Online ISSN: 3007-0244,
Print ISSN:  2410-4280
ATRIAL FIBRILLATION PREDICTORS IN PATIENT WITH ACUTE CORONARY SYNDROME IN KABUL (AFGHANISTAN) FROM 2018 TO 2020
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.
Ikramullah Ibrahimi1, Nasratullah Shinwari2, Zakirullah Sarwari1, Kairat R. Karibayev3, A .Z. Akhenbekova4 1 Department of Internal Medicine of Medical Faculty of Nangarhar University, Nangarhar Afghanistan; 2 Department of Medical Faculty of Paktia University, Paktia, Afghanistan; 3 Cardiocenter Central Clinic Hospital, Almaty c., Republic of Kazakhstan; 4 Higher School of Medicine, Faculty of Medicine and Healthcare, Al-Farabi Kazakh National University, Almaty, Republic of Kazakhstan.
1. Piccini J.P., Hammill B.G., Sinner M.F., Jensen P.N., Hernandez A.F., Heckbert S.R. et al. Incidence and prevalence of atrial fibrillation and associated mortality among Medicare beneficiaries, 1993-2007 // Circ Cardiovasc Qual Outcomes.2012;5:85-93. 2. Andersson T., Magnuson A., Bryngelsson I.L., Frøbert O., Henriksson K.M., Edvardsson N. et al. All-cause mortality in 272, 186 patients hospitalized with incident atrial fibrillation 1995–2008: a Swedish nationwide long-term case control study // EurHeart J. 2013; 34: 1061-67. 3. Haissaguerre M., Jais P., Shah D.C., Takahashi A., Hocini M., Quiniou G., Garrigue S., Le Mouroux A., Le Metayer P., Clementy J. Spontaneous initiation of atrial fibrillation by ectopic beats originating in the pulmonary veins // N Engl J Med. 1998;339:659–66. 4. Kim M.H., Johnston S.S., Chu B.C., Dalal M.R., Schulman K.L. Estimation of total incremental health care costs in patients with atrial fibrillation in the United States // Circ Cardiovasc Qual Outcomes. 2011;4:313-20. 5. Rutter M.K., Parise H., Benjamin E.J., Levy D., Larson M.G., Meigs J.B., Nesto R.W., Wilson P.W., Vasan R.S. Impact of glucose intolerance and insulin resistance on cardiac structure and function: sex-related differences in the Framingham Heart Study // Circulation. 2003;107:448–54. 6. O’Neal W.T. et al. Atrial fibrillation and incident myocardial infarction in the elderly // Clin Cardiol. 2014;37(12):750–5. 7. Andersen K., Farahmand B., Ahlbom A., Held C., Ljunghall S., Michaëlsson K., Sundström J. Risk of arrhythmias in 52 755 long-distance cross-country skiers: a cohort study // Eur Heart J. 2013;34:3624–3631. doi: 10.1093/ eurheartj/eht188. 8. O’Neal W.T., Qureshi W.T., Judd S.E., McClure L.A., Cushman M., Howard V.J., Howard G., Soliman E.Z. Environmental tobacco smoke and atrial fibrillation: the REasons for Geographic And Racial Differences in Stroke (REGARDS) Study // J Occup Environ Med. 2015;57:1154–1158. 9. Ruigómez A., Johansson S., Wallander M.A., Rodrı́guez L.A.G. Incidence of chronic atrial fibrillation in general practice and its treatment pattern // Journal of clinical epidemiology, 2002. 55(4), 358-363. 10. Cha Y.M., Redfield M.M., Shen W.K., Gersh B.J. Atrial fibrillation and ventricular dysfunction: a vicious electromechanical cycle // Circulation 2004;109:2839-2843 11. Measure D.H.S. Afghanistan Mortality Survey 2010: Afghan Public Health Institute. Ministry of Public Health, Central Statistics Organization, Kabul, Afghanistan, ICF Macro, Calverton, Maryland, USA, IIHMR, Jaipur, India and WHO/EMRO, Cairo, Egypt. 2011. 