The DOI matches its Crossref record.
Fasting vs. no fasting prior to catheterization laboratory procedures: the SCOFF trial
Open accessAbstract
Background and Aims: Current guidelines recommend 6 h of solid food and 2 h of clear liquid fasting for patients undergoing cardiac procedures with conscious sedation. There are no data to support this practice, and previous single-centre studies support the safety of removing fasting requirements. The objective of this study was to determine the non-inferiority of a no-fasting strategy to fasting prior to cardiac catheterization procedures which require conscious sedation. Methods: This is a multicentre, investigator-initiated, non-inferiority, randomized trial conducted in Australia with a prospective open-label, blinded endpoint design. Patients referred for coronary angiography, percutaneous coronary intervention, or cardiac implantable electronic device (CIED)-related procedures were enrolled. Patients were randomized 1:1 to fasting as normal (6 h solid food and 2 h clear liquid) or no-fasting requirements (encouraged to have regular meals but not mandated to do so). Recruitment occurred from 2022 to 2023. The primary outcome was a composite of aspiration pneumonia, hypotension, hyperglycaemia, and hypoglycaemia assessed with a Bayesian approach. Secondary outcomes included patient satisfaction score, new ventilation requirement (non-invasive and invasive), new intensive care unit admission, 30-day readmission, 30-day mortality, 30-day pneumonia. Results: A total of 716 patients were randomized with 358 in each group. Those in the fasting arm had significantly longer solid food fasting (13.2 vs. 3.0 h, Bayes factor >100, indicating extreme evidence of difference) and clear liquid fasting times (7.0 vs. 2.4 h, Bayes factor >100). The primary composite outcome occurred in 19.1% of patients in the fasting arm and 12.0% of patients in the no-fasting arm. The estimate of the mean posterior difference in proportions with credibility interval (CI) in the primary composite outcome was −5.2% (95% CI −9.6 to −.9), favouring no fasting. This result confirms the non-inferiority (posterior probability >99.5%) and superiority (posterior probability 99.1%) of no fasting for the primary composite outcome. The no-fasting arm had improved patient satisfaction scores with a posterior mean difference of 4.02 points (95% CI 3.36–4.67, Bayes factor >100). Secondary outcome events were observed to be similar. Conclusions: In patients undergoing cardiac catheterization and CIED-related procedures, no fasting was non-inferior and superior to fasting for the primary composite outcome of aspiration pneumonia, hypotension, hyperglycaemia, and hypoglycaemia. Patient satisfaction scores were significantly better with no fasting. This supports removing fasting requirements for patients undergoing cardiac catheterization laboratory procedures that require conscious sedation.
Overview
Integrity signals
Registry
Cites
Statistics
Verification
Claims the paper makes
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
Patient satisfaction was significantly greater in the no-fasting group.
“Patient satisfaction was significantly greater in the no-fasting group.”
From Malnutrition and Cachexia in Inpatients With Acute Cardiac Conditions: A Scientific Statement From the American Heart Association (2026) · cites this paper as [182]
In the SCOFF trial, the primary composite end point of hypotension, aspiration pneumonia, hyperglycemia, and hypoglycemia occurred in 19.1% of the fasting group and 2.0% of the no-fasting group, with analyses confirming noninferiority of no fasting.
“The primary composite end point of hypotension, aspiration pneumonia, hyperglycemia, and hypoglycemia occurred in 19.1% of the fasting group and 2.0% of the no-fasting group, with the analyses confirming noninferiority of no fasting (based on a noninferiority margin of 3% and a likelihood of 99.1%).182”
From Malnutrition and Cachexia in Inpatients With Acute Cardiac Conditions: A Scientific Statement From the American Heart Association (2026) · cites this paper as [182]
Citations
Cites
No references could be resolved yet.
