Hip fracture and risk of acute myocardial infarction: A nationwide study

Authors

  • Chia-Hung Chiang,

    1. Division of Cardiology, Department of Medicine, Zhudong Veterans Hospital, HsinChu, Taiwan
    2. Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
    3. Cardiovascular Research Center, National Yang-Ming University, Taipei, Taiwan
    4. Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan
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    • The first two authors contributed equally to this work.

  • Chia-Jen Liu,

    1. Division of Hematology and Oncology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
    2. Department of Internal Medicine, National Yang-Ming University Hospital, Yilan, Taiwan
    3. Institute of Public Health and School of Medicine, National Yang-Ming University, Taipei, Taiwan
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    • The first two authors contributed equally to this work.

  • Ping-Jen Chen,

    1. Department of Family Medicine and Department of Geriatric Medicine, Chi-Mei Medical Center, Tainan, Taiwan
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  • Chin-Chou Huang,

    1. Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
    2. Cardiovascular Research Center, National Yang-Ming University, Taipei, Taiwan
    3. Department of Medical Research and Education, Taipei Veterans General Hospital, Taipei, Taiwan
    4. Institute of Pharmacology, National Yang-Ming University, Taipei, Taiwan
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  • Chien-Yi Hsu,

    1. Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
    2. Cardiovascular Research Center, National Yang-Ming University, Taipei, Taiwan
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  • Zu-Yin Chen,

    1. Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
    2. Cardiovascular Research Center, National Yang-Ming University, Taipei, Taiwan
    3. Department of Internal Medicine, National Yang-Ming University Hospital, Yilan, Taiwan
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  • Wan-Leong Chan,

    1. Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
    2. Healthcare and Management Center, Taipei Veterans General Hospital, Taipei, Taiwan
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  • Po-Hsun Huang,

    1. Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
    2. Cardiovascular Research Center, National Yang-Ming University, Taipei, Taiwan
    3. Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan
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  • Tzeng-Ji Chen,

    1. Department of Family Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
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  • Chia-Min Chung,

    1. Institute of Biomedical Sciences, Academia Sinica, Taipei, Taiwan
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  • Shing-Jong Lin,

    1. Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
    2. Cardiovascular Research Center, National Yang-Ming University, Taipei, Taiwan
    3. Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan
    4. Department of Medical Research and Education, Taipei Veterans General Hospital, Taipei, Taiwan
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  • Jaw-Wen Chen,

    1. Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
    2. Cardiovascular Research Center, National Yang-Ming University, Taipei, Taiwan
    3. Department of Medical Research and Education, Taipei Veterans General Hospital, Taipei, Taiwan
    4. Institute of Pharmacology, National Yang-Ming University, Taipei, Taiwan
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  • Hsin-Bang Leu

    Corresponding author
    1. Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
    2. Cardiovascular Research Center, National Yang-Ming University, Taipei, Taiwan
    3. Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan
    4. Healthcare and Management Center, Taipei Veterans General Hospital, Taipei, Taiwan
    • Healthcare and Management Center, Division of Cardiology, Taipei Veterans General Hospital, No. 201, Sec. 2, Shi-Pai Road, Taipei, Taiwan, Republic of China.
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Abstract

Osteoporotic fractures are associated with increased mortality risk. However, little data are available on the risk of acute myocardial infarction (AMI) after hip fracture. Therefore, we investigated whether hip fracture increased the risk of AMI in a large, nationwide cohort study. We obtained data from 8758 patients diagnosed with hip fracture from 2000 to 2009 and from 4 matched controls for each patient from the Longitudinal Health Insurance Database (LHID 2000), Taiwan. Controls were matched for age, sex, comorbid disorders, and enrollment date. All subjects were followed up from the date of enrollment until AMI, death, or the end of data collection (2009). Cox's regression model adjusted for age, sex, comorbid disorders, and medication was used to assess independent factors determining the risk of development of AMI. As expected, despite the matching, the hip fracture patients had more risk factors for AMI at baseline. A total of 8758 subjects with hip fractures and 35,032 controls were identified. Among these patients, 1183 (257 hip fracture patients and 926 controls) developed AMI during the median 3.2-year (interquartile range 1.4 to 5.8 years) follow-up period. Patients with hip fractures had a higher incidence of AMI occurrence when compared with controls (8.7/1000 person-years versus 6.82/1000 person-years). Multivariate analysis adjusted for baseline covariates indicated that hip fracture was associated with a greater risk for AMI development (hazard ratio [HR] = 1.29; 95% confidence interval [CI] 1.12–1.48; p < 0.001). We conclude that hip fracture is independently associated with a higher risk of subsequent AMI. © 2013 American Society for Bone and Mineral Research

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