Incident atrial fibrillation and the risk of fracture in the cardiovascular health study
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 unk...
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| Veröffentlicht in: | Osteoporosis international 2017-02, Vol.28 (2), p.719-725 |
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| creator | Wallace, E. R. Siscovick, D. S. Sitlani, C. M. Dublin, S. Mitchell, P. Robbins, J. A. Fink, H. A. Cauley, J. A. Bůžková, P. Carbone, L. Chen, Z. Heckbert, S. R. |
| description | 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. |
| doi_str_mv | 10.1007/s00198-016-3778-1 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_5782802</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>1835406534</sourcerecordid><originalsourceid>FETCH-LOGICAL-c536t-e88f55f81339bd228cf0bd1fdda24c42986d9304d6cc47ea7202230a41a72aa23</originalsourceid><addsrcrecordid>eNp1kU1rVDEYhYNY7Nj6A9xIwI2bq2--bpKNIMVqoeCmhe5CJh-d1DtJTe4t9N-b6dT6Aa4S8j7nJCcHodcE3hMA-aEBEK0GIOPApFQDeYZWhDM2UD2K52gFmslBc3J1iF62dgNdo7V8gQ6plIRzzlbo6iy75EOesZ1rshOOaV3TNNk5lYxt9njeBFxT-45LxLFaNy814JQfzp2tPpU729wy2Yo3wU7zBrd58ffH6CDaqYVXj-sRujz9fHHydTj_9uXs5NP54AQb5yEoFYWIijCm155S5SKsPYneW8odp1qNXjPgfnSOy2AlBUoZWE761lrKjtDHve_tst4G73qUaidzW9PW1ntTbDJ_T3LamOtyZ4RUVMHO4N2jQS0_ltBms03Nhf4FOZSlGaKY4DAKxjv69h_0piw193iGAigYRxCiU2RPuVpaqyE-PYaA2fVm9r2Z3pvZ9WZI17z5M8WT4ldRHaB7oPVRvg7199X_d_0JUhKkQA</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2008066055</pqid></control><display><type>article</type><title>Incident atrial fibrillation and the risk of fracture in the cardiovascular health study</title><source>MEDLINE</source><source>Springer Nature - Complete Springer Journals</source><creator>Wallace, E. R. ; Siscovick, D. S. ; Sitlani, C. M. ; Dublin, S. ; Mitchell, P. ; Robbins, J. A. ; Fink, H. A. ; Cauley, J. A. ; Bůžková, P. ; Carbone, L. ; Chen, Z. ; Heckbert, S. R.</creator><creatorcontrib>Wallace, E. R. ; Siscovick, D. S. ; Sitlani, C. M. ; Dublin, S. ; Mitchell, P. ; Robbins, J. A. ; Fink, H. A. ; Cauley, J. A. ; Bůžková, P. ; Carbone, L. ; Chen, Z. ; Heckbert, S. R.</creatorcontrib><description>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.</description><identifier>ISSN: 0937-941X</identifier><identifier>EISSN: 1433-2965</identifier><identifier>DOI: 10.1007/s00198-016-3778-1</identifier><identifier>PMID: 27714443</identifier><language>eng</language><publisher>London: Springer London</publisher><subject>Accidental Falls - statistics & numerical data ; Aged ; Atrial Fibrillation - epidemiology ; Cardiac arrhythmia ; Comorbidity ; Dementia disorders ; Diagnosis ; EKG ; Endocrinology ; Female ; Fibrillation ; Forearm ; Fractures ; Health risk assessment ; Heart diseases ; Hip ; Hip Fractures - epidemiology ; Humans ; Humerus ; Incidence ; Longitudinal Studies ; Male ; Medicine ; Medicine & Public Health ; Orthopedics ; Osteoporotic Fractures - epidemiology ; Pelvis ; Prospective Studies ; Rheumatology ; Risk Factors ; Short Communication ; United States - epidemiology</subject><ispartof>Osteoporosis international, 2017-02, Vol.28 (2), p.719-725</ispartof><rights>International Osteoporosis Foundation and National Osteoporosis Foundation 2016</rights><rights>Osteoporosis International is a copyright of Springer, (2016). All Rights Reserved.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c536t-e88f55f81339bd228cf0bd1fdda24c42986d9304d6cc47ea7202230a41a72aa23</citedby><cites>FETCH-LOGICAL-c536t-e88f55f81339bd228cf0bd1fdda24c42986d9304d6cc47ea7202230a41a72aa23</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00198-016-3778-1$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00198-016-3778-1$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>230,314,776,780,881,27903,27904,41467,42536,51298</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/27714443$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Wallace, E. R.