Research works printed but not linked: 24
- Cook, 2007, Percutaneous coronary interventions in Europe: prevalence, numerical estimates, and projections based on data up to 2004, Clin Res Cardiol, 96, 375, 10.1007/s00392-007-0513-0 · DOI
- Wood, 2002, Cardiac pacemakers from the patient’s perspective, Circulation, 105, 2136, 10.1161/01.CIR.0000016183.07898.90 · DOI
- Apfelbaum, 2017, Practice guidelines for preoperative fasting and the use of pharmacologic agents to reduce the risk of pulmonary aspiration: application to healthy patients undergoing elective procedures: an updated report by the American Society of Anesthesiologists Task Force on Preoperative Fasting and the Use of Pharmacologic Agents to Reduce the Risk of Pulmonary Aspiration, Anesthesiology, 126, 376, 10.1097/ALN.0000000000001452 · DOI · Paper page
- Murdock, 1990, Comparison of meglumine sodium diatrizoate, iopamidol, and iohexol for coronary angiography and ventriculography, Cathet Cardiovasc Diagn, 19, 179, 10.1002/ccd.1810190306 · DOI
- Proctor, 2023, Fasting prior to coronary procedures, a thing of the past: a retrospective audit, Heart Lung Circ, 32, S434, 10.1016/j.hlc.2023.06.645 · DOI
- Bacus, 2020, Fasting prior to cardiac catheterisation: a single-centre observational study, N Z Med J, 133, 16
- El-Sharkawy, 2021, Fasting and surgery timing (FaST) audit, Clin Nutr, 40, 1405, 10.1016/j.clnu.2020.08.033 · DOI
- de Klerk, 2023, Incidence of excessive preoperative fasting: a prospective observational study, Br J Anaesth, 130, e440, 10.1016/j.bja.2022.12.017 · DOI
- Chon, 2017, Perioperative fasting and the patient experience, Cureus, 9, e1272, 10.7759/cureus.1272 · DOI
- Bangalore, 2021, Evidence-based practices in the cardiac catheterization laboratory: a scientific statement from the American Heart Association, Circulation, 144, e107, 10.1161/CIR.0000000000000996 · DOI · Paper page
- Tamborrino, 2024, Do we need fasting prior to coronary angiography? The CORO-NF randomized pragmatic study, Am J Med, 137, 666, 10.1016/j.amjmed.2024.01.024 · DOI
- Boukantar, 2024, A randomized controlled trial of nonfasting vs fasting before interventional coronary procedures, JACC Cardiovasc Interv, 17, 1200, 10.1016/j.jcin.2024.03.033 · DOI
- Bode, 2022, A randomized trial of non-fasting vs. fasting for cardiac implantable electronic device procedures (Fast-CIED study), Europace, 24, 1617, 10.1093/europace/euac081 · DOI
- Kimpton, 2023, Not fasting before cardiac catheterisation: an observational cohort study of patient experience and adverse events, Heart Lung Circ, 32, S85, 10.1016/j.hlc.2023.04.234 · DOI
- Ferreira, 2023, Safety and Care OF no Fasting prior to catheterisation laboratory procedures: a non-inferiority randomised control trial protocol (SCOFF trial), Eur Heart J Open, 3, oead111, 10.1093/ehjopen/oead111 · DOI
- Brar, 2014, Haemodynamic-guided fluid administration for the prevention of contrast-induced acute kidney injury: the POSEIDON randomised controlled trial, Lancet Rheumatol, 383, 1814, 10.1016/S0140-6736(14)60689-9 · DOI
- Son, 2017, Pneumonitis and pneumonia after aspiration, J Dent Anesth Pain Med, 17, 1, 10.17245/jdapm.2017.17.1.1 · DOI
- McAlister, 2005, The relation between hyperglycemia and outcomes in 2,471 patients admitted to the hospital with community-acquired pneumonia, Diabetes Care, 28, 810, 10.2337/diacare.28.4.810 · DOI
