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

Authors

  • Shwan Amen Consultant Interventional Cardiologist- Surgical Speciality Hospital -Cardiac Center- Erbil -Iraq
  • Banan Rasool General Practitioner at Batas Primary Health Care Center- directorate of Shaqlawa- Ministry of Health- Erbil-Iraq
  • Alaa Rashid Hawler Medical University - College of Medicine, Erbil, Iraq
  • Sara Shakir Hawler Medical University - College of Medicine, Erbil, Iraq
  • Parez Qadr Junior house officer at KRJ Erbil-Iraq
  • Asia Shawkat Junior House officer at KRG Ebil-Iraq
  • Rangen Abdulkarem General Practitioner at Harir Hospital- Ministry of Health -Erbil-Iraq
  • Salah Yousif Interventional cardiologist, surgical speciality hospital, Cardiac center, Erbil- Iraq
  • Don Lucero-Prisno Department of Global Health and Development, London School of Hygiene & Tropical Medicine, London, UK
  • Dina Shehata Hawler Medical University

DOI:

https://doi.org/10.22317/imj.v6i4.1186

Keywords:

Coronary Artery Disease (CAD), Primary Percutaneous Coronary Intervention (PPCI), Ramadan Intermittent Fasting, NYHA Classification, Chest Pain, Shortness of Breath (SOB)

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.

References

- Ahmad M, Mehta P, Reddivari AKR, Mungee S. Percutaneous Coronary Intervention[Internet]. Treasure Island (FL): StatPearls Publishing; 2021[cited 2021 June 18]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK556123/ (Accessed 13 November 2021).

- Traina MI, Almahmeed W, Edris A, Tuzcu EM. Coronary heart disease in the Middle East and North Africa: current status and future goals. Current atherosclerosis reports 2017 May 1;19(5):24. Available from: https://pubmed.ncbi.nlm.nih.gov/28378303/ (Accessed 13 November 2021)

- Kettani H. 2010 world Muslim population.Proceedings of the 8th Hawaii International Conference on Arts and Humanities 2010 Jan:12-16. Available from: https://static1.1.sqspcdn.com/static/f/276285/11250012/1300262558670/kettani-2010-world-muslim-population.pdf?token=B1HW28Pb8RHom8v38GOw5kgWsC4%3D (Accessed 13 November 2021)

Beshyah SA, Fathalla W, Saleh A, Al Kaddour A, Noshi M, Al Hateethi H, et al. Mini-Symposium: Ramadan Fasting and The Medical Patient: An Overview for Clinicians. Ibnosina Journal of Medicine & Biomedical Sciences. 2010 Sep 1;2(5). Available from: https://www.ijmbs.org/article.asp?issn=1947-489X;year=2010;volume=2;issue=5;spage=240;epage=257;aulast=Beshyah;type=0 (Accessed 13 November 2021)

- Beltaief K, Bouida W, Trabelsi I, Baccouche H, Sassi M, Dridi Z, et al. Metabolic effects of Ramadan fasting in patients at high risk of cardiovascular diseases. International journal of general medicine. 2019 Jul 15;12:247-254. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6643153/ ( Accessed 13 November 2021)

- Jahrami HA, Alsibai J, Obaideen AA. Impact of Ramadan diurnal intermittent fasting on the metabolic syndrome components in healthy, non-athletic Muslim people aged over 15 years: a systematic review and meta-analysis. British Journal of Nutrition. 2020 Jan;123(1):1-22. DOI: https://doi.org/10.1017/S000711451900254X

- Jahrami HA, Faris ME, Janahi AI, Janahi MI, Abdelrahim DN, Madkour MI, Sater MS, Hassan AB, Bahammam AS. Does four-week consecutive, dawn-to-sunset intermittent fasting during Ramadan affect cardiometabolic risk factors in healthy adults? A systematic review, meta-analysis, and meta-regression. Nutrition, Metabolism and Cardiovascular Diseases. 2021 Jul 22;31(8):2273-301.doi:10.1016/j.numecd.2021.05.002.

- Jahrami HA, Alsibai J, Obaideen AA. Impact of Ramadan diurnal intermittent fasting on the metabolic syndrome components in healthy, non-athletic Muslim people aged over 15 years: a systematic review and meta-analysis. British Journal of Nutrition. 2020 Jan;123(1):1-22. https://doi.org/10.1016/j.jnim.2018.11.005

- Madkour MI, Obaideen AK, Dalah EZ, Hasan HA, Radwan H, Jahrami HA, Hamdy O, Mohammad MG. Effect of Ramadan diurnal fasting on visceral adiposity and serum adipokines in overweight and obese individuals. Diabetes research and clinical practice. 2019 Jul 1;153:166-75. DOI: 10.1016/j.diabres.2019.05.023

- Sarraf-Zadegan N, Atashi M, Naderi GA, Baghai AM, Asgary S, Fatehifar MR, et al. The effect of fasting in Ramadan on the values and interrelations between biochemical, coagulation and hematological factors. Annals of Saudi medicine 2000 Sep;20(5-6):377-81. Available from: https://pubmed.ncbi.nlm.nih.gov/17264626/ (Accessed 13 November 2021)