</creatorcontrib><creatorcontrib>Siscovick, D. S.</creatorcontrib><creatorcontrib>Sitlani, C. M.</creatorcontrib><creatorcontrib>Dublin, S.</creatorcontrib><creatorcontrib>Mitchell, P.</creatorcontrib><creatorcontrib>Robbins, J. A.</creatorcontrib><creatorcontrib>Fink, H. A.</creatorcontrib><creatorcontrib>Cauley, J. A.</creatorcontrib><creatorcontrib>Bůžková, P.</creatorcontrib><creatorcontrib>Carbone, L.</creatorcontrib><creatorcontrib>Chen, Z.</creatorcontrib><creatorcontrib>Heckbert, S. R.</creatorcontrib><title>Incident atrial fibrillation and the risk of fracture in the cardiovascular health study</title><title>Osteoporosis international</title><addtitle>Osteoporos Int</addtitle><addtitle>Osteoporos Int</addtitle><description>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.</description><subject>Accidental Falls - statistics & numerical data</subject><subject>Aged</subject><subject>Atrial Fibrillation - epidemiology</subject><subject>Cardiac arrhythmia</subject><subject>Comorbidity</subject><subject>Dementia disorders</subject><subject>Diagnosis</subject><subject>EKG</subject><subject>Endocrinology</subject><subject>Female</subject><subject>Fibrillation</subject><subject>Forearm</subject><subject>Fractures</subject><subject>Health risk assessment</subject><subject>Heart diseases</subject><subject>Hip</subject><subject>Hip Fractures - epidemiology</subject><subject>Humans</subject><subject>Humerus</subject><subject>Incidence</subject><subject>Longitudinal Studies</subject><subject>Male</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Orthopedics</subject><subject>Osteoporotic Fractures - epidemiology</subject><subject>Pelvis</subject><subject>Prospective Studies</subject><subject>Rheumatology</subject><subject>Risk Factors</subject><subject>Short Communication</subject><subject>United States - epidemiology</subject><issn>0937-941X</issn><issn>1433-2965</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2017</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNp1kU1rVDEYhYNY7Nj6A9xIwI2bq2--bpKNIMVqoeCmhe5CJh-d1DtJTe4t9N-b6dT6Aa4S8j7nJCcHodcE3hMA-aEBEK0GIOPApFQDeYZWhDM2UD2K52gFmslBc3J1iF62dgNdo7V8gQ6plIRzzlbo6iy75EOesZ1rshOOaV3TNNk5lYxt9njeBFxT-45LxLFaNy814JQfzp2tPpU729wy2Yo3wU7zBrd58ffH6CDaqYVXj-sRujz9fHHydTj_9uXs5NP54AQb5yEoFYWIijCm155S5SKsPYneW8odp1qNXjPgfnSOy2AlBUoZWE761lrKjtDHve_tst4G73qUaidzW9PW1ntTbDJ_T3LamOtyZ4RUVMHO4N2jQS0_ltBms03Nhf4FOZSlGaKY4DAKxjv69h_0piw193iGAigYRxCiU2RPuVpaqyE-PYaA2fVm9r2Z3pvZ9WZI17z5M8WT4ldRHaB7oPVRvg7199X_d_0JUhKkQA</recordid><startdate>20170201</startdate><enddate>20170201</enddate><creator>Wallace, E. R.</creator><creator>Siscovick, D. S.</creator><creator>Sitlani, C. M.</creator><creator>Dublin, S.</creator><creator>Mitchell, P.</creator><creator>Robbins, J. A.</creator><creator>Fink, H. A.</creator><creator>Cauley, J. A.</creator><creator>Bůžková, P.</creator><creator>Carbone, L.</creator><creator>Chen, Z.</creator><creator>Heckbert, S. R.</creator><general>Springer London</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7QP</scope><scope>7RV</scope><scope>7TS</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8C1</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M1P</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20170201</creationdate><title>Incident atrial fibrillation and the risk of fracture in the cardiovascular health study</title><author>Wallace, E. R. ; Siscovick, D. S. ; Sitlani, C. M. ; Dublin, S. ; Mitchell, P. ; Robbins, J. A. ; Fink, H. A. ; Cauley, J. A. ; Bůžková, P. ; Carbone, L. ; Chen, Z. ; Heckbert, S. R.