Culprit Lesion Characteristics and Outcomes of Myocardial Infarction during The Month of Ramadan among Fasting Muslims Population

Objectives: This study aims to investigate the characteristics of culprit lesions and outcomes of myocardial infarction (MI) in fasting Muslims during Ramadan, compared to those in non-Ramadan periods. Methodology: This study included 138 patients diagnosed with myocardial infarction (both ST elevation and non-ST elevation) who were referred for primary percutaneous coronary intervention (PPCI) or an early invasive strategy during Ramadan (Group I: the fasting group). For comparison, 131 patients with myocardial infarction, referred for PPCI or an early invasive strategy in non-Ramadan months, were included in Group II (the non-fasting group). We compared the culprit lesion characteristics and clinical outcomes of MI between these two groups. Results: The incidence of myocardial infarction was similar during Ramadan and outside of it. However, significant differences were observed in the culprit lesion characteristics and outcomes between the two groups. During Ramadan, culprit lesions exhibited non-atheromatous characteristics with a heavier thrombus burden in Group I. The use of aspiration catheters during PCI was more frequent, and the decision to defer stenting was significantly higher in this group. Favorable metabolic changes, such as lower blood glucose, serum CRP, total cholesterol, and LDL, were noted in the fasting group; however, these changes did not significantly impact the overall clinical outcomes between the groups. Conclusion: Myocardial infarction during Ramadan is characterized by non-atheromatous coronary lesions and a higher thrombus burden. Despite these differences, the incidence of myocardial infarction and major adverse cardiac events did not significantly differ between Ramadan and other months of the year.