Comparative Evaluation of Patient Satisfaction and Safety Outcomes Between Prolonged Fasting and Controlled Nutrition Before Elective Coronary Angiography

Objective: Prolonged preprocedural fasting is routinely recommended before coronary angiography, although the procedure is minimally invasive and is usually performed without sedation. Extended fasting may cause patient discomfort without providing clear safety benefits. This study aimed to compare the effects of prolonged fasting and controlled nutrition before elective coronary angiography on patient satisfaction, comfort, and procedure-related complications.
Method: In this single-center, prospective, randomized controlled study, 394 patients scheduled for elective coronary angiography were randomly assigned to either the fasting group (n=197) or the controlled-nutrition group (n=197). Patients in the fasting group abstained from oral intake for at least 8 hours, whereas those in the controlled-nutrition group were permitted to consume foods and beverages that did not cause gastric irritation until the procedure. After angiography, patients completed a 100-mm visual analog scale (VAS) assessing hunger, thirst, fatigue, anxiety, and overall satisfaction. Periprocedural and postprocedural complications potentially related to fasting or oral intake, including nausea, vomiting, aspiration, hypotension, bradycardia, hypoglycemia, and the need for intubation, were recorded.
Results: Baseline demographic, clinical, laboratory, and procedural characteristics were similar between the groups. Complication rates were low and did not differ significantly between the groups. VAS scores for hunger, thirst, fatigue, and anxiety were significantly higher in the fasting group, whereas overall satisfaction scores were significantly higher in the controlled-nutrition group (all p<0.05).
Conclusion: Prolonged fasting before elective coronary angiography does not provide additional safety benefits and is associated with reduced patient comfort and satisfaction. Allowing controlled nutrition significantly improves patient satisfaction without increasing the risk of complications.

Keywords: Complications, controlled nutrition, coronary angiography, fasting, patient satisfaction.