02527nas a2200277 4500008004100000022001400041245009400055210006900149260001300218300001200231490000700243520176400250100001802014700002002032700001802052700001402070700001602084700001802100700001502118700001702133700001802150700001502168700001202183700001802195856003602213 2017 eng d a1433-296500aIncident atrial fibrillation and the risk of fracture in the cardiovascular health study.0 aIncident atrial fibrillation and the risk of fracture in the car c2017 Feb a719-7250 v283 a

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.

1 aWallace, E, R1 aSiscovick, D, S1 aSitlani, C, M1 aDublin, S1 aMitchell, P1 aRobbins, J, A1 aFink, H, A1 aCauley, J, A1 aBůžková, P1 aCarbone, L1 aChen, Z1 aHeckbert, S R uhttps://chs-nhlbi.org/node/7365