Arrhythmias & electrophysiologyCohort study
Fracture risks among patients with atrial fibrillation receiving different oral anticoagulants: a real-world nationwide cohort study
- Retrospective cohort study
- nationwide
- propensity-score matched
- real-world
Authors' conclusion
Compared with warfarin, NOAC was associated with a reduced fracture risk among AF patients.
Study context
- Population
- Adults newly diagnosed with atrial fibrillation (AF) in Taiwan 2012–2016 receiving NOACs or warfarin, followed until 2017 (National Health Insurance Research Database)after matching
- Participants
- 19,414 adults
- Exposure
- NOACs vs warfarin
- NOACsn = 9,707
- Warfarinn = 9,707reference
- Outcome
- Fracture (hip, vertebral, humerus/forearm/wrist)
- Follow-up
- Median 2.4 years
Main finding
Fracture
Adjusted hazard ratio
0.84
95% CI 0.77–0.93
P < 0.001
NOAC vs Warfarin
aHR 0.84 (95% CI 0.77–0.93); P < 0.001
As reported in the abstract
Observational data: associations, not effects.
Further findings
| Outcome | aHR (95% CI) | P value | |
|---|---|---|---|
| Fracture, by individual NOAC (sub-analyses) — Dabigatran vs Warfarin | 0.88 (0.78–0.99) | P = 0.027 | |
| Fracture, by individual NOAC (sub-analyses) — Rivaroxaban vs Warfarin | 0.81 (0.72–0.90) | P < 0.001 | |
| Fracture, by individual NOAC (sub-analyses) — Apixaban vs Warfarin | 0.67 (0.52–0.87) | P = 0.003 | |
| 0.512Adjusted hazard ratio (log scale) |
Fracture, all eligible patients without propensity score matching
- Similar results
Original publication
Fracture risks among patients with atrial fibrillation receiving different oral anticoagulants: a real-world nationwide cohort study. Eur Heart J. Published 1 February 2020. doi:10.1093/eurheartj/ehz952
Summarised from the published abstract; every number is checked against it