Fasting versus non-fasting before elective coronary angiography: a randomized clinical trial

Abstract Introduction Coronary artery disease is a significant public health concern worldwide, with coronary angiography being a crucial diagnostic procedure. The safety and clinical outcomes of fasting versus non-fasting before elective coronary angiography have been a topic of debate. This study aimed to address this issue and explore the impact of fasting on patient outcomes. Material and Methods A total of 600 candidates for coronary angiography were enrolled in this study and divided into two groups: fasting and non-fasting. Demographic data and clinical outcomes were collected and compared between the two groups. Various parameters, including pulmonary aspiration, hypoglycemia, gastrointestinal symptoms, vasovagal reactions, hypotension, and patient satisfaction, were evaluated. Results This study revealed that fasting before coronary angiography did not significantly impact patient outcomes. Also, there were statistically significant differences between the groups in terms of hypoglycemia during hospitalization in fasting patients (P-value=0.001), gastrointestinal symptoms in fasting patients (P=0.007), hypotension during the procedure in fasting patients (P=0.002), and vasovagal responses during sheath removal in fasting patients (P0.001). In addition, none of our patients experienced pulmonary aspiration during the procedure. Interestingly, patient satisfaction was similar between the two groups (p=0.09). Indicating that fasting may not be necessary before elective coronary angiography. Conclusion Based on the findings of this study, it can be concluded that fasting before elective coronary angiography may not be essential and does not lead to serious adverse outcomes. These results have important implications for clinical practice and may help improve patient experience and optimize care in the cardiac diagnostic setting.