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Fasting Before Cardiac Catheterization: Still Necessary? A Systematic Review and Meta-Analysis of Randomized Clinical
Adil Salihu1, Stephane Fournier1, Sarah Hugelshofer1
1Service of Cardiology Lausanne University Hospital and University of Lausanne Lausanne Switzerland.
Journal of the American Heart Association
|May 22, 2025
Summary
Fasting before coronary angiography does not reduce adverse events but lowers patient satisfaction. These findings suggest reconsidering routine fasting protocols for this procedure.
Area of Science:
- Cardiology
- Clinical Trials
- Evidence-Based Medicine
Background:
- Routine fasting before elective coronary angiography is common practice.
- Fasting aims to minimize risks like aspiration pneumonia.
- This study evaluates fasting vs. non-fasting protocols' impact on patient outcomes and satisfaction.
Purpose of the Study:
- To systematically review and meta-analyze randomized clinical trials.
- To compare adverse event rates between fasting and non-fasting groups.
- To assess patient satisfaction differences between the two protocols.
Main Methods:
- Searched PubMed, Embase, and Cochrane Library for relevant randomized clinical trials.
- Primary outcome: composite of adverse events (pneumonia, hypoglycemia, nausea/vomiting).
- Secondary outcomes: individual adverse events and patient satisfaction; meta-analysis using odds ratios and standardized mean differences.
Main Results:
- Included 8 randomized clinical trials with 3147 patients.
- No significant difference in composite adverse events between fasting and non-fasting groups (OR 1.08).
- Patient satisfaction was significantly higher in non-fasting protocols (SMD 0.62).
Conclusions:
- Fasting before elective coronary angiography does not reduce adverse events.
- Fasting protocols are associated with lower patient satisfaction.
- The necessity of routine pre-angiography fasting requires re-evaluation.
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