The Association between Acute Myocardial Infarction-Related Outcomes and the Ramadan Period: A Retrospective Population-Based Study

Abstract

Fasting throughout the Muslim month of Ramadan may impact cardiovascular health. This study examines the association between the Ramadan period and acute myocardial infarction (AMI)-related outcomes among a Muslim population. The data were retrospectively extracted from a tertiary hospital (Beer-Sheva, Israel) database from 2002–2017, evaluating Muslim patients who endured AMI. The study periods for each year were: one month preceding Ramadan (reference period (RP)), the month of Ramadan, and two months thereafter (1840 days in total). A comparison of adjusted incidence rates between the study periods was performed using generalized linear models; one-month post-AMI mortality data were compared using a generalized estimating equation. Out of 5848 AMI hospitalizations, 877 of the patients were Muslims. No difference in AMI incidence between the Ramadan and RP was found (p = 0.893). However, in the one-month post-Ramadan period, AMI incidence demonstrably increased (AdjIRR = 3.068, p = 0.018) compared to the RP. Additionally, the highest risk of mortality was observed among the patients that underwent AMI in the one-month post-Ramadan period (AdjOR = 1.977, p = 0.004) compared to the RP. The subgroup analyses found Ramadan to differentially correlate with AMI mortality with respect to smoking, age, sex, diabetes mellitus, and hypertension, suggesting the Ramadan period is a risk factor for adverse AMI-related outcomes among select Muslim patients.

Burden and Patterns of Medical Emergencies during Ramadan Fasting: A Narrative Review

“…The association between acute myocardial infarction (AMI) outcome and RF by comparing the month preceding Ramadan, Ramadan, and 1 month after Ramadan. 45 Incidents of AMI between Ramadan and 1 month before were the same, while 1-month post-Ramadan showed an increase in AMI incidence and mortality. Similar findings were observed by others who studied the 3 months per year before, during, and after RF, between the years 2012 and 2014.…”

“…Five studies explored the relationship between RF and ACS, and three examined the relationship to heart failure. 45 46 47 48 49 50 51 52 Table 4 summarizes the ACS studies. 45 46 47 48 49 All cardiology studies' salient features and conclusions are reviewed below.…”

“…45 46 47 48 49 50 51 52 Table 4 summarizes the ACS studies. 45 46 47 48 49 All cardiology studies' salient features and conclusions are reviewed below.…”

Review of the Literature on Ramadan Fasting and Health in 2022

“…In 2022, seven original research articles addressed various aspects of cardiovascular disease (CVD) 23 24 25 and risk factors 26 27 28 29 associated with RF: four on cardiac events and three on risk factors. Four other articles provided practical guidelines and management recommendations for people with CVD during RF.…”

“…Betesh-Abay et al 23 examined the association between RF and acute myocardial infarction (AMI)-related outcomes using retrospectively extracted data from a tertiary hospital database 2002–2017. The study periods for each year were 1 month preceding Ramadan (reference period [RP]), Ramadan, and 2 months after that.…”