Background Dual-axis rotational coronary angiography (DARCA) was developed as an innovative adaptation of rotational angiography (RA),but it requires a longer coronary injection compared to standard coronary angiography (SA).As the body of the average Chinese patient is smaller than that of most west patients,with the same contrast injection time,the risk of complications from the contrast agent is increased in this population.The purpose of this study was to assess the clinical safety and efficacy of DARCA in the diagnosis of coronary artery disease (CAD) in the Chinese population by directly comparing it to SA.Methods Two hundred Chinese patients were randomized to either the SA group (n=100) or DARCA group (n=100).Contrast utilization,radiation exposure and procedure time were recorded for each modalities.Blood pressure (BP),heart rate (HR) pre and post injection symptoms and any arrhythmias were recorded.Results Compared to the SA group,there was a 42％ reduction in contrast utilization,55％ reduction in radiation exposure and a 31％ shorter procedure time in the DARCA group.In both groups,there were slight declines in the systolic BP values in the left coronary artery (LCA) post injection (P ＜0.01).Moreover,post injection HRs for the LCA were also reduced in the DARCA group (P ＜0.01).But all of these changes were small,transient and without clinical importance.Only one patient (1％) in the DARCA group had an attack of ventricular tachycardia immediately post injection and it resolved by itself during LCA angiography.No arrhythmias occurred in the SA group.Conclusion DARCA is a safe,efficient,and clinically comparable altemative to SA in the diagnosis of coronary artery disease in the Chinese population with less contrast utilized,which is less radiation exposure and a shorter procedure time than SA.