Crit Pathw Cardiol. 2026 Jan 30. doi: 10.1097/HPC.0000000000000402. Online ahead of print.
ABSTRACT
Guidelines recommend fasting before catheterization laboratory (cath lab) procedures. However, recent studies question the necessity of fasting, suggesting that fasting may not provide significant clinical benefits. This study aims to evaluate the existing evidence between outcomes for patients with fasting and non-fasting regimens. We conducted a comprehensive search for randomized controlled trials (RCTs) comparing fasting and non-fasting protocols before cath lab procedures. Outcomes included hypoglycemia, aspiration pneumonia, contrast nephropathy, all-cause mortality, and cardiovascular mortality. A random effects meta-analysis was performed to derive odds ratios (ORs) and 95% confidence intervals (CIs). The meta-analysis included 8 RCTs with a total of 3,068 participants: 1,544 in the fasting group and 1,524 in the non-fasting group. Compared with fasting, non-fasting was not associated with significant differences in hypoglycemia (OR = 0.77, 95% CI: 0.44 to 1.34), aspiration pneumonia (OR = 1.33, 95% CI: 0.38 to 4.72), contrast nephropathy (OR = 1.82, 95% CI: 0.88 to 3.75), all-cause mortality (OR = 1.29, 95% CI: 0.51 to 3.28), or cardiovascular mortality (OR = 0.94, 95% CI: 0.22 to 4.05). Non-fasting regimens show no significant differences in safety outcomes compared to fasting, suggesting it may be implemented to improve patient experience without compromising safety. Larger trials are needed to confirm the safety of non-fasting regimens.
PMID:41641618 | DOI:10.1097/HPC.0000000000000402