Timing of Coronary Angiography in NSTEMI Complicated by Acute HF
TIMING-AHF
Trial of IMmediate Invasive Versus Delayed Coronary ANGiography in Non-ST-Segment Elevation Myocardial Infarction Complicated by Acute Decompensated Heart Failure: The TIMING-AHF Trial
1 other identifier
interventional
780
1 country
20
Brief Summary
Study objectives: To determine the optimal timing of coronary angiography (CAG) in patients with non-ST-segment elevation myocardial infarction (NSTEMI) complicated by acute decompensated heart failure (AHF). The primary objective of this trial is to test the hypothesis that immediate CAG ≤2 hours after establishment of NSTEMI diagnosis would result in a significant reduction in primary composite outcome of death from any cause, non-fatal myocardial infarction (MI), or hospitalization for heart failure (HF) at 12 months after randomization as compared with delayed CAG after stabilization. Study hypothesis: Immediate CAG ≤2 hours after establishment of NSTEMI diagnosis would result in a significant reduction in primary composite outcome of death from any cause, non-fatal myocardial infarction (MI), or hospitalization for heart failure (HF) at 12 months after randomization as compared with delayed CAG after stabilization. Background: Although current guidelines recommend early CAG within 2 hours for patients with NSTEMI complicated by AHF, many patients with NSTEMI complicated by AHF did not receive early CAG. However, no randomized clinical trials have evaluated the optimal timing of CAG in patients with NSTEMI complicated by AHF. Therefore, the investigators aimed to perform a prospective, investigator-initiated, open-label, muilticenter trial to compare the efficacy and safety between immediate CAG (CAG \<2 hours after establishment of NSTEMI diagnosis) and delayed CAG after stabilization (i.e. improved dyspnea and disappearance of pulmonary congestion) in participants with NSTEMI complicated by AHF. Study procedure: Following the establishment of NSTEMI diagnosis, participants fulfilling the eligibility criteria will be randomized at a ratio of 1:1 to immediate CAG ≤2 hours after randomization or delayed CAG after stabilization on another day during hospitalization.
Trial Health
Trial Health Score
Automated assessment based on enrollment pace, timeline, and geographic reach
participants targeted
Target at P75+ for not_applicable
Started Jul 2025
Longer than P75 for not_applicable
20 active sites
Health score is calculated from publicly available data and should be used for screening purposes only.
Trial Relationships
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Study Timeline
Key milestones and dates
First Submitted
Initial submission to the registry
May 17, 2025
CompletedFirst Posted
Study publicly available on registry
June 3, 2025
CompletedStudy Start
First participant enrolled
July 15, 2025
CompletedPrimary Completion
Last participant's last visit for primary outcome
April 30, 2030
ExpectedStudy Completion
Last participant's last visit for all outcomes
April 30, 2032
March 19, 2026
March 1, 2026
4.8 years
May 17, 2025
March 17, 2026
Conditions
Keywords
Outcome Measures
Primary Outcomes (1)
A cumulative incidence rate of all-cause death, non-fatal myocardial infarction (MI), or hospitalization for heart failure (HF)
1 year
Secondary Outcomes (13)
A cumulative incidence rate of all-cause death, non-fatal MI, or hospitalization for HF
1, 6, 24, 36 months
All-cause death
1, 6, 12, 24, 36 months
Non-fatal MI
1, 6, 12, 24, 36 months
Hospitalization for HF
1, 6, 12, 24, 36 months
Cardiovascular death
1, 6, 12, 24, 36 months
- +8 more secondary outcomes
Study Arms (2)
Immediate coronary angiography within 2 hours after diagnosis of non-ST-segment elevation myocardial
EXPERIMENTALCoronary angiography will be performed within 2 hours after diagnosis of non-ST-segment elevation myocardial infarction.
Delayed coronary angiography after stabilization of acute decompensated heart failure
ACTIVE COMPARATORCoronary angiography will be performed after disappearance of symptoms and signs of acute decompensated heart failure.
Interventions
Immediate coronary angiography ≤2 hours after randomization
Delayed coronary angiography after stabilization
Eligibility Criteria
You may qualify if:
- Age ≥19 years
- Non-ST-segment elevation myocardial infarction
- New-onset or worsening of dyspnea (New York Heart Association class ≥2)
- Pulmonary congestion
- Patient's or guardian's consent after understanding the study
You may not qualify if:
- Cardiogenic shock at initial presentation
- ST-segment elevation myocardial infarction
- ST-segment elevation ≥0.1 mV in at least 2 contiguous leads, or
- New onset left bundle branch block
- Posterior wall myocardial infarction
- Refractory angina
- Life threatening ventricular arrhythmias
- Life expectancy \<1 year
- Apparently non-ischemic cause of HF
- Pregnancy and lactation
- History of coronary artery bypass grafting (CABG), or planned CABG
- Patient's refusal to participate in study
Contact the study team to confirm eligibility.
Sponsors & Collaborators
Study Sites (20)
Gyeongsang National University Changwon Hospital
Changwon, South Korea
Keimyung University Dongsan Hospital
Daegu, South Korea
Kyungpook National University Hospital
Daegu, South Korea
Yeongnam University Medical Center
Daegu, South Korea
Chungnam National University Hospital
Daejeon, South Korea
Chonnam National University Hospital
Gwangju, South Korea
Gwangju Veterans Hospital
Gwangju, South Korea
Kwangju Christian Hospital
Gwangju, South Korea
Jeonbuk National University Hospital
Jeonju, South Korea
Gyeongsang National University Hospital
Jinju, South Korea
Dong-A University Hospital
Pusan, South Korea
Seoul National University Bundang Hospital
Seongnam, South Korea
Asan Medical Center
Seoul, South Korea
Kangbuk Samsung Medical Center
Seoul, South Korea
Koera University Guro Hospital
Seoul, South Korea
Korea University Anam Hospital
Seoul, South Korea
Samsung Medical Center
Seoul, South Korea
Seoul National University Hospital
Seoul, South Korea
St. Carollo General Hospital
Suncheon, South Korea
Yonsei University, Wonju Severance Christian Hospital
Wŏnju, South Korea
MeSH Terms
Conditions
Condition Hierarchy (Ancestors)
Central Study Contacts
Study Design
- Study Type
- interventional
- Phase
- not applicable
- Allocation
- RANDOMIZED
- Masking
- NONE
- Purpose
- TREATMENT
- Intervention Model
- PARALLEL
- Sponsor Type
- OTHER
- Responsible Party
- PRINCIPAL INVESTIGATOR
- PI Title
- Professor
Study Record Dates
First Submitted
May 17, 2025
First Posted
June 3, 2025
Study Start
July 15, 2025
Primary Completion (Estimated)
April 30, 2030
Study Completion (Estimated)
April 30, 2032
Last Updated
March 19, 2026
Record last verified: 2026-03
Data Sharing
- IPD Sharing
- Will not share