- Camenzind E, Steg PG, Wijns W. A cause for concern. Circulation 2007 Mar 20;115(11):1440-55. Available from: https://www.ahajournals.org/doi/full/10.1161/circulationaha.106.666800 (Accessed 13 November 2021)

- Chamsi-Pasha H, Ahmed WH. The effect of fasting in Ramadan on patients with heart disease. Saudi Med J 2004;25(1):47-51. Available from: https://pubmed.ncbi.nlm.nih.gov/14758379/ (Accessed 13 November 2021)

- Nematy M, Alinezhad-Namaghi M, Rashed MM, Mozhdehifard M, Sajjadi SS, Akhlaghi S, et al. Effects of Ramadan fasting on cardiovascular risk factors: a prospective observational study. Nutrition Journal 2012 Dec;11(1):1-7. Available from: https://nutritionj.biomedcentral.com/articles/10.1186/1475-2891-11-69 (Accessed 13 November 2021)

Amin OA, Alaarag A. The safety of Ramadan fasting following percutaneous coronary intervention. BMC Cardiovascular Disorders 2020 Dec;20(1):1-1. Available from:

https://bmccardiovascdisord.biomedcentral.com/articles/10.1186/s12872-020-01784-8 (Accessed 13 November 2021)

-Timesprayer.com. Erbil prayer times in Ramadan[Internet]. 2021. Available from: https://timesprayer.com/en/hijri-prayer-in-erbil-1442-ramadan.html (Accessed 13 November 2021)

- Weather2visit.com. Erbil weather in April[Internet]. 2021. Available from: https://www.weather2visit.com/middle-east/iraq/erbil-april.htm (Accessed 13 November 2021)

- Abazid RM, Khalaf HH, Sakr HI, Altorbak NA, Alenzi HS, Awad ZM, Smettei OA, Elsanan MA, Widyan AM, Azazy AS, Chamsi-Pasha HW. Effects of Ramadan fasting on the symptoms of chronic heart failure. Saudi medical journal 2018 Apr;39(4):395. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5938654/ (Accessed 13 November 2021)

- Mousavi M, Mirkarimi S, Rahmani G, Hosseinzadeh E, Salahi N. Ramadan fast in patients with coronary artery disease. Iranian Red Crescent Medical Journal 2014 Dec;16(12). Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4341245/ (Accessed 13 November 2021)

- O. Rifaie, M. Ahmed Abdel-Rahman, A. Mabrouk Salem Omar, Favorable inflammatory status following intermittent fasting in patients with atherosclerotic coronary heart disease after revascuralization, European Heart Journal, Volume 34, Issue suppl_1, 1 August 2013, P5502, https://doi.org/10.1093/eurheartj/eht310.P5502

- Salim I, Al Suwaidi J, Ghadban W, Alkilani H, Salam AM. Impact of religious Ramadan fasting on cardiovascular disease: a systematic review of the literature. Current medical research and opinion 2013 Apr 1;29(4):343-54. Available from: https://pubmed.ncbi.nlm.nih.gov/23391328/ (Accessed 13 November 2021)

- Khafaji HA, Bener A, Osman M, Al Merri A, Al Suwaidi J. The impact of diurnal fasting during Ramadan on the lipid profile, hs-CRP, and serum leptin in stable cardiac patients. Vascular health and risk management 2012;8:7. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3262481/ (Accessed 13 November 2021)

- Mansour AA, Shiaa NR, Ajeel NA. Attitude of patients with diabetes mellitus toward fasting Ramadan in Basrah Iraq. Endocrinol Metab Int J 2018;6(1):00146. Available from: https://medcraveonline.com/EMIJ/attitude-of-patients-with-diabetes-mellitus-toward-fasting-ramadan-in-basrah-iraq.html (Accessed 13 November 2021)

- Kwok CS, Narain A, Pacha HM, Lo TS, Holroyd EW, Alraies MC, et al. Readmissions to Hospital After Percutaneous Coronary Intervention: A Systematic Review and Meta-Analysis of Factors Associated with Readmissions. Cardiovasc Revasc Med 2020 Mar;21(3):375-391. Available from: https://www.sciencedirect.com/science/article/abs/pii/S155383891930315X?via%3Dihub (accessed 15 November 2021)

- Khazneh E, Qaddumi J, Hamdan Z, Qudaimat F, Sbitany A, Jebrin K, Sawalmeh O, Abuiram Y, Shraim M. The effects of Ramadan fasting on clinical and biochemical markers among hemodialysis patients: A prospective cohort study. PloS one 2019 Jun 24;14(6):e0218745. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6590819/ (accessed 15 November 2021)

- V RA, Zargar AH. Diabetes control during Ramadan fasting. Cleveland Clinic journal of medicine 2017 May 1;84(5):352-6. Available from: https://pubmed.ncbi.nlm.nih.gov/28530893/ (accessed 15 November 2021)

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Published

2022-12-26

How to Cite

1.
Amen S, Rasool B, Rashid A, Shakir S, Qadr P, Shawkat A, et al. The safeness of Ramadan intermittent fasting among patients who undergone primary Percutaneous Coronary Intervention. Iraq Med J [Internet]. 2022 Dec. 26 [cited 2024 Nov. 23];6(4). Available from: https://iraqmedj.org/index.php/imj/article/view/1186

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