The safeness of Ramadan intermittent fasting among patients who undergone primary Percutaneous Coronary Intervention

Abstract

Objective: This study aims to assess the ability and the safety of fasting among patients who underwent PPCI within two specified periods. Methods: This study was a Retrospective Cohort Study with a convenience sample size of 200 consecutive patients who were divided into two groups based on the duration of their last primary PCI for an attack of acute myocardial infarction (AMI) and the start of the month of Ramadan. The patients were admitted to the Causality Department of the Surgical Specialty Hospital-Cardiac Center, Erbil/Iraq. Group I included patients undergone PPCI 6 weeks or less before the start of Ramadan while group II included patients undergone PPCI for more than 6 weeks before the start of the fasting month of Ramadan. Furthermore, each of these two groups was subdivided based on their ability to complete the Ramadan Intermittent Fasting (RIF) with no recurring or worsening of symptoms into those who fasted the whole Ramadan month, those who did not fast, those who could not continue fasting, and those who passed away. At the end of the RIF, patients’ symptoms were recorded along with their status according to the New York Heart Association (NYHA). Results: In a comparison of the proportion of fasting and non-fasting patients among the two groups, 14% in group I were able to complete the 30 days of intermittent fasting during the Ramadan month while this percentage in group II was 54% (P-value=0.001). Among our findings, there were significant associations between post-PCI symptoms (exertional shortness of breath and palpitations) and RIF (P-values=0.001and P-values=0.004, respectively). With regards to New York Heart Association (NYHA) classifications assessment, Group I had a higher proportion of patients classified as Class III and Class IV compared to Group II (P-value=0.001) meaning patients were more symptomatic during the lesser interval between the start of the fasting month and the primary PCI.  Conclusion: Patients with PPCI within the first 6 weeks after the procedure, as well as patients with NYHA class III, are at a higher risk for health deterioration and are advised not to observe RIF.