• Am. J. Med. · Jul 2024

    Randomized Controlled Trial Pragmatic Clinical Trial

    Do we need fasting before coronary angiography? The CORO-NF randomized pragmatic study.

    • Pietro Paolo Tamborrino, Laura Papi, Laura Michelotti, Carlo Vitale, Paolo Caravelli, Anna Sonia Petronio, Emilia Terlizzi, Della VolpeLudovicaLChair and Postgraduate School of Cardiology, University of Pisa and Cardiovascular Division 1, Pisa University Hospital, Italy., Mihaela Virlan, Annamaria Sardanelli, Riccardo Morganti, and Raffaele De Caterina.
    • Chair and Postgraduate School of Cardiology, University of Pisa and Cardiovascular Division 1, Pisa University Hospital, Italy.
    • Am. J. Med. 2024 Jul 1; 137 (7): 666672666-672.

    BackgroundSimilar to procedures requiring general anesthesia, current guidelines recommend fasting for 6 hours for solids and for 2 hours for liquids prior to coronary angiography, but without data supporting such recommendation. The CORO-NF study aimed at assessing whether a shorter fasting period prior to elective coronary angiography associates with improved patient satisfaction without more complications compared with the standard fasting approach.MethodsWe conducted a single-center, randomized, prospective, pragmatic study in 2 sequential phases: a "conventional protocol phase," continuing the usual practice (F Group); and an "experimental phase" (NF Group), reducing minimum fasting duration to 2 hours. Patients received a questionnaire to express a satisfaction score ranging from 1 (maximum complain/no approval) to 5 (minimum or no complain/full approval). All patients admitted acutely were enrolled in a control A Group registry. Fasting time and every major complication and periprocedural complications were analyzed.ResultsFasting time was 821 ± 357 minutes in the F Group and 230 ± 146 minutes in the NF Group (P < .001). The satisfaction score was higher in the NF Group (4.2 ± 0.7 vs 2.9 ± 1.2, P < .001), even at multivariable analysis considering fasting time (P < .001). No intraprocedural food ingestion-related adverse events occurred in either of the 2 experimental groups, as well as in the parallel A Group, with no excess of peri- and postprocedural complications in the NF Group.ConclusionsThe significantly higher satisfaction scores among patients undergoing a shorter-than-recommended fasting period prior to coronary angiography, not counterbalanced by decreased safety, underscores the potential benefits of revising the traditional 6-hour fasting protocols.Copyright © 2024 Elsevier Inc. All rights reserved.

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