Acute coronary syndrome in hajj women-gender specific characteristics-single center experience

Abstract

The prevalence of cardiovascular disease had increased significantly and the number of acute coronary syndrome (ACS) patients had increased dramatically. Ramadan is a lunar month where all-healthy Muslims are obligated to fast from dawn to sunset. Although observed fasting has several documented health associated benefits, many individual follow an unhealthy lifestyle in the non-fasting hours which may have cardiovascular negative effects. Thus, the aim of this analysis is to determine if ACS incidence increases during or right after the month of Ramadan. All patients presented with ACS to King Abdulaziz Cardiac Center between 2008 and 2017 during months of Shaban, Ramadan and Shawal were included. Electronic medical records were used to retrieve patients’ demographics, cardiovascular risk factors and lab results. We divided patients according to their ACS types (STEMI, NSTEMI and UA). Groups were compared using Kruskal-Wallis and Chi Square, as appropriate. A multivariate logistic regression models were used to determine if the month of Ramadan was independently associated with increased incidence of ACS types. A total of 1855 patients (22.8% were females, mean age 61 years) were admitted with ACS in those three months. The incidence of STEMI gradually increased with concomitant decreased in the incidence of unstable angina in Shaban and Shawal. In the adjusted multivariate logistic regression, Ramadan and Shawal were independent predictors of STEMI patients (OR 1.88, 95% CI 1.41–2.51) and (OR 1.99, 95% CI 1.5–2.64), respectively. Our results showed that the incidence of STEMI was significantly higher during and right after Ramadan. That might be an influence of unhealthy lifestyle changes that many individuals follow in the month of Ramadan.