Atrial fibrillation and the risk of bone fractures: A meta-analysis of prospective cohort studies

BACKGROUND: Some observational studies have suggested that atrial fibrillation (AF) might be associated with an increased risk of bone fracture, but the results remain inconsistent. Therefore, we aimed to evaluate the relationship between them by performing a meta-analysis of prospective cohort studies. METHODS: We identified relevant studies through PubMed and Embase databases up to the end of October 2023. Study characteristics and outcomes were abstracted for each included study. Pooled relative risks (RRs) and 95% confidence intervals (CIs) for associations of AF with fracture risk were calculated with fixed- or random-effects models. RESULTS: Six prospective cohort studies were finally included in the analysis. The pooled RRs of any type of fractures for AF were 1.53 (95% CI: 1.26-1.86, P = .026) with substantial heterogeneity (I2 = 87.9%, P = .000). For the specific type of fracture, a statistically significant association of AF with hip fracture was found (RR = 1.71, 95% CI: 1.25-2.34, P = .001, n = 5). No evidence of publication bias was observed. CONCLUSION: Our results demonstrated that AF was significantly and independently associated with a higher risk of bone fracture, especially for hip fracture.