• Posted May 3, 2024

You May Not Have to Fast Before Catheter-Based Heart Test, Study Suggests

Folks undergoing cardiac catheterization procedures to diagnose heart problems may be able to safely skip the traditional pre-op fasting that's now the norm, new research shows.

“Just as our techniques and technology for cardiac catheterization have evolved, so should our approach to pre-procedure management,” lead researcher Dr. Brian Mitchell said in a news release from the Society for Cardiovascular Angiography & Interventions (SCAI). He's an interventional cardiology fellow at Virginia Commonwealth University in Richmond.

Mitchell's team presented its findings Thursday at SCAI's annual meeting in Long Beach, Calif.

Each year, more than a million cardiac catheterizations are performed in the United States, according to the researchers. In the procedure, a thin catheter is inserted into a chamber or vessel of the heart, either for diagnostic purposes, or as part of treatment interventions such as angioplasty or stenting. 

Cardiac catheterization is typically very low risk, although bleeding, pain, infections or blood clots could sometimes arise. 

According to the Mayo Clinic, patients are routinely asked to refrain from eating for six hours prior to the procedure, though Mitchell's team said there's no good evidence to back up that requirement.

In their new study, the Richmond team tracked outcomes for 198 patients who underwent planned or emergency cardiac catheterizations. Some were told not to eat anything after midnight, prior to their procedures, while others were allowed to eat freely.

Asked to answer "well-being" questions regarding hunger, fatigue, anxiety and nausea, "non-fasting patients showed significantly better composite pre-procedural well-being scores" than patients who'd been asked to forgo food, the team reported. 

Asked how they felt afterward, patients who hadn't fasted reported "significantly higher" satisfaction versus those who had, the study found.

Most importantly, the decision not to fast before cardiac catheterization appears safe, because "adverse events did not differ between groups," Mitchell's team noted.

“Few studies have prospectively explored this strategy in such a diverse patient population, and with such liberal non-fasting allowances, making it the most comprehensive and generalizable study on this topic to date," Mitchell said. "Given our findings, we hope that providers will limit pre-procedural fasting to those patients at high risk of aspiration [food entering the lungs] or conversion to general anesthesia.”

Because these findings were presented at a medical meeting, they should be considered preliminary until published in a peer-reviewed journal.

More information

Find out more about cardiac catheterization at the American Heart Association.

SOURCE: Society for Cardiovascular Angiography & Interventions, news release, May 2, 2024