Heart failure and fracture risk: a meta-analysis

This meta-analysis was conducted to investigate whether heart failure is associated with an increased risk of fractures by summarizing all the available evidence. The PubMed, EMBASE, and Cochrane Library databases were searched for all relevant studies published from the date of database inception to April 2018. Studies that investigated the association between heart failure and fracture risk and conducted a comparison with controls were included. Seven cohort studies were finally identified as eligible for inclusion in the meta-analysis. All included studies were of high quality as evaluated by the Newcastle-Ottawa Scale. There was a significantly higher risk of any fracture in patients diagnosed with heart failure (N = 53,038) than in controls (N = 126,727) (RR 1.66, 95% CI 1.14–2.43, I² = 94%, P = 0.008). The results were the same for hip (RR 3.45, 95% CI: 1.86–6.40, I² = 95%, P < 0.0001) and humerus fractures (RR 1.91, 95% CI 1.07–3.40, I² = 39%, P = 0.03) but not for vertebral and forearm fractures. To conclude, this meta-analysis demonstrated that patients with heart failure had an increased risk of fractures, especially hip and humerus fractures. Patients with heart failure may need to pay greater attention to their bone health. This meta-analysis found a significantly higher risk of fractures in patients with heart failure than in those without heart failure. Greater attention should be paid to bone health in patients with heart failure.