Early invasive coronary angiography and acute ischaemic hear
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While myocardial ischaemia plays a major role in the pathogenesis of heart failure (HF), the indications for coronary angiography during acute HF are not established. Researchers determined the association of early coronary angiography during acute HF hospitalization with 2-year mortality, cardiovascular death, HF readmissions, and coronary revascularization.

In a two-stage sampling process, they identified acute HF patients who presented to 70 emergency departments in Ontario and determined whether they underwent early coronary angiography within 14 days after presentation using administrative databases. After clinical record review, researchers defined a cohort with acute ischaemic HF as patients with at least one factor suggesting underlying ischaemic heart disease, including previous myocardial infarction, troponin elevation, or angina on presentation.

They oversampled patients undergoing angiography. We used inverse-probability-of-treatment weighting (IPTW) to adjust for baseline differences. Of 7239 patients with acute HF, 2994 met inclusion criteria [median age 75 (interquartile range 65–83) years; 40.9% women]. Early angiography was performed in 1567 patients (52.3%) and was associated with lower all-cause mortality, cardiovascular death, and HF readmissions after IPTW. Those undergoing early angiography experienced higher rates of percutaneous coronary intervention and coronary artery bypass grafting within 2?years.

Conclusively, early coronary angiography was associated with lower all-cause mortality, cardiovascular death, HF readmissions, and higher rates of coronary revascularization in acute HF patients with possible ischaemia.

Source: https://academic.oup.com/eurheartj/advance-article/doi/10.1093/eurheartj/ehab423/6331345?rss=1