Effects of Ramadan fasting on aspirin resistance in type 2 diabetic patients

Wahid Bouida, Kaouthar Beltaief, Houda Baccouche, Mouna Sassi, Zohra Dridi, Imen Trabelsi, Kamel Laaouiti, Taher Chakroun, Ilhem Hellara, Riadh Boukef, Nabil Sakly, Mohsen Hassine, Faouzi Added, Rabie Razgallah, Fadhel Najjar, Semir Nouira, Ramadan Research Group, Wahid Bouida, Kaouthar Beltaief, Houda Baccouche, Mouna Sassi, Zohra Dridi, Imen Trabelsi, Kamel Laaouiti, Taher Chakroun, Ilhem Hellara, Riadh Boukef, Nabil Sakly, Mohsen Hassine, Faouzi Added, Rabie Razgallah, Fadhel Najjar, Semir Nouira, Ramadan Research Group

Abstract

Aims: Ramadan fasting (RF) may affect aspirin resistance. We conducted this study in patients with cardiovascular risk (CVR) factors to assess the effect of RF on aspirin resistance and explore whether type 2 diabetes mellitus (DM) would influence this effect.

Methods: A total of 177 stable patients with ≥2 CVR factors were recruited. All patients observed RF and were taking aspirin. Physical exam and standard biological tests including glycaemia and serum lipids data were performed before Ramadan (Pre-R), at the last week of Ramadan (R) and four weeks after the end of Ramadan (Post-R). In the same visits caloric intake was calculated and platelet reactivity to aspirin was assessed using Verify Now point-of-care assay.

Results: In the overall population, there was no significant change in absolute aspirin reaction unit (ARU) values and in metabolic parameters. In DM patients (n = 127), ARU change from Pre-R values was+19.7 (p = 0.01) and +14.4 (p = 0.02) respectively at R and Post-R. During Ramadan, glycaemia, triglycerides, and cholesterol levels increased significantly and returned to Pre-R values thereafter. These changes were not observed in non-DM patients.

Conclusions: During RF aspirin resistance increased only in DM patients. This effect persisted one month after Ramadan. Simultaneous alteration of glycemic control and increase of serum lipids levels could potentially be a favorable factor.

Study registration: The protocol was registered at clinicaltrials.gov under: NCT02720133.

Conflict of interest statement

Competing Interests: The authors did not receive funding from Medis Laboratories Tunisia, a commercial company, for this study. One of the authors, RR, is affiliated with Medis Laboratories. There are no patents, products in development or marketed products to declare. This does not alter the authors' adherence to all the PLOS ONE policies on sharing data and materials.

Figures

Fig 1. Study profile.
Fig 1. Study profile.
Fig 2. Mean absolute ARU change from…
Fig 2. Mean absolute ARU change from baseline during and after Ramadan.
*p

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Source: PubMed

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