Title

Vitamin K antagonists' use and fracture risk: results from a systematic review and meta-analysis

Publication Date

2015

Journal Title

J Thromb Haemost

Abstract

BackgroundAlthough vitamin K antagonists (VKAs) lower serum values of bone deposition markers, the link with osteoporosis and fractures remains controversial. ObjectivesTo assess whether the use of VKAs is associated with an increased prevalence and/or incidence of osteoporosis, fractures, or lower bone mineral density (BMD) values. MethodsWe conducted a systematic PubMed and EMBASE literature search until August 31, 2014, and a meta-analysis of cross-sectional and longitudinal studies investigating fractures and BMD, comparing patients treated with VKAs and healthy controls (HCs) or with patients with medical illness (medical controls, MCs). Standardized mean differences95% and confidence intervals (CIs) were calculated for BMD, and risk ratios (RRs) were calculated for prevalent and incident fractures. ResultsOf 4597 initial hits, 21 studies were eligible, including 79 663 individuals treated with VKAs vs. 597348 controls. Compared with HCs, VKA-treated individuals showed significantly higher fracture risk in cross-sectional (three studies; RR=1.24; 95% CI: 1.12-1.39, P

Volume Number

13

Issue Number

9

Pages

1665-1675

Document Type

Article

EPub Date

2015/07/17

Status

Faculty

Facility

School of Medicine

Primary Department

Psychiatry

Additional Departments

Molecular Medicine

PMID

26179400

DOI

10.1111/jth.13052