2022 COACH TRIAL Trial of an intervention to improve acute heart failure outcomes cross-sectional, cluster-randomized trial M Objective: To determine the effectiveness of systematic use of a hospital-based point-of-care tool to support clinical decision-making, followed by rapid follow-up in an outpatient clinic among patients with acute heart failure seeking emergency care 5452 patients Inclusion criteria: Patients ≥18 years who presented to the emergency department with acute heart failure VS Intervention group (n=2480) Usual care group (n=2972) 12.1 PRIMARY OUTCOMES Death from any cause or hospitalization for CV causes within 30 days % HR 0.88; 95% CI, 0.78 to 0.99; P=0.04 14.5 54.4 Death from any cause or hospitalization for CV causes within 20 months % 56.2 HR 0.95; 95% CI, 0.92 to 0.99 SECONDARY OUTCOMES Hospitalization for cardiovascular causes at 30 days % 8.1 HR 0.85; 95% CI, 0.74 to 0.98 10.6 5.9 Death from any cause at 30 days% HR 0.94; 95% CI, 0.74 to 1.19 6.6 Conclusion: Among patients, use of a hospital-based strategy to support clinical decision making and rapid follow-up led to a lower risk of the composite of death from any cause or hospitalization for cardiovascular causes within 30 days than usual care. DS Lee et al. DOI: 10.1056/NEJMoa2211680, AHA, 2022