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Immediate Risk for Cardiovascular Events in Hip Fracture Patients: A Population-Based Cohort Study

Hsu, WWK; Sing, C-W; Li, GHY; Tan, KCB; Cheung, BMY; Wong, JSH; Wong, I; (2022) Immediate Risk for Cardiovascular Events in Hip Fracture Patients: A Population-Based Cohort Study. Journal of Gerontology Series A: Biological Sciences and Medical Sciences , 77 (9) pp. 1923-1929. 10.1093/gerona/glab336. Green open access

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Abstract

Background: Emerging evidence showed that bone metabolism and cardiovascular diseases (CVD) are closely related. We previously observed a potential immediate risk of cardiovascular mortality after hip fracture. However, whether there is an immediate risk of cardiovascular events after hip fracture is unclear. The aim of this study was to evaluate the risk for major adverse cardiovascular events (MACEs) between patients having experienced falls with and without hip fracture. / Methods: This retrospective population-based cohort study used data from a centralized electronic health record database managed by Hong Kong Hospital Authority. Patients having experienced falls with and without hip fracture were matched by propensity score (PS) at a 1:1 ratio. Adjusted associations between hip fracture and risk of MACEs were evaluated using competing risk regression after accounting for competing risk of death. / Results: Competing risk regression showed that hip fracture was associated with increased one-year risk of MACEs (hazard ratio [HR], 1.27; 95% CI, 1.21 to 1.33; p<0.001), with a 1-year cumulative incidence difference of 2.40% (1.94% to 2.87%). The HR was the highest in the first 90-day after hip fracture (HR of 1.32), and such an estimate was continuously reduced in 180-day, 270-day, and 1-year after hip fracture. / Conclusions: Hip fracture was associated with increased immediate risk of MACEs. This study suggested that a prompt evaluation of MACE among older adults aged 65 years and older who are diagnosed with hip fracture irrespectively of cardiovascular risk factors may be important, as early management may reduce subsequent risk of MACE.

Type: Article
Title: Immediate Risk for Cardiovascular Events in Hip Fracture Patients: A Population-Based Cohort Study
Open access status: An open access version is available from UCL Discovery
DOI: 10.1093/gerona/glab336
Publisher version: https://doi.org/10.1093/gerona/glab336
Language: English
Additional information: This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions.
Keywords: Major adverse cardiovascular events, Osteoporosis, Propensity score matching, Unintentional falls
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Life Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Life Sciences > UCL School of Pharmacy
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Life Sciences > UCL School of Pharmacy > Practice and Policy
URI: https://discovery.ucl.ac.uk/id/eprint/10137714
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