HIP Fracture Accelerated Surgical TreaTment And Care tracK 2 Trial

Inclusion Criteria: 1. age ≥45 years; 2. diagnosis of hip fracture during working hours with a low-energy mechanism requiring surgery; 3. troponin elevation ( at least one troponin measurement above the upper limit of normal occurring from the time of hip fracture to the time of randomization); and 4. informed consent. Exclusion Criteria: 1. taking a therapeutic dose of an anticoagulant for which no reversing agent is available and the anesthesiologist or surgeon believe surgery within 6 hours of eligibility criteria met would not be safe; 2. patients on a therapeutic vitamin K antagonist with a history of heparin induced thrombocytopenia (HIT); 3. patients with peri-prosthetic fracture, open fracture or bilateral fractures; 4. patients requiring an emergency surgery for another reason (e.g., subdural hematoma); 5. patients with acute myocardial infarction deemed to be clinically unstable, with a mechanical complication (i.e., acute papillary muscle rupture, ventricular septal defect), ST elevation myocardial infarction, or cardiogenic shock; 6. patients refusing consent; or 7. patients previously enrolled in HIP ATTACK-2.