Abstract
BACKGROUND: The rising prevalence of patients undergoing coronary angiography who require oral anticoagulation (OAC) presents a challenge in periprocedural management. While current North American guidelines advise OAC interruption before nonemergent coronary angiography, the impact of continuation vs interruption on outcomes remains unclear. METHODS: This retrospective study included patients who underwent elective outpatient transradial coronary angiography from August 1, 2018, to March 20, 2023 at a tertiary medical center. The primary end point included 30-day outcomes of hematoma, pseudoaneurysm, perforation, arteriovenous fistula, compartment syndrome, and stroke or transient ischemic attack. RESULTS: Of the 470 patients, 225 patients (48%) continued OAC (uninterrupted group), and 245 patients (52%) had OAC stopped periprocedurally (interrupted group). There were no differences in baseline demographic characteristics and clinical characteristics. The uninterrupted group trended toward higher rates of warfarin use (17.3% vs 10.6%) and lower rates of rivaroxaban use (13.3% vs 20.4%; P = .031). The interrupted group had higher rates of conversion to the alternate radial access (6.1% vs 1.8%; P =.019) and percutaneous coronary intervention (46.5% vs 24.0%; P < .001). No significant differences were found between the interrupted and uninterrupted groups with respect to 30-day rates of hematoma (2.9% vs 4.0%; P = .495), pseudoaneurysm (0.8% vs 0%; P = .5), and stroke or transient ischemic attack (1.2% vs 0.4%; P = .625), respectively. No perforations, arteriovenous fistula, or compartment syndrome were observed at 30 days. CONCLUSIONS: In this institutional registry of patients who underwent elective outpatient transradial coronary angiography, an uninterrupted OAC strategy was not associated with higher rates of 30-day complications.