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c536t-e88f55f81339bd228cf0bd1fdda24c42986d9304d6cc47ea7202230a41a72aa23</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2017</creationdate><topic>Accidental Falls - statistics & numerical data</topic><topic>Aged</topic><topic>Atrial Fibrillation - epidemiology</topic><topic>Cardiac arrhythmia</topic><topic>Comorbidity</topic><topic>Dementia disorders</topic><topic>Diagnosis</topic><topic>EKG</topic><topic>Endocrinology</topic><topic>Female</topic><topic>Fibrillation</topic><topic>Forearm</topic><topic>Fractures</topic><topic>Health risk assessment</topic><topic>Heart diseases</topic><topic>Hip</topic><topic>Hip Fractures - epidemiology</topic><topic>Humans</topic><topic>Humerus</topic><topic>Incidence</topic><topic>Longitudinal Studies</topic><topic>Male</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Orthopedics</topic><topic>Osteoporotic Fractures - epidemiology</topic><topic>Pelvis</topic><topic>Prospective Studies</topic><topic>Rheumatology</topic><topic>Risk Factors</topic><topic>Short Communication</topic><topic>United States - epidemiology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Wallace, E. R.</creatorcontrib><creatorcontrib>Siscovick, D. S.</creatorcontrib><creatorcontrib>Sitlani, C. M.</creatorcontrib><creatorcontrib>Dublin, S.</creatorcontrib><creatorcontrib>Mitchell, P.</creatorcontrib><creatorcontrib>Robbins, J. A.</creatorcontrib><creatorcontrib>Fink, H. A.</creatorcontrib><creatorcontrib>Cauley, J. A.</creatorcontrib><creatorcontrib>Bůžková, P.</creatorcontrib><creatorcontrib>Carbone, L.</creatorcontrib><creatorcontrib>Chen, Z.</creatorcontrib><creatorcontrib>Heckbert, S. R.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Calcium & Calcified Tissue Abstracts</collection><collection>Nursing & Allied Health Database</collection><collection>Physical Education Index</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>ProQuest Public Health Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Osteoporosis international</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Wallace, E. R.</au><au>Siscovick, D. S.</au><au>Sitlani, C. M.</au><au>Dublin, S.</au><au>Mitchell, P.</au><au>Robbins, J. A.</au><au>Fink, H. A.</au><au>Cauley, J. A.</au><au>Bůžková, P.</au><au>Carbone, L.</au><au>Chen, Z.</au><au>Heckbert, S. R.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Incident atrial fibrillation and the risk of fracture in the cardiovascular health study</atitle><jtitle>Osteoporosis international</jtitle><stitle>Osteoporos Int</stitle><addtitle>Osteoporos Int</addtitle><date>2017-02-01</date><risdate>2017</risdate><volume>28</volume><issue>2</issue><spage>719</spage><epage>725</epage><pages>719-725</pages><issn>0937-941X</issn><eissn>1433-2965</eissn><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.</abstract><cop>London</cop><pub>Springer London</pub><pmid>27714443</pmid><doi>10.1007/s00198-016-3778-1</doi><tpages>7</tpages><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0937-941X |
| ispartof | Osteoporosis international, 2017-02, Vol.28 (2), p.719-725 |
| issn | 0937-941X 1433-2965 |
| language | eng |
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| source | MEDLINE; Springer Nature - Complete Springer Journals |
| subjects | Accidental Falls - statistics & numerical data Aged Atrial Fibrillation - epidemiology Cardiac arrhythmia Comorbidity Dementia disorders Diagnosis EKG Endocrinology Female Fibrillation Forearm Fractures Health risk assessment Heart diseases Hip Hip Fractures - epidemiology Humans Humerus Incidence Longitudinal Studies Male Medicine Medicine & Public Health Orthopedics Osteoporotic Fractures - epidemiology Pelvis Prospective Studies Rheumatology Risk Factors Short Communication United States - epidemiology |
| title | Incident atrial fibrillation and the risk of fracture in the cardiovascular health study |
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