Meta-Analysis on Comparison of Fasting Versus No Fasting Before Cardiac Catheterization

Patients undergoing cardiac catheterization are advised not to take anything by mouth after midnight. However, limited scientific data exist on whether fasting before catheterization procedures improves clinical outcomes compared with nonfasting. A comprehensive literature search was performed by investigators using major bibliographic databases to identify studies that compared clinical outcomes for fasting versus nonfasting patient groups following cardiac catheterization procedures. The risk ratios (RR) and mean difference (MD) were pooled along with 95% confidence intervals (CIs) for dichotomous and continuous outcomes using R studios. A total of 9 trials were included in the review reporting data for 3432 patients (fasting: 1710 and nonfasting: 1702). There was no statistically significant difference between the 2 groups for incidence of procedural complications (RR: 1.05, 95% CI: 0.78-1.40; P = 0.757), 30-day mortality (RR: 0.83, 95% CI: 0.32-2.18; P = 0.71), 30-day readmissions (RR: 1.05, 95% CI: 0.74-1.49; P = 0.77), aspiration (RR: 0.45, 95% CI: 0.06-3.50; P = 0.45), contrast-associated acute kidney injury (RR: 0.90, 95% CI: 0.52-1.58; p 0.72), hypoglycemia (RR: 1.27, 95% CI: 0.74-2.17; P = 0.39), and nausea/vomiting (RR: 0.83, 95% CI: 0.46-1.51; P = 0.55). The nonfasting group was associated with significantly better satisfaction scores compared to the fasting group (standardized MD: 0.70, 95% CI: 0.13-1.27; P = 0.02). Before cardiac catheterization, a nonfasting approach is associated with higher satisfaction and similar procedural outcomes and adverse events compared to a fasting approach. The practice of routine fasting before cardiac catheterization should be reconsidered.