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Effect of Atrial Fibrillation on the Incidence and Outcome of Osteoporotic Fracture - A Nationwide Population-Based Study.

Authors
 Daehoon Kim  ;  Pil-Sung Yang  ;  Tae-Hoon Kim  ;  Jae-Sun Uhm  ;  Junbeom Park  ;  Hui-Nam Pak  ;  Moon-Hyoung Lee  ;  Boyoung Joung 
Citation
 CIRCULATION JOURNAL, Vol.82(8) : 1999-2006, 2018 
Journal Title
 CIRCULATION JOURNAL 
ISSN
 1346-9843 
Issue Date
2018
Keywords
Atrial fibrillation ; Death ; Fractures ; General population ; Osteoporosis
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.
Files in This Item:
T201802549.pdf Download
DOI
10.1253/circj.CJ-17-1179
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Tae-Hoon(김태훈) ORCID logo https://orcid.org/0000-0003-4200-3456
Pak, Hui Nam(박희남) ORCID logo https://orcid.org/0000-0002-3256-3620
Yang, Pil Sung(양필성)
Uhm, Jae Sun(엄재선) ORCID logo https://orcid.org/0000-0002-1611-8172
Lee, Moon Hyoung(이문형) ORCID logo https://orcid.org/0000-0002-7268-0741
Joung, Bo Young(정보영) ORCID logo https://orcid.org/0000-0001-9036-7225
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/163208
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