Hip fracture and risk of acute myocardial infarction: A nationwide study

Chia Hung Chiang, Chia Jen Liu, Ping Jen Chen, Chin Chou Huang, Chien Yi Hsu, Zu Yin Chen, Wan Leong Chan, Po Hsun Huang, Tzeng Ji Chen, Chia Min Chung, Shing Jong Lin, Jaw Wen Chen, Hsin Bang Leu

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44 Citations (Scopus)


Osteoporotic fractures are associated with increased mortality risk. However, little data are available on the risk of acute myocardial infarction (AMI) after hip fracture. Therefore, we investigated whether hip fracture increased the risk of AMI in a large, nationwide cohort study. We obtained data from 8758 patients diagnosed with hip fracture from 2000 to 2009 and from 4 matched controls for each patient from the Longitudinal Health Insurance Database (LHID 2000), Taiwan. Controls were matched for age, sex, comorbid disorders, and enrollment date. All subjects were followed up from the date of enrollment until AMI, death, or the end of data collection (2009). Cox's regression model adjusted for age, sex, comorbid disorders, and medication was used to assess independent factors determining the risk of development of AMI. As expected, despite the matching, the hip fracture patients had more risk factors for AMI at baseline. A total of 8758 subjects with hip fractures and 35,032 controls were identified. Among these patients, 1183 (257 hip fracture patients and 926 controls) developed AMI during the median 3.2-year (interquartile range 1.4 to 5.8 years) follow-up period. Patients with hip fractures had a higher incidence of AMI occurrence when compared with controls (8.7/1000 person-years versus 6.82/1000 person-years). Multivariate analysis adjusted for baseline covariates indicated that hip fracture was associated with a greater risk for AMI development (hazard ratio [HR] = 1.29; 95% confidence interval [CI] 1.12-1.48; p < 0.001). We conclude that hip fracture is independently associated with a higher risk of subsequent AMI.

Original languageEnglish
Pages (from-to)404-411
Number of pages8
JournalJournal of Bone and Mineral Research
Issue number2
Publication statusPublished - Feb 1 2013
Externally publishedYes


  • acute myocardial infarction
  • HIP fracture
  • osteoporosis

ASJC Scopus subject areas

  • Orthopedics and Sports Medicine
  • Endocrinology, Diabetes and Metabolism


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