Comparison between no fasting vs. fasting in patients undergoing cardiac catheterization laboratory procedures: a systematic review and meta-analysis

Segura-Saldaña P.; Alvarez-Vargas M.; Ludeña-Meléndez V.; Llaja-Socorro J.; Davila-Paredes C.; Sánchez-Cárdenas J.; Galvez-Rodriguez E.; Santillán-Rodríguez A.; Cabrera-Cruzado C.; Guerra-Canchari P.; Diaz-Arocutipa C. · European Heart Journal Open (2026) · DOI: 10.1093/ehjopen/oeaf123

Resumen

Aims: Fasting prior to procedures in the cardiac catheterization laboratory is an established indication in clinical practice. However, the evidence supporting this recommendation is uncertain. Objectives: The aim of this systematic review and meta-analysis was to evaluate the impact of non-fasting vs. fasting before cardiac catheterization. Methods and results: PubMed, Embase, Scopus, and Web of Science databases were searched until September 2024. Randomized controlled trials comparing both strategies were included. Outcomes were hypoglycaemia, aspiration pneumonia, contrast-induced acute kidney injury (AKI), nausea/vomiting, hypotension, and patient satisfaction. Risk of bias was assessed using the RoB 2.0 tool. All meta-analyses were performed using a random-effects model. Six studies were included (n = 2736). The mean age ranged from 62 to 70 years, and 31% were female. There was no significant difference in the risk of hypoglycaemia [risk ratio (RR) 0.82, 95% confidence interval (CI) 0.49–1.38], aspiration pneumonia (RR 1.31, 95% CI 0.28–6.05), nausea/vomiting (RR 0.95, 95% CI 0.58–1.55), contrast-induced AKI (RR 1.87, 95% CI 0.94–3.72) between the non-fasting and fasting groups. In contrast, patients in the non-fasting group had a lower risk of hypotension (RR 0.57, 95% CI 0.38–0.86) and higher satisfaction scores (standardized mean difference −1.53, 95% CI −2.11 to −0.96) compared with the fasting group. The risk of bias was judged as some concerns in three of four studies. Conclusion: Our results suggest that in patients who underwent cardiac catheterization procedures, non-fasting was a safe strategy and provoked higher satisfaction compared to fasting. © The Author(s) 2026. Published by Oxford University Press on behalf of the European Society of Cardiology.

Instituciones: Universidad Peruana Cayetano Heredia; Universidad Nacional de Trujillo; Universidad San Ignacio de Loyola