Prevalent vertebral fracture is associated with incident cardiovascular disease events in older individuals referred for bone densitometry
Author Identifier (ORCID)
Syed Zulqarnain Gilani: https://orcid.org/0000-0002-7448-2327
Joshua R. Lewis: https://orcid.org/0000-0003-1003-8443
Abstract
Background: It is unknown if prevalent vertebral fracture (PVFx) captured on bone density vertebral fracture assessment (VFA) images predicts incident CVD events. Methods: 11,760 individuals (mean [SD] age 75.7 [6.8] years, 94 % female) had VFA contemporaneously with bone densitometry in Manitoba, Canada, between February 2010 and December 2017, of whom 1919 (16.3 %) had ≥1 PVFx. This cohort was followed over a mean (SD) 3.8 (2.3) years for Major Adverse Cardiovascular Events (MACE, composite of hospitalization for myocardial infarction, non-hemorrhagic stroke, or all-cause mortality) and other CVD events (hospitalization for coronary artery disease, congestive heart failure, peripheral vascular disease, or coronary bypass/stenting). Proportional hazards models were used to estimate hazard ratios (HR) for incident MACE and other CVD events in those with compared to those without PVFx. Results: Adjusted for age and sex, those with PVFx had HR for incident MACE of 1.34 (95 % C·I. 1.19, 1.51), hospitalization for myocardial infarction (HR 1.35, 95 % C.I. 1.02, 1.79), all-cause mortality (HR 1.36, 95 % C.I, 1.19, 1.56), and other CVD events (HR 1.40, 95 % C.I. 1.21, 1.61). These associations were only slightly attenuated with further adjustment for prior CVD disease and additional CVD risk factors. Conclusion: Prevalent vertebral fracture identified on VFA images in routine clinical practice is robustly associated with incident MACE, independent of other risk factors including AAC which can be simultaneously ascertained on the same images. VFA may have utility for prediction of fractures and CVD outcomes via ascertainment of both prevalent vertebral fracture and AAC.
Document Type
Journal Article
Date of Publication
11-1-2025
Volume
200
Publication Title
Bone
Publisher
Elsevier
School
Nutrition and Health Innovation Research Institute / Centre for Artificial Intelligence and Machine Learning (CAIML) / School of Science
Funders
Rady Innovation Fund / Rady Faculty of Health Sciences / University of Manitoba / National Health and Medical Research Council / Medical Research Future Fund 2022 Cardiovascular Health Mission Grant (MRF2024225) / National Heart Foundation Future Leader Fellowship (107323)
Grant Number
NHMRC Number : APP1183570
Copyright
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Comments
Schousboe, J. T., Monchka, B. A., Davidson, J. M., Kimelman, D., Gilani, S. Z., Ilyas, Z., Reid, S., Lewis, J. R., & Leslie, W. D. (2025). Prevalent vertebral fracture is associated with incident cardiovascular disease events in older individuals referred for bone densitometry. Bone, 200, 117601. https://doi.org/10.1016/j.bone.2025.117601