Effect of atrial fibrillation on the incidence and outcome of osteoporotic fracture ― A nationwide population-based study ―

Daehoon Kim, Pil Sung Yang, Tae Hoon Kim, Jae Sun Uhm, Junbeom Park, Hui Nam Pak, Moon Hyoung Lee, Boyoung Joung

Research output: Contribution to journalArticle

Abstract

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.

Original languageEnglish
Pages (from-to)1999-2006
Number of pages8
JournalCirculation Journal
Volume82
Issue number8
DOIs
Publication statusPublished - 2018 Jan 1

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Osteoporotic Fractures
Atrial Fibrillation
Incidence
Population
Osteoporosis
Bone Fractures
National Health Programs
Confidence Intervals
Exercise
Thiazides
Propensity Score
Thinness
Transient Ischemic Attack
Korea
Hypnotics and Sedatives
Body Mass Index
Stroke
Regression Analysis
Databases
Mortality

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine

Cite this

Kim, Daehoon ; Yang, Pil Sung ; Kim, Tae Hoon ; Uhm, Jae Sun ; Park, Junbeom ; Pak, Hui Nam ; Lee, Moon Hyoung ; Joung, Boyoung. / Effect of atrial fibrillation on the incidence and outcome of osteoporotic fracture ― A nationwide population-based study ―. In: Circulation Journal. 2018 ; Vol. 82, No. 8. pp. 1999-2006.
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abstract = "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.",
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Effect of atrial fibrillation on the incidence and outcome of osteoporotic fracture ― A nationwide population-based study ―. / Kim, Daehoon; Yang, Pil Sung; Kim, Tae Hoon; Uhm, Jae Sun; Park, Junbeom; Pak, Hui Nam; Lee, Moon Hyoung; Joung, Boyoung.

In: Circulation Journal, Vol. 82, No. 8, 01.01.2018, p. 1999-2006.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Effect of atrial fibrillation on the incidence and outcome of osteoporotic fracture ― A nationwide population-based study ―

AU - Kim, Daehoon

AU - Yang, Pil Sung

AU - Kim, Tae Hoon

AU - Uhm, Jae Sun

AU - Park, Junbeom

AU - Pak, Hui Nam

AU - Lee, Moon Hyoung

AU - Joung, Boyoung

PY - 2018/1/1

Y1 - 2018/1/1

N2 - 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.

AB - 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.

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U2 - 10.1253/circj.CJ-17-1179

DO - 10.1253/circj.CJ-17-1179

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VL - 82

SP - 1999

EP - 2006

JO - Circulation Journal

JF - Circulation Journal

SN - 1346-9843

IS - 8

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