Acute Heart Failure
Conditions
Keywords
Coronary angiography, Invasive strategy, Myocardial infarction, Troponin, Heart failure
Brief summary
To compare the outcomes of patients with acute heart failure who undergo early coronary angiography vs. usual care
Interventions
PROCEDURECoronary angiography
Coronary angiogram performed either in hospital or post-discharge, within 14 days after initial hospital presentation with heart failure
Sponsors
Institute for Clinical Evaluative Sciences
Study design
Observational model
COHORT
Time perspective
RETROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
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
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Cardiovascular mortality | 2 years | Death due to cardiovascular causes after 14 days in landmark analysis |
| All-cause mortality | 2 years | Death from any cause after 14 days in landmark analysis |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| All-cause hospital readmission | 2 years | Readmissions for all causes after 14 days or hospital discharge in landmark analysis |
| Heart failure readmission | 2 years | Readmissions for heart failure after 14 days or hospital discharge in landmark analysis |
| Readmission for myocardial infarction | 2 years | Readmissions for myocardial infarction after 14 days or hospital discharge in landmark analysis |
| Rates of revascularization | 90 days | Coronary revascularization with CABG surgery or PCI procedure |
Countries
Canada
Outcome results
None listed