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Religious fasting safe in HFrEF

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Rami M. Abazid

Fasting for Ramadan was considered safe in patients with chronic HF with reduced ejection fraction, according to data presented at the Annual Conference of the Saudi Heart Association.

“Although few studies have reported that the majority of patients diagnosed with acute heart failure remain stable with no deterioration following Ramadan fasting, this is the first prospective study investigating the effect of Ramadan fasting on the symptoms of chronic heart failure with reduced ejection fraction,” Rami M. Abazid, MD, FRCP, cardiologist at Prince Sultan Cardiac Centre in Qassim, Saudi Arabia, said in an interview with Cardiology Today.

In this prospective study, researchers analyzed data from 249 patients with HFrEF who fasted for Ramadan in Saudi Arabia. Information was obtained the month before and during Ramadan, including diagnosis, clinical assessment, hospitalization and ED visits.

Ninety-one percent of patients participated in the fast for the entire month. While fasting, 8% of patients were hemodynamically unstable, whereas 92% of patients were stable. The stable group had a lower NYHA functional class compared with the unstable group (1.46 vs. 3.22; P < .0001). There were no differences between the two groups before Ramadan.

Compared with patients who were stable, those who were unstable were less likely to adhere to diet (39% vs. 79%; P < .0001) or to medications (67% vs. 94%; P < .0001). They were also less likely to have ischemic cardiomyopathy as an underlying cause of HFrEF (33% vs. 57%; P = .046).

The unstable group had more hospitalization (39% vs. 0%; P .0001) and ED visits (50% vs. 10%; P .0001) compared with the stable group.

NYHA classification was higher in both groups before Ramadan (P < .0001).

“Positive balanced patients with decompensated heart failure or those requiring large doses of diuretics should be advised not to fast, particularly when Ramadan falls in the summer,” Abazid said in an interview. “Since there are no current studies addressing this category of patients, an adverse outcome could potentially be life-threatening, and a prospective study is warranted.”– by Darlene Dobkowski

References:

Abazid R, et al. Effects of Ramadan fasting on the symptoms of chronic heart failure. Presented at: Annual Conference of the Saudi Heart Association; March 1-3, 2018; Riyadh, Saudi Arabia.

Abazid R, et al. Saudi Med J. 2018;doi:10.15537/smj.2018.4.22011.

Disclosures: The authors report no relevant financial disclosures.