Premium
Relationship between number of medications and incidence of falls or bone fracture in elderly patients with non‐valvular atrial fibrillation: Shinken database analysis
Author(s) -
Fujisawa Tomoki,
Arita Takuto,
Suzuki Shinya,
Yagi Naoharu,
Otsuka Takayuki,
Kishi Mikio,
Kano Hiroto,
Matsuno Shunsuke,
Kato Yuko,
Uejima Tokuhisa,
Oikawa Yuji,
Matsuhama Minoru,
Iida Mitsuru,
Yajima Junji,
Yamashita Takeshi
Publication year - 2021
Publication title -
geriatrics and gerontology international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.823
H-Index - 57
eISSN - 1447-0594
pISSN - 1444-1586
DOI - 10.1111/ggi.14242
Subject(s) - medicine , atrial fibrillation , polypharmacy , incidence (geometry) , hazard ratio , proportional hazards model , cardiology , confidence interval , physics , optics
Aim Polypharmacy is known to be a risk factor for falls or bone fracture (F/F) in elderly patients. However, this relationship is not fully described in patients with non‐valvular atrial fibrillation (NVAF), for which F/F may lead to serious clinical outcomes, including major bleeding. Methods We analyzed 509 elderly (aged ≥75 years) patients with NVAF who had recently visited a hospital specializing in cardiology, of which 272 patients had paroxysmal atrial fibrillation (PAF) and 237 had persistent/permanent atrial fibrillation (PeAF). Patients were divided into four groups according to the number of medications: ≤3, 4–6, 7–9, and ≥10. The relationship between the number of medications and incidence rate of F/F in AF patients was analyzed. In addition, this relationship was analyzed in patients with each AF type. Results Cumulative incidence of F/F at 3 years in the respective categories was 3.7%, 5.4%, 4.3% and 5.7% for PAF, and 5.2%, 7.5%, 7.8% and 25.0% for PeAF (log‐rank test, P = 0.930 and 0.003, respectively). In a multivariable model, patients with ≥10 medications showed a significantly higher risk for F/F compared with those with ≤3 medications as reference only in PeAF (adjusted hazard ratio 4.82, 95%CI 1.42–16.33), without significant interaction ( P = 0.081). Conclusions Elderly NVAF patients using ≥10 medications showed a higher risk for F/F. In subgroup analysis, this association was observed only in patients with PeAF, although there was no significant interaction between number of medications and AF type. Geriatr Gerontol Int 2021; 21: 802–809 .