Letter to the Editor

Dear Editor,

We thank our colleagues for their interest in our investigation [1]. Different circadian periodicity in the time of onset of ST-elevation myocardial infarction (STEMI) has been raised as a potential confounder of our results. They advised simultaneous measurement of physiological variables including blood pressure, heart rate, cardiac output and endothelial function in fasting patients. Blood pressure and heart rate were not statistically different between fasting and non-fasting patients (it was stated in Table 1 in the manuscript). On the other hand, it is clear that measuring endothelial dysfunction and cardiac output was beyond the aim of the paper. However, we have further analyzed the infarct site of fasting patients according to the onset of MI and found no difference (the numbers of patients with anterior vs inferior were 2/3 in 0-6 h, 4/6 in 6-12 h, 20/16 in 12-18 h and 2/2 in 18-24 h, respectively (p = 0.795)). Similarly, there was no difference between the infarct site and the onset of MI (the numbers of patients with anterior vs inferior were 3/3 in 0-6 h, 20/16 in 6-12 h, 6/18 in 12-18 h and 13/17 in 18-24 h, respectively (p = 0.135)) in non-fasting patients. Our colleagues’ other suggestion regarding further studies may be helpful to define the role of Ramadan fasting to affect the circadian clock. Finally, we provided information about our patients’ time of onset of STEMI in Figure 1.



References  

1. Turker Y, Aydin M, Aslantas Y, et al. The effect of Ramadan fasting on circadian variation of Turkish patients with acute myocardial infarction. Postep Kardiol Inter 2012; 3: 193-198.


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