@article{ref1,
title="Atrial fibrillation, CHA2DS2-VASc score, antithrombotics and risk of non-traffic-, non-cancer-related bone fractures: a population-based cohort study",
journal="European journal of internal medicine",
year="2015",
author="Lai, Hui-Chin and Chien, Wu-Chien and Chung, Chi-Hsiang and Lee, Wen-Lieng and Wu, Tsu-Juey and Wang, Kuo-Yang and Liu, Chia-Ning and Liu, Tsun-Jui",
volume="26",
number="10",
pages="798-806",
abstract="BACKGROUND: Accidental bone fractures are a major cause of premature disabilities and death. Whether atrial fibrillation (AF) treated with or without antithrombotics correlates with occurrence of such events remains under-investigated. <br><br>METHODS: Patients ≥18 years with newly diagnosed AF between 2005 and 2009 without previous cancers or traffic injury were identified from the &quot;Longitudinal Health Insurance Database 2005&quot; (1 million beneficiaries) of Taiwan's National Health Research Institutes and served as the AF group. A fourfold number of age-, gender-, and comorbidity-matched patients but without AF served as the non-AF controls. Patients were followed, and cumulative incidence of hospitalization-requiring bone fractures was compared between groups. Predictors of accidental bone fractures were determined by Cox regression analysis. <br><br>RESULTS: Within a mean follow-up of 3.6 years, bone fractures, especially those involving neck/trunk and lower limbs, were significantly more frequent in patients with AF (N=6925) than in those without (N=27,700) (7.0 vs. 3.8 per 1000 person-years, log-rank p=0.001, adjusted HR=1.85, 95% CI=1.50-2.30, p<0.001). Cox models identified female gender, previous stroke, and CHA2DS2-VASc score≧1 as risk factors for bone fractures in AF patients, whereas oral anticoagulants (HR=0.62, 95% CI=0.35-0.91, p=0.034), especially when used in patients with CHA2DS2-VASc score≧1 but not antiplatelet therapy (p=0.39) as negative predictors. <br><br>CONCLUSION: Patients with AF are more vulnerable to non-traffic-, non-cancer-related bone fractures especially when with specified characteristics. For those with higher CHA2DS2-VASc scores, the use of anticoagulant but not antiplatelet agents could be associated with lower risk of such events.<p /> <p>Language: en</p>",
language="en",
issn="0953-6205",
doi="10.1016/j.ejim.2015.10.002",
url="http://dx.doi.org/10.1016/j.ejim.2015.10.002"
}