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Stable Angina (SA)BACON-RCTNCT06996639

Breaking Fasts Ahead of Cardiac Caths

A study testing Non-Fasting and Fasting in people with Stable Angina (SA) and Unstable Angina (UA), run by University of South Florida at 1 site in United States.

Recruiting

Looking for participants now. Contact the study team or a site below to ask about taking part.

Sites and contacts
Official record
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Trial summary

The goal of this clinical trial is to find out whether fasting is necessary before urgent inpatient cardiac catheterizations. For patients presenting with urgent heart-related pain or even mild heart attacks, researchers want to know whether eating and drinking before their procedure improves comfort without raising… Read more about this study

Who is it for?
Ages 18 years and older
What is being tested?
Non-Fasting and Fasting
Could I receive a placebo?
No, everyone receives an active treatment
How many people
400 participants
Where
1 siteUnited States
Study dates
13 Oct 2025to Jul 2026
Phase
Interventional
Are there results?
Not yet: the study is under way

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • All scheduled urgent inpatient non-high risk cardiac catheterizations for worsening angina (cardiac chest pain or anginal equivalent), unstable angina, or non-high risk NSTEMI-NSTEMI's with GRACE score <140 points) utilizing proceduralist guided sedation

Who cannot join

  • High risk NSTEMI's defined as NSTEMI's with a GRACE score >140 points
  • Hemodynamic instability (<SBP 90)
  • Unstable arrythmias
  • Chest pain refractory to nitroglycerin drip
  • New ejection fraction less than 25%
  • Evidence of severe decompensated heart failure on presentation requiring BiPAP or mechanical intubation
Show all 13Show fewer
  • Inability to consent
  • Patients <18 years old
  • Pregnant patients
  • Need for general anesthesia
  • Acute hypoxic respiratory failure requiring >6L Nasal Cannula Supplementation, BiPAP, or invasive ventilation
  • Emergent interventions: STEMI/high risk NSTEMI
  • Need for mechanical circulatory support-ECMO, Impella or intra-aortic balloon pump

Trial locations and contacts

1 site in 1 country. Contact the study team or a site near you to ask about taking part.

Samip Vasaiwala, MD contact

312-375-8104

samipv@usf.edu

USF Institutional Review Board contact

RSCH-IRB@usf.edu

United States1 site, 1 recruiting
  • Tampa General Hospital

    Tampa, Florida, 33606

    Samip Vasaiwala, MD, 312-375-8104, Samipv@usf.edu

    University of South Florida IRB, RSCH-IRB@usf.edu

    Recruiting

Other trials in United States

About this study

Official title: Breaking Fasts Ahead of Cardiac Caths: an Open Label Non-Blinded RCT (BACON-RCT)

The goal of this clinical trial is to find out whether fasting is necessary before urgent inpatient cardiac catheterizations. For patients presenting with urgent heart-related pain or even mild heart attacks, researchers want to know whether eating and drinking before their procedure improves comfort without raising the risk of complications.

The study will answer:

Read more
  • Does eating and drinking before the procedure improve patient comfort?
  • Does it increase the risk of adverse events like vomiting, aspiration (food or liquid entering the lungs), breathing problems, or death, etc?

Participants will be randomly assigned to either:

  • A standard fasting group (no food for 6 hours, no clear liquids for 2 hours), or
  • A no-fasting group (able to eat and drink as usual).

Patients will complete brief surveys before the procedure to assess comfort and satisfaction. Researchers will also review medical records weekly and 30 days later to monitor for safety outcomes.

Read the detailed description

While pre-procedural fasting is a longstanding tradition in cardiac catheterization, there is limited evidence supporting its necessity in low-risk patients undergoing urgent procedures for acute coronary syndromes (ACS). Existing studies have lacked adequate recruitment of ACS patients, comprehensive demographic capture, and long-term outcomes.

This randomized clinical trial will enroll adult inpatients undergoing cardiac catheterization for worsening angina and low risk ACS (unstable angina, and non-high risk NSTEMI's) with planned moderate proceduralist-guided sedation. Participants will be randomized 1:1 to either standard fasting (≥6 hours for solids and ≥2 hours for clear liquids) or no fasting requirement.

The primary endpoint is a composite of patient-reported outcomes assessing comfort and satisfaction. Secondary outcomes focus on clinical safety metrics, such as hemodynamic instability, aspiration pneumonia, ICU admission, procedural sedation requirements, and 30-day mortality, etc.

