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Updated: Jan 23, 2026
Interventional Diagnostic Procedure: A Practical Guide for the Assessment of Coronary Vascular Function
Published on: March 15, 2022
Performing diagnostic radial access coronary angiography on uninterrupted direct oral anticoagulant therapy: a
Napohn Chongprasertpon1, Aiste Zebrauskaite1, John Joseph Coughlan1
1Cardiology, University Hospital Limerick, Dooradoyle, Ireland.
Insights
Continuing direct oral anticoagulants during coronary angiography is safe. This study found no increased risk of complications or longer compression times in patients on uninterrupted direct oral anticoagulant therapy compared to a control group.
Area of Science:
- Cardiology
- Vascular Medicine
- Pharmacology
Background:
- Direct oral anticoagulants (DOACs) are increasingly used for thromboembolism prevention.
- Cardiovascular conditions often necessitate both DOACs and coronary angiography.
- Limited data exists on the safety of continuing DOACs during angiography.
Purpose of the Study:
- To evaluate the safety of diagnostic radial access coronary angiography with uninterrupted DOAC therapy.
- To assess hemorrhagic and access site complications in patients on DOACs.
Main Methods:
- Prospective observational study of 49 patients on uninterrupted DOACs undergoing elective coronary angiography.
- Comparison with 49 control patients undergoing the same procedure.
- Analysis of radial compression time and complication rates.
Main Results:
- No significant difference in mean radial compression duration between groups (258.4 min vs. 235.8 min, p=0.07).
- No significant difference in complication rates between the DOAC and control groups (p=1).
Conclusions:
- Uninterrupted DOAC therapy during coronary angiography appears safe.
- Similar complication rates and compression times observed in both groups.
- Larger randomized controlled trials are recommended to confirm findings.
Purpose:
We sought to assess the safety of performing diagnostic radial access coronary angiography with uninterrupted anticoagulation on patients receiving direct oral anticoagulant therapy.
Background:
Direct oral anticoagulants have become a popular choice for the prevention of thromboembolism. Risk factors for thromboembolism are common among cardiovascular conditions and indications for direct oral anticoagulant therapy as well as coronary angiography often overlap in patients. It has been hypothesised that uninterrupted direct oral anticoagulant therapy would increase haemorrhagic and access site complications, however data in this area is limited.
Methods:
This was a prospective observational analysis of 49 patients undergoing elective diagnostic coronary angiography while receiving uninterrupted anticoagulation with direct oral anticoagulants. This population was compared with a control group of 49 unselected patients presenting to the cardiology service for elective diagnostic coronary angiography. Continuous variables were analysed using the independent samples t-test and categorical variables using Pearson's χ2 test.
Results:
The mean duration of radial compression for the control group was 235.8±62.8 min and for the uninterrupted direct oral anticoagulant group was 258.4±56.5 min. There was no significant difference in mean duration of radial compression (p=0.07; 95% CI=-1.4 to 46.5). There was also no difference in the complication rate between the two groups (p=1).
Conclusions:
We observed similar complication rates and radial artery compression time postangiography in both groups. This small prospective observational study suggests that uninterrupted continuation of direct oral anticoagulants during coronary angiography is safe. Larger randomised control studies in this area would be beneficial.
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