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

Wei Chen1,2, Yuyu Zhang1, Huaze Xie1,3

  • 1Department of General Practice, Xijing Hospital, The Fourth Military Medical University, Xi'an, Shannxi, China.

Frontiers in Medicine
|June 11, 2025
PubMed

Insights

Atrial fibrillation (AF) does not significantly increase fracture risk overall. However, Asian individuals with AF show a higher propensity for fractures, suggesting a population-specific association.

Area of Science:

  • Cardiology
  • Orthopedics
  • Epidemiology

Background:

  • Clinical observations suggest a link between atrial fibrillation and fractures.
  • The relationship between atrial fibrillation and fracture risk requires further investigation.

Purpose of the Study:

  • To conduct a meta-analysis investigating the association between atrial fibrillation and bone fracture risk.

Main Methods:

  • Searched PubMed and Cochrane Library for cohort studies comparing fracture prevalence in AF patients versus controls.
  • Included five cohort studies with 187,868 participants.

Main Results:

  • Overall, no statistically significant increased fracture risk was observed in patients with atrial fibrillation (OR = 1.17, P = 0.65).
  • Subgroup analysis revealed a significantly higher fracture risk in the Asian population with atrial fibrillation (OR = 1.61, P < 0.00001).
  • No significant association was found in the Caucasian population (OR = 0.94, P = 0.92).

Conclusions:

  • Atrial fibrillation is associated with an increased risk of fracture in Asian populations.
  • Further research may elucidate ethnic-specific risk factors and mechanisms.
Abstract

Keywords:
Asiansatrial fibrillationcohort studyfracturemeta-analysis

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