Does atrial fibrillation increase the risk of fractures? A systematic review and meta-analysis

ObjectivesWe have observed in clinical practice that patients with fractures often have concomitant atrial fibrillation. However, it remains unclear whether atrial fibrillation increases the risk of bone fracture. A meta-analysis was performed to investigate the association between atrial fibrillati...

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Published in:Frontiers in Medicine
Main Authors: Wei Chen, Yuyu Zhang, Huaze Xie, Haiyi Guo, Yangfan Gong, Zhuohao Yin, Kai Zhao, Wei Ge
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-05-01
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Online Access:https://www.frontiersin.org/articles/10.3389/fmed.2025.1528195/full
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Summary:ObjectivesWe have observed in clinical practice that patients with fractures often have concomitant atrial fibrillation. However, it remains unclear whether atrial fibrillation increases the risk of bone fracture. A meta-analysis was performed to investigate the association between atrial fibrillation and fracture.MethodsPubMed and Cochrane Library were searched for relevant studies from 1 January 1943 to 31 December 2024 that compared the prevalence of fracture in atrial fibrillation group with non-atrial fibrillation group.ResultsA total of five cohort studies with 187,868 participants met all the eligibility criteria for our study. A total of 835 people suffered a fracture in atrial fibrillation group and 6,512 in non-atrial fibrillation group. The overall risk of fractures was non-statistically higher in patients with 5.4% (835/15,395) in atrial fibrillation group and 3.8% (6,512/172,473) in non-atrial fibrillation group. Analysis of included studies observed non-significant association between atrial fibrillation and fractures [odds ratio (OR) = 1.17, 95% confidence interval (CI) = 0.60–2.29, P = 0.65]. 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, P < 0.00001), whereas no similar outcomes were seen in Caucasian population (OR = 0.94, 95% CI = 0.24–3.59, P = 0.92).ConclusionThe evidence indicated that Asians with atrial fibrillation were more prone to fractures.Systematic review registrationhttps://www.crd.york.ac.uk/PROSPERO/myprospero, identifier CRD42018107794.
ISSN:2296-858X