The Risk Probability of Fasting Ramadan for Patients with CABG
Ahmed Samy1, Moshira H. Sabry 2, Abdelhady M. Hamada 2 and Osama Rifaie 3
1Cardiothoracic Surgery, 2Clinical and Chemical Pathology, 3Cardiology Cardiothoracic Surgery Department & Cardiology Department; Faculty of Medicine, Ain Shams University
Abstract: The effect of Fasting Ramadan on high risk patients with coronary artery disease (CAD) who had coronary artery bypass grafting (CABG) is a difficult question to answer. Some doctors advise these patients to break fasting, but many patients keep fasting with no medical problems or if present not recorded. Patients with CABG who persist to fast Ramadan give us the opportunity to do our study. We studied 42 patients as regard the effect of Ramadan fast on their clinical status including chest pain (angina), blood pressure, cardiac enzymes, ECG and echocardiography. We also, study the effect of fasting on serum cholesterol, triglycerides and Malondialdehyde (MDA) as the end product of lipid peroxidation, Ultrasensitive CRP (Hs-CRP) as a predictive value of the inflammatory process and the osmolarity of the blood during fasting and compared to the non-fasting. The results showed three patients developed chest pain on day 17, 20, 24 of fasting due to chest infection and pleurisy with no other abnormalities detected. Two other patients developed elevated systolic blood pressure due to stoppage of diuretics without replacement with other drug during fasting. Two patients of the cigarette smokers were frequently complained of chest pain before fasting they become symptoms free during fasting which may be due to cessation of smoking which was of great benefit for these patients to release this risk factor. There was significant decrease of Hs-CRP during fasting which reflects improvement of the inflammatory process thus releasing one of the risk factors for CAD. There was no significant difference between fasting and non-fasting cholesterol and triglycerides levels. MDA showed significant increase during fasting reflecting increased lipid peroxidation. There was also sig increased osmolarity during fasting with hem concentration. We conclude that the patient can fast Ramadan safely with proper medical supervision for control of hypertension and if diuretic was withdrawn it must be replaced with other modality of treatment during fasting with proper hydration. Also, the patient must take anti-oxidant during fasting.
[Ahmed Samy, Moshira H. Sabry, Abdelhady M. Hamada and Osama Rifaie. The Risk Probability of Fasting Ramadan for Patients with CABG. Life Sci J 2013;10(1):354-359]. (ISSN: 1097-8135).http://www.lifesciencesite.com. 57
Key Words: Malondialdehyde (MDA), CAPG, Hs-CRP, Ramadan fasting Full Text 57