Incident atrial fibrillation and the risk of fracture in the cardiovascular health study

E. R. Wallace; D. S. Siscovick; C. M. Sitlani; S. Dublin; P. Mitchell; J. A. Robbins; H. A. Fink; J. A. Cauley; P. Bůžková; Laura D Carbone; Z. Chen; S. R. Heckbert

doi:10.1007/s00198-016-3778-1

Incident atrial fibrillation and the risk of fracture in the cardiovascular health study

E. R. Wallace, D. S. Siscovick, C. M. Sitlani, S. Dublin, P. Mitchell, J. A. Robbins, H. A. Fink, J. A. Cauley, P. Bůžková, Laura D Carbone, Z. Chen, S. R. Heckbert

Rheumatology

Research output: Contribution to journal › Article › peer-review

8 Scopus citations

Abstract

Summary: In this prospective cohort of 4462 older adults, incident atrial fibrillation (AF) was not statistically significantly associated with subsequent risk of incident fracture. Introduction: AF is associated with stroke, heart failure, dementia, and death, but its association with fracture is unknown. Therefore, we examined the association of incident AF with the risk of subsequent fracture in the Cardiovascular Health Study (CHS) cohort. Methods: Of the CHS participants aged ≥65 years, 4462 were followed between 1991 and 2009, mean follow-up 8.8 years. Incident AF was identified by annual study electrocardiogram (ECG), hospital discharge diagnosis codes, or Medicare claims. Fractures of the hip, distal forearm, humerus, or pelvis were identified using hospital discharge diagnosis codes or Medicare claims. We used Cox proportional hazard models to estimate hazard ratios (HRs) and 95 % confidence intervals (CIs) for the association between incident AF (time-varying) and the risk of subsequent fracture. We also evaluated whether AF was associated with risk of sustaining a fall. Results: Crude incident fracture rate was 22.9 per 1000 person-years in participants with AF and 17.7 per 1000 person-years in participants without AF. Individuals with incident AF were not at significantly higher risk of hip fracture (adjusted HR = 1.09, 95 % CI 0.83–1.42) or fracture at any selected site (adjusted HR = 0.97, 95 % CI 0.77–1.22) or risk of sustaining a fall (adjusted HR = 1.00, 95 % CI = 0.87–1.16) compared with those without AF. Conclusion: In this cohort of older, community-dwelling adults, incident AF was not shown to be associated with falls or hip or other fractures.

Original language	English (US)
Pages (from-to)	719-725
Number of pages	7
Journal	Osteoporosis International
Volume	28
Issue number	2
DOIs	https://doi.org/10.1007/s00198-016-3778-1
State	Published - Feb 1 2017

Keywords

Arrhythmia
Atrial fibrillation
Fracture
Hip fracture

ASJC Scopus subject areas

Endocrinology, Diabetes and Metabolism

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1007/s00198-016-3778-1

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@article{e0fc215cc85f4129ab6c96cd518f229e,

title = "Incident atrial fibrillation and the risk of fracture in the cardiovascular health study",

abstract = "Summary: In this prospective cohort of 4462 older adults, incident atrial fibrillation (AF) was not statistically significantly associated with subsequent risk of incident fracture. Introduction: AF is associated with stroke, heart failure, dementia, and death, but its association with fracture is unknown. Therefore, we examined the association of incident AF with the risk of subsequent fracture in the Cardiovascular Health Study (CHS) cohort. Methods: Of the CHS participants aged ≥65 years, 4462 were followed between 1991 and 2009, mean follow-up 8.8 years. Incident AF was identified by annual study electrocardiogram (ECG), hospital discharge diagnosis codes, or Medicare claims. Fractures of the hip, distal forearm, humerus, or pelvis were identified using hospital discharge diagnosis codes or Medicare claims. We used Cox proportional hazard models to estimate hazard ratios (HRs) and 95 % confidence intervals (CIs) for the association between incident AF (time-varying) and the risk of subsequent fracture. We also evaluated whether AF was associated with risk of sustaining a fall. Results: Crude incident fracture rate was 22.9 per 1000 person-years in participants with AF and 17.7 per 1000 person-years in participants without AF. Individuals with incident AF were not at significantly higher risk of hip fracture (adjusted HR = 1.09, 95 % CI 0.83–1.42) or fracture at any selected site (adjusted HR = 0.97, 95 % CI 0.77–1.22) or risk of sustaining a fall (adjusted HR = 1.00, 95 % CI = 0.87–1.16) compared with those without AF. Conclusion: In this cohort of older, community-dwelling adults, incident AF was not shown to be associated with falls or hip or other fractures.",

keywords = "Arrhythmia, Atrial fibrillation, Fracture, Hip fracture",

author = "Wallace, {E. R.} and Siscovick, {D. S.} and Sitlani, {C. M.} and S. Dublin and P. Mitchell and Robbins, {J. A.} and Fink, {H. A.} and Cauley, {J. A.} and P. Bů{\v z}kov{\'a} and Carbone, {Laura D} and Z. Chen and Heckbert, {S. R.}",

note = "Funding Information: This research was supported by contracts HHSN268201200036C, HHSN268200800007C, N01 HC55222, N01HC85079, N01HC85080, N01HC85081, N01HC85082, N01HC85083, and N01HC85086 and grants HL080295 and HL102214 from the National Heart, Lung, and Blood Institute (NHLBI), with additional contribution from the National Institute of Neurological Disorders and Stroke (NINDS). Additional support was provided by AG023629 from the National Institute on Aging (NIA). A full list of principal CHS investigators and institutions can be found at CHS-NHLBI.org . Erin Wallace was supported by a NHLBI I-T32-HL07902 training grant. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. Publisher Copyright: {\textcopyright} 2016, International Osteoporosis Foundation and National Osteoporosis Foundation.",

year = "2017",

month = feb,

day = "1",

doi = "10.1007/s00198-016-3778-1",

language = "English (US)",

volume = "28",

pages = "719--725",

journal = "Osteoporosis International",

issn = "0937-941X",

publisher = "Springer London",

number = "2",

}

TY - JOUR

T1 - Incident atrial fibrillation and the risk of fracture in the cardiovascular health study

AU - Wallace, E. R.

