Association between Serum Potassium and Magnesium Imbalance with In-Hospital Morbidity and Mortality in New-Onset Atrial Fibrillation Patients

Abstract

Objectives: To investigate the association between serum potassium and magnesium imbalances and adverse in-hospital outcomes, including morbidity and mortality, in patients with new-onset atrial fibrillation (AF). Methodology: This cross-sectional study was conducted at the Department of Cardiology, Khyber Teaching Hospital, Peshawar, from October 2021 to September 2022. Serum potassium and magnesium levels were measured at admission in patients diagnosed with new-onset AF. Clinical outcomes, including heart failure, thromboembolism, major bleeding, and in-hospital mortality, were recorded and analyzed. Results: A total of 270 patients were enrolled, with a predominance of females (61.1%). The median age was 60 years (IQR: 20), and most patients (60.0%) were between 51 and 80 years old. Hypokalemia was present in 17% (n=46), while hypomagnesemia occurred in 14.8% (n=40). Hypokalemia showed significant associations with heart failure (p=0.011), transient ischemic attack (p<0.001), non-ST-segment elevation myocardial infarction (NSTEMI) (p<0.001), sustained ventricular tachycardia (p=0.019), and ventricular fibrillation (p=0.001). Mortality was significantly higher in hypokalemic patients (6.5%) compared to those with normokalemia (0.5%) (p=0.008). Magnesium imbalance was significantly linked with ST-segment elevation myocardial infarction (STEMI) (p=0.001) and ventricular fibrillation (p=0.009). The overall in-hospital mortality was 1.5%, with hypokalemia identified as a significant contributing factor. Conclusion: Hypokalemia markedly increases the risk of adverse in-hospital outcomes, including morbidity and mortality, among patients with new-onset AF. Magnesium imbalance also contributes to severe cardiac events. Early detection and correction of these electrolyte disturbances are essential for optimizing clinical management of AF patients.