Proceduralists will remain unblinded; however, outcome assessment and statistical analysis will be performed by blinded third-party personnel. This trial aims to provide high-quality data to assess the necessity and impact of fasting in this specific patient population.

Being tested
Non-Fasting, Fasting
Keywords
Fasting, NPO, Cardiac Catheterization, ACS, Angina, Unstable Angina, Worsening Angina, Low Risk NSTEMI, NSTEMI, Acute Coronary Syndrome, Urgent Cardiac Catheterization, Patient satisfaction, Periprocedural care, Non-fasting, Safety outcomes, Pre-procedural protocol, Survey-based research
Medical subject headings
Angina, Stable, Angina, Unstable, Non-ST Elevated Myocardial Infarction, Fasting, Angina Pectoris, Acute Coronary Syndrome, Patient Satisfaction

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Non-FastingBehavioural

    No pre-procedural fasting required; participants may eat and drink as usual.

  • FastingBehavioural

    Standard pre-procedural fasting (≥6 hours for solids, ≥2 hours for clear liquids) or "NPO at Midnight."

Study groups in NCT06996639
Study groupRoleWhat they receive
FastingActive comparatorParticipants in this group will follow standard pre-procedural fasting guidelines: no solid food for at least 6 hours and no clear liquids for at least 2 hours before their cardiac catheterization or "NPO at Midnight."
Receives: Behavioral: Fasting
Non-FastingExperimentalParticipants in this group will have no dietary restrictions before their cardiac catheterization and may eat and drink as they normally would.
Receives: Behavioral: Non-Fasting

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Pre-procedural patient satisfaction and comfort

    Patient satisfaction and comfort will be assessed using a six-item survey evaluating hunger, thirst, nausea, nervousness, anger, and weakness. Each item is rated on a 5-point Likert scale from 1 ("strongly disagree" = least discomfort) to 5 ("strongly agree" = most discomfort). The total score ranges from 6 (best possible comfort) to 30 (worst possible discomfort). Higher scores indicate greater overall discomfort.

    Measured: Within one hour pre-cardiac catheterization

Secondary outcomes (11)
  1. Time since last oral intake

    Time (in minutes) between last oral intake (food or fluid) as self-reported on pre-procedural survey and start of cardiac catheterization.

    Measured: At time of procedure

  2. Hypotension

    Number of individuals with an occurrence of systolic blood pressure <85 mmHg or mean arterial pressure (MAP) <65 mmHg during or within 6 hours after the procedure.

    Measured: During procedure and up to 6 hours post-procedure

  3. Hyperglycemia

    Number of individuals with an occurrence of blood glucose >200 mg/dL during or within 6 hours after the procedure, based on point-of-care or laboratory testing.

    Measured: During or within 6 hours post-procedure

  4. Hypoglycemia

    Number of individuals with an occurrence of blood glucose <70 mg/dL within 6 hours before, during, or after the procedure based on point-of-care or laboratory testing.

    Measured: Within 6 hours pre and post-procedure

  5. New hypoxic respiratory failure

    Number of individuals with the development of new hypoxia (SpO₂ <85% on room air or requiring supplemental oxygen >4 L/min) during or within 6 hours post-procedure, not present prior to catheterization.

    Measured: During or with 6 hours post-procedure, not present prior to catheterization.

  6. Aspiration pneumonia

    Number of individuals with a new diagnosis of aspiration pneumonia within 72 hours post-procedure, based on new pulmonary infiltrate on imaging plus clinical signs (e.g., cough, fever, hypoxia), not present prior to procedure.

    Measured: Within 72 hours post-procedure, not present prior to catheterization.

  7. New non-invasive or invasive ventilation

    Number of individuals with the initiation of CPAP, BiPAP, or endotracheal intubation during the procedure or within 24 hours post-procedure.

    Measured: During or within 24 hours post-procedure

  8. New intensive care unit (ICU) admission

    Number of individuals with a new admission to an ICU within 24 hours post-procedure that was not planned prior to catheterization.

    Measured: Within 24 hours post-procedure

  9. Need for emergency surgical intervention

    Number of individuals with an unplanned surgical procedure initiated during or within 24 hours after catheterization as a result of a procedural complication.

    Measured: During or within 24 hours post-procedure

  10. 30-day mortality

    To be gathered by chart review 30 days post-procedure.

    Measured: 30 days post-procedure

  11. Sedation use

    Total volume (mg or mcg) of midazolam and fentanyl administered during the procedure, as documented in the procedural record.