AU - Siscovick, D. S.

AU - Sitlani, C. M.

AU - Dublin, S.

AU - Mitchell, P.

AU - Robbins, J. A.

AU - Fink, H. A.

AU - Cauley, J. A.

AU - Bůžková, P.

AU - Carbone, Laura D

AU - Chen, Z.

AU - Heckbert, S. R.

N1 - Funding Information: This research was supported by contracts HHSN268201200036C, HHSN268200800007C, N01 HC55222, N01HC85079, N01HC85080, N01HC85081, N01HC85082, N01HC85083, and N01HC85086 and grants HL080295 and HL102214 from the National Heart, Lung, and Blood Institute (NHLBI), with additional contribution from the National Institute of Neurological Disorders and Stroke (NINDS). Additional support was provided by AG023629 from the National Institute on Aging (NIA). A full list of principal CHS investigators and institutions can be found at CHS-NHLBI.org . Erin Wallace was supported by a NHLBI I-T32-HL07902 training grant. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. Publisher Copyright: © 2016, International Osteoporosis Foundation and National Osteoporosis Foundation.

PY - 2017/2/1

Y1 - 2017/2/1

N2 - Summary: In this prospective cohort of 4462 older adults, incident atrial fibrillation (AF) was not statistically significantly associated with subsequent risk of incident fracture. Introduction: AF is associated with stroke, heart failure, dementia, and death, but its association with fracture is unknown. Therefore, we examined the association of incident AF with the risk of subsequent fracture in the Cardiovascular Health Study (CHS) cohort. Methods: Of the CHS participants aged ≥65 years, 4462 were followed between 1991 and 2009, mean follow-up 8.8 years. Incident AF was identified by annual study electrocardiogram (ECG), hospital discharge diagnosis codes, or Medicare claims. Fractures of the hip, distal forearm, humerus, or pelvis were identified using hospital discharge diagnosis codes or Medicare claims. We used Cox proportional hazard models to estimate hazard ratios (HRs) and 95 % confidence intervals (CIs) for the association between incident AF (time-varying) and the risk of subsequent fracture. We also evaluated whether AF was associated with risk of sustaining a fall. Results: Crude incident fracture rate was 22.9 per 1000 person-years in participants with AF and 17.7 per 1000 person-years in participants without AF. Individuals with incident AF were not at significantly higher risk of hip fracture (adjusted HR = 1.09, 95 % CI 0.83–1.42) or fracture at any selected site (adjusted HR = 0.97, 95 % CI 0.77–1.22) or risk of sustaining a fall (adjusted HR = 1.00, 95 % CI = 0.87–1.16) compared with those without AF. Conclusion: In this cohort of older, community-dwelling adults, incident AF was not shown to be associated with falls or hip or other fractures.

AB - Summary: In this prospective cohort of 4462 older adults, incident atrial fibrillation (AF) was not statistically significantly associated with subsequent risk of incident fracture. Introduction: AF is associated with stroke, heart failure, dementia, and death, but its association with fracture is unknown. Therefore, we examined the association of incident AF with the risk of subsequent fracture in the Cardiovascular Health Study (CHS) cohort. Methods: Of the CHS participants aged ≥65 years, 4462 were followed between 1991 and 2009, mean follow-up 8.8 years. Incident AF was identified by annual study electrocardiogram (ECG), hospital discharge diagnosis codes, or Medicare claims. Fractures of the hip, distal forearm, humerus, or pelvis were identified using hospital discharge diagnosis codes or Medicare claims. We used Cox proportional hazard models to estimate hazard ratios (HRs) and 95 % confidence intervals (CIs) for the association between incident AF (time-varying) and the risk of subsequent fracture. We also evaluated whether AF was associated with risk of sustaining a fall. Results: Crude incident fracture rate was 22.9 per 1000 person-years in participants with AF and 17.7 per 1000 person-years in participants without AF. Individuals with incident AF were not at significantly higher risk of hip fracture (adjusted HR = 1.09, 95 % CI 0.83–1.42) or fracture at any selected site (adjusted HR = 0.97, 95 % CI 0.77–1.22) or risk of sustaining a fall (adjusted HR = 1.00, 95 % CI = 0.87–1.16) compared with those without AF. Conclusion: In this cohort of older, community-dwelling adults, incident AF was not shown to be associated with falls or hip or other fractures.

KW - Arrhythmia

KW - Atrial fibrillation

KW - Fracture

KW - Hip fracture

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U2 - 10.1007/s00198-016-3778-1

DO - 10.1007/s00198-016-3778-1

M3 - Article

C2 - 27714443

AN - SCOPUS:84990855842

SN - 0937-941X

VL - 28

SP - 719

EP - 725

JO - Osteoporosis International

JF - Osteoporosis International

IS - 2

ER -

Incident atrial fibrillation and the risk of fracture in the cardiovascular health study

Abstract

Keywords

ASJC Scopus subject areas

UN SDGs

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