Key result
Atrial fibrillation was not significantly associated with an increased overall risk of fractures compared to non-atrial fibrillation (OR 1.17), although subgroup analysis indicated a higher risk in Asian populations.
Why the study?
Patients with fractures often have concomitant atrial fibrillation, but whether atrial fibrillation increases the risk of bone fracture remains unclear.
Does atrial fibrillation increase the risk of fractures in adult patients?
Systematic Review (n=187,868)
Does atrial fibrillation increase the risk of fractures in adult patients?
Atrial fibrillation is associated with a significantly higher risk of fractures in Asian populations, highlighting the need for fall and fracture prevention strategies in this specific demographic, despite a non-significant association in the overall population.
No significant AF-fracture link in meta-analysis; leaves open need for prospective confirmation in high-risk subgroups.
Objectives We have observed in clinical practice that patients with fractures often have concomitant atrial fibrillation. However, it remains unclear whether atrial fibrillation increases the risk of bone fracture. A meta-analysis was performed to investigate the association between atrial fibrillation and fracture. Methods PubMed and Cochrane Library were searched for relevant studies from 1 January 1943 to 31 December 2024 that compared the prevalence of fracture in atrial fibrillation group with non-atrial fibrillation group. Results A total of five cohort studies with 187,868 participants met all the eligibility criteria for our study. A total of 835 people suffered a fracture in atrial fibrillation group and 6,512 in non-atrial fibrillation group. The overall risk of fractures was non-statistically higher in patients with 5.4% (835/15,395) in atrial fibrillation group and 3.8% (6,512/172,473) in non-atrial fibrillation group. Analysis of included studies observed non-significant association between atrial fibrillation and fractures [odds ratio (OR) = 1.17, 95% confidence interval (CI) = 0.60–2.29, P = 0.65]. However, subgroup analysis displayed that Asian population with atrial fibrillation had a higher risk of fracture (OR = 1.61, 95% CI = 1.38–1.87, P < 0.00001), whereas no similar outcomes were seen in Caucasian population (OR = 0.94, 95% CI = 0.24–3.59, P = 0.92). Conclusion The evidence indicated that Asians with atrial fibrillation were more prone to fractures. Systematic review registration https://www.crd.york.ac.uk/PROSPERO/myprospero , identifier CRD42018107794.
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Chen et al. (2025) conducted a systematic review in Atrial fibrillation (n=187,868). Atrial fibrillation vs. Non-atrial fibrillation was evaluated on Composite fracture risk (any fracture site) (OR 1.17, 95% CI 0.60-2.29, p=0.65). Atrial fibrillation was not significantly associated with an increased overall risk of fractures compared to non-atrial fibrillation (OR 1.17), although subgroup analysis indicated a higher risk in Asian populations.
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