ATRIAL FIBRILLATION PREDICTORS IN PATIENT WITH ACUTE CORONARY SYNDROME IN KABUL (AFGHANISTAN) FROM 2018 TO 2020

Abstract

Aim: The study was aimed to find out the atrial fibrillation predictors in patient with acute coronary syndrome in Kabul,
Afghanistan from 2018 to 2020.
Methodology: It was a cross-sectional descriptive study based on purposive sampling conducted in three different
hospitals in Kabul. The study included 1416 both male and female patients with known ACS (148 AF) aging over 20 years.
Results: The mean age was 59±13 (22-95), the mean systolic BP was 128± 24 (60-210) mmHg, diastolic BP was
82±15 (40-125) mmHg, and mean BMI was 26.1±4.6 (16.1-37.7), CHA2DS2-VASc score was strongly associated with AF (P
value < 0.001, 95% CI: 1.36-1.99) and the cases of AF significantly increased with increasing CHA2DS2-VASc score. In
addition, mean CHA2DS2-VASC score was different across AF group (2.85 ± 1.64 vs. 2.23±1.23 P value 0.001). AF was
more prevalent in hypokalemia (75.10% P value < 0.001) and the mean serum potassium was significantly different across
AF group (3.83±0.66 vs. 4.28±0.62 in sinus rhythm). AF prevalence was more in the elevated WBC group (P value 0.001)
and there was a strong correlation between AF and WBC (pearson correlation 0.9). Moreover, mean WBC count was
different across AF group (10400 ±2900 vs. 9500±3200 in sinus rhythm.
Conclusion: Atrial fibrillation is the most common heart rhythm disorder that is strongly and significantly associated with
increased CHA2DS2-VASc score, elevated WBC count and low serum potassium level. Patients with these disorders should
be closely monitored and serum potassium level should be kept over 3.5 mEq/L. A large cohort study is needed to propose
these tests for the screening purpose of atrial fibrillation development in patients with acute coronary syndrome.