Key result
AF shows no significant link to osteoporotic fracture risk overall.
Why the study?
It remains unclear whether atrial fibrillation increases the risk of osteoporotic fractures, despite links between cardiovascular diseases and fracture risk.
Meta-Analysis (n=187,868)
Objectives Falls among the elderly often occur in the community. The elderly with osteoporosis frequently induces fractures after falls. The incidence of osteoporotic fractures is high, and the prognosis is poor, which warrants attention. This is particularly crucial for community primary health care providers, as they need to identify the risk factors contributing to increased osteoporotic fractures. Several cardiovascular diseases have been linked to an elevated risk of bone fractures. However, it remains unclear whether atrial fibrillation increases the risk of bone fracture. To address this, we conducted a systematic review and meta-analysis of relevant studies to quantify the magnitude of the association between atrial fibrillation and the incidence of osteoporotic fractures. Methods PubMed/MEDLINE, EMBASE and Cochrane Library were searched for relevant studies from January 1st 2000 to March 10th 2022. Observational studies which compared the association of osteoporotic fracture in atrial fibrillation group with non-atrial fibrillation group were included. Results A total of 5 cohort studies with 187868 participants met all the eligibility criteria for our study. 835 people suffered a fracture in atrial fibrillation group and 6512 in non-atrial fibrillation group. The overall risk of osteoporotic fractures was non-statistically higher in patients with 5.4% (835/15395) in atrial fibrillation group and 3.8% (6512/172473) in non-atrial fibrillation group. Analysis of included studies observed non-significant association between atrial fibrillation and osteoporotic fractures (odds ratio (OR)=1.17, 95% confidence intervals (CIs)=0.60-2.29). 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), whereas Caucasian population with atrial fibrillation suggested a negative result. (OR=0.94, 95%CI=0.24-3.59). Conclusions The association between atrial fibrillation and an increased risk of fracture may be related to race. Asians with atrial fibrillation have been found to be more prone to fractures, whereas the risk remains insignificant in the Caucasian population. It is important to note that the number of studies included in this article is limited. Therefore, further research and additional data are needed to fully support the results of our study. Keywords atrial fibrillation; osteoporotic fracture; risk factor; cohort study; meta-analysis
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Chen et al. (2023) conducted a meta-analysis in Osteoporotic fracture (n=187,868). Atrial fibrillation vs. Non-atrial fibrillation group was evaluated on Incidence of osteoporotic fractures (OR 1.17, 95% CI 0.60-2.29). Atrial fibrillation was not significantly associated with an increased risk of osteoporotic fractures overall (OR 1.17), though subgroup analysis found a 61% increased risk in Asian populations.
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