12. Gage B.F., van Walraven C., Pearce L., et al. Selecting patients with atrial fibrillation for anticoagulation: stroke risk stratification in patients taking aspirin. Circulation. 2004. 110(16): 2287–92. 13. Aksoy F., Baş H. A., Bağcı A., Oskay T. The CHA2DS2-VASc score for predicting atrial fibrillation in patients presenting with ST elevation myocardial infarction: prospective observational study // Sao Paulo Medical Journal, 2019. 137(3), 248-254. 14. Lip G.Y., Nieuwlaat R., Pisters R., Lane D.A., Crijns H.J. Refining Clinical Risk Stratification for Predicting Stroke and Thromboembolism in Atrial Fibrillation Using a Novel Risk Factor-Based Approach // Chest 2010;137:263-272. 15. Tousoulis D., Antoniades C., Stefanadis C. Assessing inflammatory status in cardiovascular disease // Heart. 2007;93(8):1001-7. PMID: 17639118. 16. Engelmann M.D., Svendsen J.H. Inflammation in the genesis and perpetuation of atrial fibrillation // Eur Heart J. 2005. 26:2083–2092. 17. Brown MJ, Brown DC and Murphy MB. Hypokalemia from beta2-receptor stimulation by circulating epinephrine // NEngl J Med. 1983; 309: 1414–1419. 18. Hulting J. In-hospital ventricular fibrillation and its relation to serum potassium // Acta Med Scand Suppl. 1981; 647:109–116. 19. Kafka H., Langevin L., Armstrong P.W. Serum magnesium and potassium in acute myocardial infarction. Influence on ventricular arrhythmias // Arch Intern Med. 1987; 147:465–469. 20. Solomon R.J., Cole A.G. Importance of potassium in patients with acute myocardial infarction // Acta Med ScandSuppl 1981; 647: 87–93. 21. Rienstra M., Sun J.X., Magnani J.W., Sinner M.F., Lubitz S.A., Sullivan L.M., Benjamin E.J. White blood cell count and risk of incident atrial fibrillation (from the Framingham Heart Study) // The American journal of cardiology, 2012. 109(4), 533-537. 22. Misialek J.R., Bekwelem W., Chen L.Y., Loehr L.R., Agarwal S.K., Soliman E.Z., Alonso A. Association of white blood cell count and differential with the incidence of atrial fibrillation: the Atherosclerosis Risk in Communities (ARIC) study // PloS one, 2015. 10(8), e0136219. 23. Byrne C.E., Fitzgerald A., Cannon C.P. et al. Elevated white cell count in acute coronary syndromes: relationship to variants in inflammatory and thrombotic genes // BMC Med Genet 5, 13 (2004). 24. Yoshizaki T., Umetani K., Ino Y. et al. Activated inflammation is related to the incidence of atrial fibrillation in patients with acute myocardial infarction // Intern Med. 2012 51:1467–1471.
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Ibrahimi I., Shinwari N., Sarwari Z., Karibayev K.R., Akhenbekova A.Z. Atrial fibrillation predictors in patient with acute coronary syndrome in Kabul (Afghanistan) from 2018 to 2020 // Nauka i Zdravookhranenie [Science & Healthcare]. 2021, (Vol.23) 3, pp. 146-152. doi 10.34689/SH.2021.23.3.017 Икрамулла И., Шинвари Н., Сарвари З., Карибаев К.Р., Ахенбекова А.Ж. Предикторы фибрилляции предсердий у пациентов с острым коронарным синдромом в Кабуле (Афганистан) с 2018 по 2020 год // Наука и Здравоохранение. 2021. 3(Т.23). С. 146-152. doi 10.34689/SH.2021.23.3.017 Икрамулла И., Шинвари Н., Сарвари З., Карибаев К.Р., Ахенбекова А.Ж. 2018 жылдан 2020 жылға дейін Ауғанстанның Кабул қаласында жедел коронарлық синдромы бар науқаста атриальды фибрилляцияны болжаушылар // Ғылым және Денсаулық сақтау. 2021. 3 (Т.23). Б. 146-152. doi 10.34689/SH.2021.23.3.017

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