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
DOI
10.1111/jth.13052