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Whether vitamin K anticoagulation (VKA) is associated with elevated risks for osteoporosis and bone fractures is an unresolved question. In a retrospective analysis of Danish national databases, investigators examined histories of patients with atrial fibrillation (AF) who were treated with anticoagulation for at least 180 days and had not previously used anti-osteoporosis medications.
Of 37,350 patients (median age, 73), 33% were treated with VKA; the remaining 67% were treated with direct oral anticoagulants (DOACs). The 2-year fracture rates were surprising low in both groups. Still, DOACs were associated with a lower incidence of any fracture than VKA (3.1% vs. 3.8%), leading to a 15% lower risk with DOACs. The incidence of major fractur…