    Measured: During procedure

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted30 May 2025
  2. Study start13 Oct 2025
  3. Primary completionJun 2026 (estimated)
  4. Study completionJul 2026 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Health services research
Allocation
Randomised
Intervention model
Parallel groups
Masking
None (open label)
Enrolment
400 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT06996639
Sponsor's protocol ID
STUDY007430
Acronym
BACON-RCT
Status last verified
Dec 2025
First submitted
30 Apr 2025
Last updated
16 Dec 2025
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
Yes: The de-identified individual participant data (IPD) dataset will include information necessary to support the primary and secondary outcome findings.

Publications

  • Mitchell BK, Tomdio A, Pir MS, Mishra SK, Dayanand P, Bonnet G, Alu MC, Gertz ZM. A Randomized Trial of Cardiac Catheterization With Fasting Versus Liberal Oral Intake: The CALORI Trial. J Soc Cardiovasc Angiogr Interv. 2024 Oct 24;3(12):102291. doi: 10.1016/j.jscai.2024.102291. eCollection 2024 Dec.

    PubMed 39807233
  • Woods C, Wood M, Boylan A, Flanagan ME, Powers J. Fasting Versus a Heart-Healthy Diet Before Cardiac Catheterization: A Randomized Controlled Trial. Am J Crit Care. 2024 Jan 1;33(1):29-33. doi: 10.4037/ajcc2024115.

    PubMed 38161168
  • Saad M, Waqas SA, Aamir J, Sohail MU, Ansari I, Mohan A, Kumar V, Alraies MC. Fasting Versus Nonfasting Before Cardiac Catheterization: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Am J Cardiol. 2025 Mar 1;238:40-46. doi: 10.1016/j.amjcard.2024.11.030. Epub 2024 Nov 28.

    PubMed 39613281
  • Granger CB, Goldberg RJ, Dabbous O, Pieper KS, Eagle KA, Cannon CP, Van De Werf F, Avezum A, Goodman SG, Flather MD, Fox KA; Global Registry of Acute Coronary Events Investigators. Predictors of hospital mortality in the global registry of acute coronary events. Arch Intern Med. 2003 Oct 27;163(19):2345-53. doi: 10.1001/archinte.163.19.2345.

    PubMed 14581255
  • 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. 2017 Mar;126(3):376-393. doi: 10.1097/ALN.0000000000001452. No abstract available.

    PubMed 28045707
  • Mishra A. Strict versus no fasting prior to cardiac catheterization: a prospective evaluation of safety and clinical outcomes. Can we safely have our patients eat with cardiac catheterization - nix or allow: the CHOW NOW study [abstract 11758].SCAI 2020 Virtual Scientific Sessions: Virtual Conference, May 14 to 16, 2020.

  • Ferreira D, Hardy J, Meere W, Butel-Simoes L, McGee M, Whitehead N, Healey P, Ford T, Oldmeadow C, Attia J, Wilsmore B, Collins N, Boyle A. Safety and care of no fasting prior to catheterization laboratory procedures: a non-inferiority randomized control trial protocol (SCOFF trial). Eur Heart J Open. 2023 Oct 17;3(6):oead111. doi: 10.1093/ehjopen/oead111. eCollection 2023 Nov.

    PubMed 38025651
  • Tamborrino PP, Papi L, Michelotti L, Vitale C, Caravelli P, Petronio AS, Terlizzi E, Della Volpe L, Virlan M, Sardanelli A, Morganti R, De Caterina R. Do We Need Fasting Prior to Coronary Angiography? The CORO-NF Randomized Pragmatic Study. Am J Med. 2024 Jul;137(7):666-672. doi: 10.1016/j.amjmed.2024.01.024. Epub 2024 Feb 7.

    PubMed 38336086

Questions about this trial

What is this clinical trial studying?

A study testing Non-Fasting and Fasting in people with Stable Angina (SA) and Unstable Angina (UA), run by University of South Florida at 1 site in United States.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 1 inclusion and 13 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: looking for participants now, as of the sponsor's last update on 16 Dec 2025. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in United States. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

This study is still under way. Results are not available in the source record yet.

How can a doctor refer a patient or contact the research team?

Contact Samip Vasaiwala, MD (312-375-8104, samipv@usf.edu), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Pre-procedural patient satisfaction and comfort (time frame: Within one hour pre-cardiac catheterization). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT06996639, which also lists 8 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 16 Dec 2025.

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