Effect of Ramadan Fasting on the International Normalized Ratio and Prosthetic valve function in Patients with Mechanical Prosthetic Heart Valves

Abdelrahman, Yasser Hosny; Ammar, Saad Mahmud; El-morshedy, Mohamed Zaki Ibrahim; Abdelmoneum, Mahmoud Shawky

doi:10.21608/bmfj.2023.245457.1941

	Effect of Ramadan Fasting on the International Normalized Ratio and Prosthetic valve function in Patients with Mechanical Prosthetic Heart Valves
Benha Medical Journal
Articles in Press, Accepted Manuscript, Available Online from 22 December 2023 PDF (662.77 K)
Document Type: Original Article
DOI: 10.21608/bmfj.2023.245457.1941
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Authors
Yasser Hosny Abdelrahman¹; Saad Mahmud Ammar²; Mohamed Zaki Ibrahim El-morshedy ³; Mahmoud Shawky Abdelmoneum⁴
¹Associate Professor of Cardiology, Faculty of Medicine, Benha University
²Professor of Cardiology, Faculty of Medicine, Benha University
³Department of Cardiology Faculty of medicine Benha University
⁴Assistant Professor of Cardiology, Faculty of Medicine, Benha University
Abstract
Background: Ramadan fasting presents unique challenges for patients with mechanical prosthetic heart valves on Warfarin therapy. This study aimed to evaluate the potential effects of Ramadan fasting and lifestyle changes during Ramadan on the INR level in patients using Vitamin K anticoagulant VKA (Warfarin) for mechanical prosthetic heart valves as anticoagulation. Methods: This prospective study included 150 Muslim patients with mechanical prosthetic heart valves, tracking their INR levels over a period encompassing the month of Ramadan. Patients underwent regular assessments, including clinical examinations, INR measurements, and echocardiography. Data were collected on medication regimens, Warfarin intake timing, and fasting adherence. Results: The mean INR levels increased during Ramadan, with the most significant rise occurring in the last two weeks. Patients exhibited a significantly higher mean INR during Ramadan compared to the pre-Ramadan and post-Ramadan periods. Importantly, more patients reached the supra-therapeutic INR range during Ramadan, while fewer were within the sub-therapeutic range when compared to the post-Ramadan phase. Conclusion: Ramadan fasting can lead to significant fluctuations in INR levels in patients with mechanical prosthetic heart valves using Warfarin. Careful monitoring and adjustment of anticoagulation therapy may be necessary to maintain therapeutic INR ranges during this religious observance.
Keywords
Ramadan Fasting; International Normalized Ratio; Mechanical Prosthetic Heart Valves; Warfarin; Anticoagulation Therapy


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