Coronary Angiography in Early Ischemic Heart Failure

Eligibility Details: 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