Relationship between number of medications and incidence of falls or bone fracture in elderly patients with non‐valvular atrial fibrillation: Shinken database analysis. Issue 9 (15th July 2021)

• Record Type: Journal Article
• Authors: 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
• Is Part Of: Geriatrics and gerontology international. Volume 21:Issue 9(2021)
• Page Start: 802
• Page End: 809
• Publication Date: 2021-07-15
• Subjects: accidental falls -- atrial fibrillation -- bone fracture -- elderly -- polypharmacy; Geriatrics -- Periodicals; Gerontology -- Periodicals; Geriatrics -- Japan -- Periodicals; Gerontology -- Japan -- Periodicals; 618.97
• DOI: 10.1111/ggi.14242
• Languages: English
• ISSNs: 1444-1586

Abstract

Abstract : 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 .