Work

Changes in quality of vitamin K antagonist treatment and clinical outcomes during Ramadan: a Dutch population-based cohort study

Year: 2025

Type: article

Abstract: Background: Ramadan fasting alters the timing and content of food, including dietary vitamin K, and medication intake, potentially affecting stability of vitamin K antagonist (VKA) treatment and clinical outcomes. Objectives: To assess population-level changes in VKA treatment quality and incidence of clinical events, including bleeding and venous and arterial thromboembolism, during Ramadan in the Netherlands. Methods: Data from 17 Dutch anticoagulation clinics were linked to Statistics Netherlands. Prevalent VKA users in 2013-2019 with an immigration background who were likely to fast during Ramadan (ie, the Ramadan cohort) were studied from 2 months preceding Ramadan until 2 months after. During each 30-day interval, VKA treatment quality and risk of clinical events were assessed. A cohort of native Dutch VKA users was studied as negative control. Results: = 139,207). Monthly risk of the composite of bleeding and thromboembolic events remained unchanged across Ramadan in both cohorts. Conclusion: There were no clinically relevant population-level changes across Ramadan in VKA treatment quality and clinical outcomes, except for a slightly higher proportion of supratherapeutic INRs and dose reductions.

Source: Research and Practice in Thrombosis and Haemostasis

DOI: 10.1016/j.rpth.2025.103010