- Workgroup on Hypoglycemia, American Diabetes Association, 2005, Defining and reporting hypoglycemia in diabetes: a report from the American Diabetes Association Workgroup on Hypoglycemia, Diabetes Care, 28, 1245, 10.2337/diacare.28.5.1245 · DOI · Paper page
- Popovic, 2021, Development and validation of a questionnaire assessing patient distress from preoperative fasting in cataract surgery, Ophthalmic Epidemiol, 28, 337, 10.1080/09286586.2020.1849742 · DOI
- Woods, 2024, Fasting versus a heart-healthy diet before cardiac catheterization: a randomized controlled trial, Am J Crit Care, 33, 29, 10.4037/ajcc2024115 · DOI
- Atkinson, 2023, Randomized controlled trial of liberal vs. standard fasting instructions in percutaneous cardiac procedures, Perioper Med, 12, 44, 10.1186/s13741-023-00333-z · DOI
- Sheehan, 2004, Fasting hyperglycemia: etiology, diagnosis, and treatment, Diabetes Technol Ther, 6, 525, 10.1089/1520915041705910 · DOI
- Rybicka, 2011, The dawn phenomenon and the Somogyi effect—two phenomena of morning hyperglycaemia, Endokrynol Pol, 62, 276
Cited by
Sorted by citations
Vest, A. R., DiDomenico, R. J., Lichtenstein, L., Slater, T., Ekpo, E., Damluji, A. A., Bohula, E., Alviar, C. L., on behalf of the American Heart Association Acute Cardiac Care and General Cardiology Committee of the Council on Clinical Cardiology, & Council on Cardiovascular and Stroke Nursing (2026) · Circulation · doi:10.1161/cir.0000000000001405 · Cited by 15
Lam, S., Cannesson, M. P., Osuna-Garcia, A., & Livingston, E. H. (2025) · Surgery · doi:10.1016/j.surg.2025.109483 · Cited by 9
Balbaa, E., Ibrahim, A., Bazzazeh, M., Tabassum, S., Ramadan, S., Gadelmawla, A., Elshimy, A., Altobaishat, O., & Abuelazm, M. (2025) · Perioperative Medicine · doi:10.1186/s13741-024-00485-6 · Cited by 7
“All the included studies were single-center RCTs; four were single-blinded (Bode et al. 2022; Boukantar et al. 2024; Ferreira et al. 2024; Woods et al. 2024), and the other was open-label (Atkinson et al. 2023).”
Nutrition Optimization Among Critically Ill Patients in the Cardiac Intensive Care Unit
Allaparthi, S., Bode, A., Bury, C., & Vest, A. R. (2025) · Current Cardiology Reports · doi:10.1007/s11886-025-02208-9 · Cited by 7
Salihu, A., Fournier, S., Hugelshofer, S., Liabot, Q., Weerts, V., Τζίμας, Γ., Rancati, V., Ferlay, C., Zimmerli, A., Müller, O., et al. (2025) · Journal of the American Heart Association · doi:10.1161/jaha.124.040445 · Cited by 5
“15,18,19,21,22 One study specified a particular diet to be followed before the procedure, without any time limitations.”
InfluentialReconsidering Pre-Procedural Fasting for Elective Percutaneous Cardiac Procedures
Ibrahim, S., Singireddy, S., Ezenna, C., Acero, L. M. R., Nouri, A., Akman, Z., Babapour, G., Frampton, J., Goldsweig, A., Damluji, A. A., et al. (2025) · Circulation. Cardiovascular Interventions · doi:10.1161/circinterventions.124.015089 · Cited by 4
Muniz, J., Gonçalves, A. O., Morais, B. A. A. H., Suciu-Bogdan, C., Ferreira, D., Braghiroli, J., Camara, S. F., & Ribeiro, H. (2025) · Catheterization and cardiovascular interventions · doi:10.1002/ccd.31547 · Cited by 3
Self-citationChaturvedi, A., Al-Qaraghuli, A., Verma, B., Haberman, D., Cellamare, M., Zhang, C., Galo, J., Abusnina, W., Lupu, L., Hashim, H. D., et al. (2025) · Cardiovascular Revascularization Medicine · doi:10.1016/j.carrev.2025.08.019 · Cited by 2
Meta-Analysis on Comparison of Fasting Versus No Fasting Before Cardiac Catheterization.
