The safety of Ramadan Fasting following Percutaneous Coronary Intervention
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The safety of Ramadan Fasting following Percutaneous Coronary Intervention Osama A. Amin1* and Ahmed Alaarag2
Abstract Background: This work aimed to assess the safety of Ramadan Fasting following the Percutaneous Coronary Intervention. Methods: In our two centers’ Prospective Cohort Study, We included 303 patients who had successful Percutaneous Coronary Intervention before the first day of Ramadan. We advised the patients that recent Percutaneous Coronary Intervention could be a valid excuse for not fulfilling Ramadan Fasting. However, many patients intended to fast the following Ramadan, and we included them in the fasting Group I. We added the patients who decided not to fast the following Ramadan as a control Group II. We followed all the patients during Ramadan and for 6 months after Ramadan. Results: The demographic data of both groups and the complexity of the coronary anatomy showed no statistically significant difference. Group I (n = 153) showed a statistically significant difference in the incidence of Major Adverse Cardiac Events compared to Group II with a P value (0.005). The logistic multivariate regression analysis showed that the duration from index PCI till the start of RF, SYNTAX score > 22, and Complex procedure were independent predictors of Major Adverse Cardiac Events in the fasting Group I with {P = 0.001, OR (2.302), P = 0.026, OR (2.419), and P = 0.032 OR (1.952)}, respectively. Major Adverse Cardiac Events in Group I occurred mainly during Ramadan Fasting, with 19 patients having Major Adverse Cardiac Events during Ramadan and four patients during the remaining of the follow-up period. The Receiver Operating Characteristic curve analysis showed the decline of the incidence of Major Adverse Cardiac Events after 90 days from Percutaneous Coronary Intervention till the start of Ramadan Fasting with Sensitivity and specificity (90% and 65%), respectively. Conclusions: We suggest that low-risk patients with a normal systolic function who underwent Percutaneous Coronary Intervention may safely fast Ramadan. At the same time, Ramadan Fasting during the first 3 months following the Percutaneous Coronary Intervention may not be safe. Keywords: Ramadan Fasting, Percutaneous Coronary Intervention, Major adverse cardiovascular events Background Ramadan Fasting (RF) is considered one of the pillars of Islam. RF includes refraining from any form of ingestion into the body from dawn until Sunset. RF is mandatory for all adult Muslims except for patients with medical disorders that exclude them from fasting. *Correspondence: [email protected] 1 Department of Cardiology, Beni Suef University, Beni Suef, Egypt Full list of author information is available at the end of the article
Although physicians always exempt patients with illnesses from this religious obligation, many continue with fasting for spiritual reasons, and they strictly organize their prescription timetable to outfit RF. The metabolic and clinical effects of RF have been previously studied systematical
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