026-09-19)","document_type":"imported_text","citation_label":"AI-assisted research curation; primary references, access levels and experimental limitations individually identified. 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