Abstract 14197: The Impact of Comorbid Atrial Fibrillation on the Incidence and Outcome of Fracture in Patients With Osteoporosis: A Propensity Score Matched Analysis
Introduction: Both atrial fibrillation (AF) and osteoporosis are common in elderly. AF is associated with dizziness, weakness, and decreased cerebral perfusion, and these in turn may increase the likelihood of falls. Oral anticoagulants, used in AF, have also been linked to reduced bone mineral density. However, the associations of comorbid AF with the incidence and outcome of fracture in osteoporotic patients are not well understood.
Hypothesis: We hypothesize that the comorbid AF is associated with the increased risk of facture occurrence and mortality after fracture in osteoporotic patients.
Methods: From Korean National Health Insurance Service-National Sample Cohort, we included 36,179 patients with osteoporosis older than 50 years and received national health check-up from 2009 to 2013. Patients with cancer history were excluded. Propensity scores for each of study patients were estimated and used to assemble a cohort for patients with AF (n = 1,479) and matched patients without AF (n = 4,437).
Results: 4.1% (1,484 of 36,179) of osteoporotic patients had comorbid AF. In propensity-matched patients with osteoporosis, the incidence of fracture in AF patients was significantly higher than that in non-AF patients (38.8 vs. 32.0 per 1,000 person-year, p = 0.021). In a multivariate Cox regression analysis, AF was associated with incidence of fracture independently of other risk factors (HR: 1.24, 95% CI: 1.05-1.46, p = 0.010). In subgroup analysis, this association was especially pronounced in patients without heart failure (HR: 1.34, 95% CI: 1.09-1.64, p = 0.006) and those with hypertension (HR: 1.28, 95% CI: 1.08-1.53, p = 0.005). The mortality after fracture event of the osteoporotic patients with AF was significantly higher than that of osteoporotic patients without AF (28.1% vs 8.4%, during follow-up, p<0.001).
Conclusions: Comorbid AF in osteoporotic patients is an independent risk factor for facture occurrence and increases mortality after fracture.
Author Disclosures: P. Yang: None. D. Shin: None. T. Kim: None. J. Uhm: None. H. Pak: None. M. Lee: None. B. Joung: None.
- © 2016 by American Heart Association, Inc.