Fasting versus Nonfasting for Cardiac Interventions: A Systematic Review and Meta-Analysis

A BSTRACT Fasting before invasive procedures is a long-standing surgical practice, but its necessity for cardiac interventions under conscious sedation is unclear. To clarify this, we performed a meta-analysis of randomized controlled trials comparing fasting and nonfasting protocols in patients undergoing cardiac interventions. Our international prospective register of systematic reviews (PROSPERO) registered study (CRD-42024616824) systematically reviewed literature up to April 2025, ultimately including seven trials with 2532 patients. We found nonfasting status didn’t show any differences for hypoglycemia (OR: 0.63, CI: 0.23–1.74), periprocedural nausea/vomiting (OR: 0.94, CI: 0.48–1.87), short-term mortality (OR: 0.75, CI: 0.16–3.40) and respiratory infections (OR: 0.49, CI: 0.10–2.34). Our meta-analysis challenged the traditional practice of prolonged fasting before cardiac interventions, revealing no higher odds of adverse events, including nausea, vomiting, short-term mortality, and pneumonia in a nonfasting state before the cardiac interventions.