Journal
JOURNAL OF THE AMERICAN GERIATRICS SOCIETY
Volume 56, Issue 7, Pages 1171-1176Publisher
BLACKWELL PUBLISHING
DOI: 10.1111/j.1532-5415.2008.01786.x
Keywords
warfarin; fractures; BMD; men
Categories
Funding
- NCRR NIH HHS [UL1 RR024140] Funding Source: Medline
- NIAMS NIH HHS [U01 AR45614, U01 AR45647, K24 AR051895, U01 AR45632, U01 AR045654, U01 AR45583, U01 AR045632, U01 AR045614, U01 AR45654, U01 AR045580, U01 AR45580, U01 AR045647, U01 AR045583, K24 AR051895-01] Funding Source: Medline
- NIA NIH HHS [U01-AG027810, U01 AG027810, U01 AG18197, U01 AG018197] Funding Source: Medline
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OBJECTIVES: To determine whether warfarin use, assessed at a single point in time, is associated with bone mineral density (BMD), rates of bone loss, and fracture risk in older men. DESIGN: Secondary analysis of data from a prospective cohort study. SETTING: Six U.S. clinical centers. PARTICIPANTS: Five thousand five hundred thirty-three community-dwelling, ambulatory men aged 65 and older with baseline warfarin use data. MEASUREMENTS: Warfarin use was assessed as current use of warfarin at baseline using an electronic medication coding dictionary. BMD was measured at the hip and spine at baseline, and hip BMD was repeated at a follow-up visit 3.4 years later. Self-reported nonspine fractures were centrally adjudicated. RESULTS: At baseline, the average age of the participants was 73.6 +/- 5.9, and 321 (5.8%) were taking warfarin. Warfarin users had similar baseline BMD as nonusers (n=5,212) at the hip and spine (total hip 0.966 +/- 0.008 vs 0.959 +/- 0.002 g/cm(2), P=.37; total spine 1.079 +/- 0.010 vs 1.074 +/- 0.003 g/cm(2), P=.64). Of subjects with BMD at both visits, warfarin users (n=150) also had similar annualized bone loss at the total hip as nonusers (n=2,683) (-0.509 +/- 0.082 vs -0.421 +/- 0.019%/year, P=.29). During a mean follow-up of 5.1 years, the risk of nonspine fracture was similar in warfarin users and nonusers (adjusted hazard ratio=1.06, 95% confidence interval=0.68-1.65). CONCLUSION: In this cohort of elderly men, current warfarin use was not associated with lower BMD, accelerated bone loss, or higher nonspine fracture risk.
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