Basit, J., Ahmed, M., Burhan, M., Shahzad, M., Ahsan, A., Ullah, W., & Alonso, A. (2025) · Cardiology in Review · doi:10.1097/crd.0000000000000930 · Cited by 2
Bangalore, S., & Maqsood, M. (2024) · European Heart Journal · doi:10.1093/eurheartj/ehae754 · Cited by 2
Preoperative carbohydrate loading: evolution, trends, and future directions
Liu, S., Liu, Q., Zhu, Y.-H., Xiang, P., Liu, X.-Y., Cao, J., & Jia, M. (2026) · Frontiers in Nutrition · doi:10.3389/fnut.2026.1750029 · Cited by 1
“More seriously, this insulin-resistant state is further amplified by the release of contra-insulin hormones, including glucocorticoids and catecholamines, which drive stress hyperglycemia—a phenomenon observed even in non-diabetic patients (5, 6).”
Vargas, K. G., Karthikesan, D., Huber, K., Bekfani, T., Parco, C., Lin, Y., & Wolff, G. (2025) · Clinical Research in Cardiology · doi:10.1007/s00392-025-02810-5 · Cited by 1
“…of the occurrence of nausea or vomiting (OR 0.88; 95% CI 0.43–1.80; I 2 0%, 5 trials) [2, 4–7], hypoglycemia (OR 0.73; 95% CI 0.41–1.29; I 2 44%, 3 trials) [2, 3, 5], and contrast-induced acute kidney injury (OR 2.18; 95% CI 0.93–5.11; I 2 0%, 2 trials) [2, 3] were similar for both study arms (Fig.”
InfluentialErqou, S., Kwok, M., Shin, Y., Motaweih, M., Heinz, E. R., Schatz, A., Tomdio, A. N., & Guzman, L. A. (2025) · Journal of the Society for Cardiovascular Angiography & Interventions · doi:10.1016/j.jscai.2025.103819 · Cited by 1
“Eight RCTs 10,14 – 21 with a total of 3451 participants were included in the meta-analysis.”
Focus on trials in dyslipidaemias, arrhythmias, cardiomyopathies, and interventional cardiology.
Crea, F. (2024) · European Heart Journal · doi:10.1093/eurheartj/ehae830 · Cited by 1
Carvalho, J. B., Harle, M., Becker, E. D. O., de Oliveira, A. G. G., Lösch, K., & de Azevedo, L. C. (2026) · Revista Eletrônica Acervo Saúde · doi:10.25248/reas.e25232.2026
“Publicações recentes aprovam a abreviação do jejum pré-operatório em pacientes de cardiologia intervencionista com evidências de superioridade em termos de satisfação do paciente (FERREIRA D, et al., 2024).”
Corovic, M., Srirangan, A., McGrath, B., Sheehan, L., McFarling, M., Schwalm, J., Sheth, T., Valettas, N., Pinilla-Echeverri, N., Velianou, J., et al. (2026) · Journal of patient safety · doi:10.1097/pts.0000000000001552
Lam, S., Cannesson, M. P., Osuna-Garcia, A., & Livingston, E. H. (2026) · American Journal of Surgery · doi:10.1016/j.amjsurg.2026.117012
Segura-Saldaña, P., Álvarez-Vargas, M., Ludeña-Meléndez, V., Llaja-Socorro, J., Davila-Paredes, C., Sánchez-Cárdenas, J., Gálvez-Rodríguez, E., Santillán-Rodríguez, A., Cabrera-Cruzado, C., Guerra-Canchari, P., et al. (2026) · European Heart Journal Open · doi:10.1093/ehjopen/oeaf123
Bhat, V., Kumar, A., Georgy, I., & Kalra, A. (2026) · Journal of the Society for Cardiovascular Angiography & Interventions · doi:10.1016/j.jscai.2025.104161
Fasting versus Nonfasting for Cardiac Interventions: A Systematic Review and Meta-Analysis
Dawadi, S., Shrestha, D., Oli, P., Shtembari, J., Pant, K., & Meghani, M. (2026) · Journal of Clinical and Preventive Cardiology · doi:10.4103/jcpc.jcpc_41_25
Sudo, K., Kuroki, K., Asahina, C., Atsumi, M., Nakagawa, K., Asakawa, T., Hasegawa, T., Aonuma, K., & Sato, A. (2025) · Cardiovascular Electrophysiology · doi:10.1111/jce.70096
Pir, M., Mitchell, B. K., Saqib, N., Saleem, M. S., & Gertz, Z. M. (2025) · American Heart Journal · doi:10.1016/j.ahj.2025.06.019
Fasting versus non-fasting before elective coronary angiography: A randomized clinical trial
Baharvand, F., Salari, A., Hasanipour, S., Arami, S., Pourrajabi, A., & Kafi, M. (2025) · Journal of Cardiovascular and Thoracic Research · doi:10.34172/jcvtr.025.33273
“21 Our study has its limitations, which can be covered in future studies.”
