Alaarag Ahmed F, Elkhalek Abou-Omar Mahmoud A, Amin Osama A
Department of Cardiology, Tanta University, Egypt.
Department of Cardiology, Beni-Suef University, Egypt.
J Saudi Heart Assoc. 2025 Jan 30;37(1):3. doi: 10.37616/2212-5043.1419. eCollection 2025.
Even though Islam excludes the sick from Ramadan Fasting (RF), countless Muslims choose to fast throughout this holy month. So, it is of paramount importance to review how RF influences patients with chronic Heart Failure with reduced Ejection Fraction (HFrEF). Our study intended to check the safety of RF in these patients.
We selected patients under 75 years old with compensated chronic HFrEF. After applying all the exclusion conditions, those who insisted on fasting during the coming Ramadan were enrolled in fasting Group I (90 patients). Those who decided not to fast were listed as control Group II (68 patients) to ensure a comprehensive model.
Patients with prior revascularization, AF, lower e-GFR, and poor functional capacity (higher NYHA class) had higher AEs after RF with P values (0.013, 0.027, 0.001, and 0.038), respectively. The low e-GFR and prior revascularization were independent predictors of AEs with P-values (0.005 & 0.031), respectively. The e-GFR (50 ml/min/1.73 m) was cut off at which the incidence of AEs increased, with a specificity and sensitivity of 65 % and 81 %, respectively.
RF may be harmless in low-risk patients with chronic HFrEF under the supervision of a medical professional. However, HFrEF patients with prior coronary revascularization or CKD may have a higher incidence of AEs.
尽管伊斯兰教允许患病者不参与斋月禁食（RF），但仍有无数穆斯林选择在这个神圣的月份里禁食。因此，回顾RF如何影响射血分数降低的慢性心力衰竭（HFrEF）患者至关重要。我们的研究旨在检验RF在这些患者中的安全性。
我们选择了75岁以下病情得到控制的慢性HFrEF患者。在应用所有排除标准后，那些坚持在即将到来的斋月期间禁食的患者被纳入禁食第一组（90例患者）。那些决定不禁食的患者被列为对照组第二组（68例患者），以确保建立一个全面的模型。
既往有血管重建、房颤、估算肾小球滤过率（e-GFR）较低以及功能能力较差（纽约心脏协会分级较高）的患者在RF后发生不良事件（AE）的几率更高，P值分别为（0.013、0.027、0.001和0.038）。低e-GFR和既往血管重建是AE的独立预测因素，P值分别为（0.005和0.031）。e-GFR（50 ml/min/1.73 m²）是一个临界值，在该值时AE的发生率会增加，其特异性和敏感性分别为65%和81%。
在医学专业人员的监督下，RF对低风险的慢性HFrEF患者可能无害。然而，既往有冠状动脉血管重建或慢性肾脏病（CKD）的HFrEF患者发生AE的几率可能更高。
