The paper reports that new users of chondroitin sulfate have a substantially lower risk of acute myocardial infarction (heart attack), while glucosamine use shows no clear effect on heart attack risk.[1]

Study goal and design

The authors aimed to test whether starting chondroitin sulfate (CS) or glucosamine is associated with a change in risk of acute myocardial infarction (AMI). They used a nested case-control design within a large Spanish primary care database (BIFAP), including adults aged 40–99 from 2002–2015. For each of 23,585 incident AMI cases, five controls were matched on age, sex, and index date, and adjusted odds ratios were estimated using conditional logistic regression, considering only new users of CS or glucosamine.[1]

Main results for chondroitin

Among cases and controls, 0.38% and 0.64% were current CS users, respectively, corresponding to an adjusted odds ratio of 0.57, indicating about a 43% lower AMI risk in current CS users. This apparent protective association was seen in short-term users (<365 days) and long-term users (>364 days), in both men and women, in people younger and older than 70, and particularly in those with intermediate or high baseline cardiovascular risk, but not in those at low risk.[1]

Findings for glucosamine

For glucosamine, current use was not meaningfully associated with AMI risk, with an adjusted odds ratio of 0.86 and confidence intervals including no effect. Thus, in contrast to CS, glucosamine appeared cardiologically neutral in this dataset.[1]

Authors’ conclusion and implications

The authors conclude that their results support a cardioprotective effect of chondroitin sulfate against acute myocardial infarction, especially in individuals with higher cardiovascular risk. They emphasize that glucosamine does not seem to increase or decrease AMI risk, and that these findings come from observational data, not a randomized trial, so causality cannot be firmly established.[1]

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