{"id":"f63ae468-4b16-5c25-a59f-aa4bcacd0b64","stable_key":"1ff3a29f-ef80-5bff-9300-30b98c60b90d:strontium-cardiovascular-death","predicate":"has_comparator_dependent_association","statement":"Cardiovascular-death odds were higher for current ranelate versus current bisphosphonate use, OR 1.35 (1.02–1.80), but lower for current versus past ranelate use, OR 0.68 (0.48–0.96).","claim_class":"observational","status":"source_derived_draft","evidence_grade":"ungraded","direction":"context_dependent","is_public":true,"mechanism_event_id":"2af96815-d0b3-5838-b022-12fac21ea97a","mechanism_event_label":"Changing the comparison changed the association.","subject":{"id":"a319eca8-b0ed-5a8c-8659-e7f106bed73a","slug":"strontium-ranelate","display_name":"Strontium ranelate","entity_type_key":"chemical_species"},"object":{"id":"c02f5b77-ab2c-5823-98ab-b08257627a26","slug":"human-ranelate-cardiovascular-death","display_name":"Cardiovascular death in ranelate observational cohorts","entity_type_key":"cellular_process"},"evidence_count":1,"mechanism_event":{"id":"2af96815-d0b3-5838-b022-12fac21ea97a","stable_key":"1ff3a29f-ef80-5bff-9300-30b98c60b90d:strontium-cardiovascular-death-event","event_type":"observed_relationship","label":"Changing the comparison changed the association.","description":"Cardiovascular-death odds were higher for current ranelate versus current bisphosphonate use, OR 1.35 (1.02–1.80), but lower for current versus past ranelate use, OR 0.68 (0.48–0.96).","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":"c02f5b77-ab2c-5823-98ab-b08257627a26","slug":"human-ranelate-cardiovascular-death","display_name":"Cardiovascular death 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":"Same healthcare-database study.","comparator":null,"unit":null,"notes":"","entity":null},{"dimension":"limitations","value_text":"Authors discuss treatment cessation near end of life and residual confounding; this is not a demonstrated biological reversal or a draft conflict.","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":"Changing the comparison changed the association.","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":"2754dec4-fa69-5792-8072-1ec6da2d9a2d","evidence_kind":"source_excerpt","locator":"Lines 454-460","start_line":454,"end_line":460,"excerpt":"## strontium-cardiovascular-death\nChanging the comparison changed the association.\nCardiovascular-death odds were higher for current ranelate versus current bisphosphonate use, OR 1.35 (1.02–1.80), but lower for current versus past ranelate use, OR 0.68 (0.48–0.96).\nModel: Same healthcare-database study.\nLimitations: Authors discuss treatment cessation near end of life and residual confounding; this is not a demonstrated biological reversal or a draft conflict.\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":"Same healthcare-database study.","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. Not publisher full text.","file_path":"","sha256":"51221949263cdf8a22a79c32e3989599de1a37dc215700e0a076f436b40a1005","revision_id":"84f6df49-c456-5ad2-8214-cc69d5dc7722","review_status":"unverified_draft","notes":""}}],"relations":[],"conflicts":[],"corrections":[],"research":null}