Herzkatheter/Device-Implantation: nüchtern oder nicht nüchtern? (randomisierte SCOFF-Studie)
(2025) · Aktuelle Kardiologie · doi:10.1055/a-2505-0715
Assessing the Likelihood of Procedural Intubation During Percutaneous Coronary Intervention
Herson, M., Tan, S., O'Brien, J., Teoh, Z., Manmathan, G., Dinh, D., Brennan, A., Brown, A. J., & Chew, D. P. (2025) · Journal of the American Heart Association : Cardiovascular and Cerebrovascular Disease · doi:10.1161/jaha.124.038092
To fast or not to fast—that is the question?
Goel, V., Nerlekar, N., & Brown, A. J. (2024) · AME Clinical Trials Review · doi:10.21037/actr-24-160
“(7).”
Consenso mexicano de ayuno previo a intervenciones cardiovasculares diagnósticas y terapéuticas
Moguel-Ancheita, R., Olvera-Ruiz, R., Jiménez-Carbajal, M., Lozoya-Morales, J. J., González-Ramírez, N., Ponte-González, G., García, Y., Cabrera-Arroyo, C., Rodríguez-Diez, G., Félix-Téllez, F., et al. (2026) · Cardiovascular and Metabolic Science · doi:10.35366/123381
Metadata
- Authors
- Ferreira, D., Hardy, J., Meere, W., Butel-Simoes, L., Sritharan, S., Ray, M., French, M., McGee, M., O’Connor, S., Whitehead, N., Turner, S., Healey, P., Davies, A., Morris, G., Jackson, N., Barlow, M., Ford, T., Leask, S., Oldmeadow, C., Attia, J., Sverdlov, A., Collins, N., Boyle, A., & Wilsmore, B.
- Affiliations
- John Hunter Hospital (AU)
- Gosford Hospital (AU)
- Tamworth Hospital (AU)
- Calvary Mater Newcastle Hospital (AU)
- Hunter Medical Research Institute (AU)
- Corresponding author
- Ferreira, David
- ORCID
- Venue
- European Heart Journal
- Publisher
- Oxford University Press (OUP)
- Published
- 2024-09-01
- Volume
- 45
- Issue
- 47
- Pages
- 4990-4998
- ISSN
- 0195-668X (ISSN-L)
- 1522-9645
- OpenAlex
- W4402103529
- Cited by
- 26
- References
- 0
- Citations by year
- 2026: 8 · 2025: 15 · 2024: 3
- FWCI
- 10.95
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- European Heart Journal (publishedVersion)
- PubMed (publishedVersion)
- Funders
- John Hunter Hospital Charitable Trust
- Hunter Medical Research Institute
- Medical Research Support Program
- National Heart Foundation of Australia (106025)
- NSW Health Cardiovascular Capacity Building
- Topics
- Health Sciences › Medicine › Surgery › Enhanced Recovery After Surgery
- Health Sciences › Medicine › Physiology (medical) › Dietary Effects on Health
- Health Sciences › Medicine › Anesthesiology and Pain Medicine › Anesthesia and Sedative Agents
- Keywords
- conscious sedation, cardiac catheterization, aspiration pneumonia, hypoglycemia, hyperglycemia, hypotension, patient satisfaction, non-inferiority, coronary angiography, percutaneous coronary intervention, cardiac implantable electronic devices, Bayesian analysis, intensive care unit admission, 30-day mortality
- MeSH terms
- Aged, Fasting, Female, Cardiac Catheterization, Humans, Hyperglycemia, Hypoglycemia, Hypotension, Male, Middle Aged, Pneumonia, Aspiration, Prospective Studies, Conscious Sedation, Procedural Sedation, Coronary Angiography, Patient Satisfaction, Percutaneous Coronary Intervention
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
