Effect of atrial fibrillation on the incidence and outcome of osteoporotic fracture ― A nationwide population-based study ―
- 주제(키워드) Atrial fibrillation , Death , Fractures , General population , Osteoporosis
- 후원정보 Ministry of Education, Science and Technology
- 등재 SCIE, SCOPUS
- 발행기관 Japanese Circulation Society
- 발행년도 2018
- URI http://www.dcollection.net/handler/ewha/000000156729
- 본문언어 영어
- Published As http://dx.doi.org/10.1253/circj.CJ-17-1179
초록/요약
Background: Both atrial fibrillation (AF) and osteoporosis are common in older adults. The purpose of this study was to investigate whether comorbid AF in patients with osteoporosis is associated with fracture incidence, or death after fracture. Methods and Results: From the National Health Insurance Service database of Korea, we selected 31,778 patients with osteoporosis. During a median follow-up of 48 months, the incidence of bone fractures was higher in AF patients than in non-AF patients (3.20 vs. 2.18 per 100 person-years), respectively. In the multivariate Cox regression analysis, AF was associated with fracture independently of other risk factors with an adjusted hazard ratio (HR) of 1.21 (95% confidence interval [CI], 1.02–1.41; P=0.031). The mortality rate after fracture was significantly higher in AF patients than it was in non-AF patients (adjusted HR, 1.92; 95% CI, 1.35–3.27; P=0.016). After propensity score-matching, AF was consistently associated with a higher risk of osteoporotic fracture and subsequent death after fracture. In AF patients, older age, female sex, being underweight (body mass index <18.5 kg/m2), decreased physical activity (exercise <3 times/week), history of stroke or transient ischemic attack, thiazide use, sedative use, and higher CHADS2 (≥2 points) or CHA2DS2-VASc (≥2 points) scores were associated with the incidence of fractures. Conclusions: Comorbid AF in patients with osteoporosis was associated with an increased risk of bone fracture and death after fracture. © 2018, Japanese Circulation Society. All rights reserved.
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