title: Increased risk of coronary heart disease in patients with hip fracture: a nationwide cohort study.
abstract: The study indicates that hip fracture is independently associated with increased risk of coronary heart disease. In addition, the highest risk of coronary heart disease following hip fracture appeared within the first year after hip fracture, indicating the need for multidisciplinary care for the patients.
  
  
  BACKGROUND
  Bone and vasculature are modulated through numerous common pathways. However, data on the risk of coronary heart disease (CHD) after hip fracture are scarce. Therefore, we investigated whether hip fracture increased the risk of CHD by conducting a large nationwide cohort study.
  
  
  METHODS
  Using universal insurance claims data from 2000 to 2010, we identified a study cohort of 6013 participants newly diagnosed with hip fracture and a control cohort of 23,802 participants. Both cohorts were followed up to the end of 2011 to evaluate the risk of CHD.
  
  
  RESULTS
  The overall incidence of CHD was 1.69-fold higher in the hip fracture cohort than it was in the control cohort (29.2 vs. 17.1 per 1000 person-years) with an adjusted hazard ratio of 1.51 (95 % confidence interval [CI] = 1.39-1.65). Sex-, age-, and comorbidity-specific analyses showed a higher relative risk of CHD for both women and men, all age groups, those with and without comorbidities, and patients with hip fracture compared with the control cohort. The highest risk of CHD was within the first year after hip fracture (adjusted HR = 1.72, 95 % CI = 1.45-2.04), and the risk remained high in the following years.
  
  
  CONCLUSIONS
  Hip fracture was independently associated with a subsequent risk of CHD.
authors: Graduate Institute of Clinical Medicine, China Medical University, Taichung, Taiwan.|Department of Orthopedics, China Medical University Hospital, Taichung, Taiwan.
authors: C-H
authors: CH
authors: Tsai
authors: Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan.|College of Medicine, China Medical University, Taichung, Taiwan.
authors: C-L
authors: CL
authors: Lin
authors: Graduate Institute of Clinical Medicine, China Medical University, Taichung, Taiwan.|Department of Orthopedics, China Medical University Hospital, Taichung, Taiwan.
authors: H-C
authors: HC
authors: Hsu
authors: Department of Internal Medicine, Taichung Hospital, Ministry of Health and Welfare, No. 199, Section 1, San-Min Road, Taichung City, 40343, Taiwan. chung.w53@msa.hinet.net.|Department of Health Services Administration, China Medical University, Taichung, Taiwan. chung.w53@msa.hinet.net.|Department of Healthcare Administration, Central Taiwan University of Science and Technology, Taichung, Taiwan. chung.w53@msa.hinet.net.
authors: W-S
authors: WS
authors: Chung
mesh_terms: D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D015897:Comorbidity; D003324:Coronary Artery Disease / Q000453:epidemiology / Q000209:etiology*; D005260:Female; D006620:Hip Fractures / Q000150:complications* / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D058866:Osteoporotic Fractures / Q000150:complications / Q000453:epidemiology; D012189:Retrospective Studies; D018570:Risk Assessment / Q000379:methods; D017678:Sex Distribution; D013624:Taiwan / Q000453:epidemiology; D055815:Young Adult
keywords: Cohort study; Coronary heart disease (CHD); Hip fracture