Posted on 09/04/2024 8:47:26 PM PDT by ConservativeMind
There was no difference in complications in patients who fasted or did not fast before cardiac catheterization procedures requiring conscious sedation, according to research.
"In the SCOFF trial, we were able to show no increased risk of complications with normal eating," said Dr. David Ferreira.
The investigator-initiated, randomized SCOFF trial, with a prospective open-label, blinded endpoint design, assessed the non-inferiority of no fasting prior to cardiac catheterization laboratory procedures requiring conscious sedation.
Patients who had been referred for coronary angiography, coronary intervention or cardiac implantable electronic device-related procedures were recruited. They were randomized 1:1 to fasting before the procedure (no solid food for six hours and no clear liquids for two hours) or to no fasting where the patient was encouraged to have regular meals as usual, but this was not mandatory.
The primary composite endpoint was hypotension, aspiration pneumonia, hyperglycemia and hypoglycemia assessed with a Bayesian approach.
In total, 716 patients were recruited.
The primary composite outcome occurred in 19.1% in the fasting group and 12.0% in the no-fasting group. In an intention to treat analysis, the estimate of the mean posterior difference was −5.2% (95% confidence interval [CI] −9.6 to −0.9) favoring no fasting. This result confirmed the non-inferiority of no fasting, based on a non-inferiority margin of 3% with a likelihood of greater than 99.5%.
No fasting was also potentially superior to fasting for the primary outcome with a likelihood of 99.1%. There was an absolute risk difference between the groups of 7.1% in favor of no fasting, with a number needed to treat of 14.1 to prevent one primary outcome event.
"Taken together with data from the CHOW-NOW, TONIC and the Fast-CIED trials and from various observational studies, there is now a strong case that fasting is not needed in patients undergoing these types of procedures.
(Excerpt) Read more at medicalxpress.com ...
Europeans maybe. They are skinny and for breakfast have a half of a Weetabix and a sip of espresso out of a thimble-cup.
It takes about three Europeans, weight wise, to equal one American.
The American patient will have six Egg McMuffins on the way to the cath lab, finishing the last on the elevator on the way up.
The American will have gastric stasis from Type 2 DM. And will have taken his Wegovy or Mounjaro the day before.
The population size is not enough to show the uncommon though devastating outcome of aspiration.
Patients should still fast. It is way safer.
Don't know why researchers do studies like like this. Patients complain about fasting but it pays off during or after when nausea is as common as 30 percent.
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‘In patients who have been referred.’ Thats a nice steady pace. What about a fat guy like me who has a heart stopper right after a bi prime rib meal? You gonna make me wait till I am starving again?
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