Fasting Versus Nonfasting Before Cardiac Catheterization: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Abstract

This meta-analysis compared postprocedural outcomes between fasting and nonfasting groups in patients who underwent cardiac catheterization. Online databases were searched up to September 2024 to identify studies comparing postprocedural outcomes in fasting and nonfasting groups. Data were meta-analyzed using a random-effects model to calculate the standardized mean differences (SMDs) and risk ratios (RRs) with 95% confidence intervals. A total of 7 randomized controlled trials with a total of 2,870 patients (1,450 fasting vs 1,420 nonfasting) were included. Nonfasting patients demonstrated significantly better patient satisfaction scores than fasting patients (SMD −0.72 [−1.33 to −0.12], p = 0.02). There were no significant differences between the fasting and nonfasting groups for nausea/vomiting (RR 1.15 [0.62 to 2.14], p = 0.66), hypoglycemia (RR 0.79 [0.46 to 1.35], p = 0.38), hospital length of stay (SMD −0.16 [−0.71 to 0.38], p = 0.55), aspiration pneumonia (RR 0.46 [0.06 to 3.57], p = 0.46), contrast-associated acute kidney injury (RR 1.48 [0.79 to 2.76], p = 0.22), 30-day mortality (RR 1.53 [0.49 to 4.80], p = 0.46), and hyperglycemia (RR 0.64 [0.34 to 1.19], p = 0.15). Nonfasting improved patient satisfaction and was just as safe as fasting in patients who underwent cardiac catheterization, showing no significant differences in key postprocedural outcomes. Future research should evaluate liberal fasting protocols in distinct populations to ensure safety and guide tailored recommendations.