To compare the outcomes of patients with acute heart failure who undergo early coronary angiography vs. usual care

Inclusion Criteria: Adult patients with acute heart failure, hospitalized in Ontario, Canada, with evidence of possible ischemic heart disease, defined as at least one of: a) prior myocardial infarction, b) troponin elevation, or c) angina.

Exclusion Criteria:

• Recent myocardial infarction
• Coronary angiogram or revascularization within previous 3 months before admission
• Nonresidents of Ontario, invalid health card number
• HF diagnosed after admission
• Admission BNP or NT-proBNP not diagnostic of HF
• Died within 14 days of admission
• Palliative within 6 months prior to hospital admission
• Elevated creatinine concentration
• Documented anaphylactic contrast allergy
• Ischemic or hemorrhagic stroke within 3 months prior to admission
• Highest category of Hospital Frailty Risk Score
• Active severe bleeding at time of hospital admission
• Absolute platelet count < 20
• Metastatic cancer

Self-described male or female

Hospitalized patients in Ontario, Canada with acute heart failure