Edoxaban versus enoxaparin-warfarin in patients undergoing cardioversion of atrial fibrillation (ENSURE-AF): a randomised, open-label, phase 3b trial
Por:
Goette, A, Merino, JL, Ezekowitz, MD, Zamoryakhin, D, Melino, M, Jin, J, Mercuri, MF, Grosso, MA, Fernandez, V, Al-Saady, N, Pelekh, N, Zenin, S, Batushkin, V, Lip, GYH, Weitz, J, Freemantle, N, Klein, H, Buller, H, Segers, A, Roos, Y, Slagboom, T, Thijs, V, van Mechelen, R, Larrey, D, Laleman, W, Heidbuchel, H, Goudev, A, Rasmussen, L, Le Heuzey, JY, Glikson, M, Banach, M, Ruda, M, Lundqvist, CB, Ezekowitz, M, Gwechenberger, M, Huber, K, Purerfellner, H, Roithinger, F, Scherr, D, Stuhlinger, M, Delforge, M, Rivero-Ayerza, M, Thoeng, J, Vervoort, G, Vijgen, J, Willems, R, Benov, H, Dimov, B, Nikolov, F, Godev, A, Jorgova-Makedonska, J, Lazov, P, Marchev, S, Mihov, L, Petranov, S, Raev, D, Stoyanov, M, Tarnovska-Kadreva, R, Todorov, G, Tumbev, H, Cermak, O, Slany, N, Jarkovsky, P, Kautzner, J, Lukac, B, Nadenickova, P, Peterka, K, Slaby, J, Spinar, J, Vesely, J, Vitovec, M, Zavada, F, Al-Hashimi, S, Bronnum-Schou, J, Egstrup, K, Frost, L, Gislason, G, Lomholdt, J, Malczynski, J, Moller, DS, Nielsen, T, Raymond, I, Riahi, S, Tuxen, C, Cohen, A, Cottin, Y, Defaye, P, Deharo, JC, Depuis, JM, Elbaz, M, Ferrari, E, Gosse, P, Goube, P, Paganelli, F, Pineau, J, Piot, O, Biermann, J, Bosch, R, Brachmann, J, Darius, H, Dengler, T, Hartmann, A, Kreis, I, Lamparter, S, Licka, M, Maier, L, Schellong, S, Schmitt, J, Stellbrink, C, Walkili, R, Willems, S, vom Dahl, J, Dezsi, A, Edes, I, Laszlo, S, Lupkovics, G, Matoltsy, A, Merkely, B, Nagy, A, Nagy, L, Palinkas, A, Simor, T, Tomcsanyi, J, Toth, L, Alcalai, R, Hayek, T, Katz, A, Mazen, E, Shechter, M, Shochat, M, Zeltser, D, Zimlichman, R, Boriani, G, De Caterina, R, Di Pasquale, G, Fattore, L, Grimaldi, M, Gulizia, M, Mazzone, C, Themistoclakis, S, Volpe, M, Allaart, C, de Groot, J, Elvan, A, Folkeringa, R, Hazeleger, R, Jansen, W, Nierop, P, Willems, A, de Ruiter, G, Czarnecka, D, Gniot, J, Januszewicz, A, Jaworska, K, Loboz-Grudzien, K, Niezgoda, K, Ptaszynski, P, Wysokinski, A, Bartos, D, Bengus, C, Bolohan, R, Chioncel, O, Coman, IM, Crisu, D, Dan, GA, Dobreanu, D, Dumitrescu, S, Gurghean, A, Lighezan, D, Militaru, C, Minescu, B, Podoleanu, CCG, Pop, C, Popescu, MI, Rosu, RO, Tase, A, Voicu, OC, Belenky, D, Bolshakova, O, Chumakova, G, Demko, A, Goloshchekin, B, Kostenko, V, Kuznetsov, V, Libov, I, Nevzorova, V, Nikolaev, K, Popov, S, Shubik, Y, Staroverov, I, Timofeev, A, Zrazhevskiy, K, Valladares, FA, Lopez, MA, Arenal, A, Gonzalez, VB, Cosin-Sales, J, Gonzalez-Juanatey, JR, Rubio, AM, Martinez, JG, Falconi, E, Mont, L, Bermejo, MAP, Sabate, X, Camano, MV, Vida, M, Vinolas, X, Gomez, JLZ, Lindquist, CB, Fredholm, O, Savelieva, I, Haywood, G, Aggarwal, R, Bakhai, A, Balasubramaniam, R, Betts, T, Campbell, P, Choy, AM, Davis, G, Izzat, L, Kadr, H, Lindsay, S, Lip, G, More, R, Ng, GA, Payne, G, Schilling, R, Senior, R, Tayebjee, M, Travill, C, Rishko, M, Batushkin, V, Fushtey, I, Karpenko, O, Karpenko, Y, Klantsa, A, Kraiz, I, Kushnir, M, Kutniy, O, Parkhomenko, A, Petrovskyy, R, Reshotko, D, Stanislavchuk, M, Sychov, O, Tseluyko, V, Vasylets, V, Minakova, PO, Volkov, D, Zharinov, O, Zhurba, S, Aggarwal, R, Bahu, M, Bashir, F, Berk, M, Cheirif, J, Clay, A, Crenshaw, J, Ellenbogen, K, Ganeshram, V, Halpern, S, Heiman, M, Henderson, D, Ho, A, Kovach, T, Mckenzie, M, Nadar, V, Penny-Peterson, E, Rao, S, Sawhney, N, Shaoulian, E, Sheikh, K, Torres-Heisecke, R, Weiss, R
Publicada:
22 oct 2016
Resumen:
Background Edoxaban, an oral factor Xa inhibitor, is non-inferior for prevention of stroke and systemic embolism in patients with atrial fibrillation and is associated with less bleeding than well controlled warfarin therapy. Few safety data about edoxaban in patients undergoing electrical cardioversion are available.
Methods We did a multicentre, prospective, randomised, open-label, blinded-endpoint evaluation trial in 19 countries with 239 sites comparing edoxaban 60 mg per day with enoxaparin-warfarin in patients undergoing electrical cardioversion of non-valvular atrial fibrillation. The dose of edoxaban was reduced to 30 mg per day if one or more factors (creatinine clearance 15-50 mL/min, low bodyweight [<= 60 kg], or concomitant use of P-glycoprotein inhibitors) were present. Block randomisation (block size four)-stratified by cardioversion approach (transoesophageal echocardiography [TEE] or not), anticoagulant experience, selected edoxaban dose, and region-was done through a voice-web system. The primary efficacy endpoint was a composite of stroke, systemic embolic event, myocardial infarction, and cardiovascular mortality, analysed by intention to treat. The primary safety endpoint was major and clinically relevant non-major (CRNM) bleeding in patients who received at least one dose of study drug. Follow-up was 28 days on study drug after cardioversion plus 30 days to assess safety. This trial is registered with ClinicalTrials.gov, number NCT02072434.
Findings Between March 25, 2014, and Oct 28, 2015, 2199 patients were enrolled and randomly assigned to receive edoxaban (n= 1095) or enoxaparin-warfarin (n= 1104). The mean age was 64 years (SD 10 . 54) and mean CHA(2)DS(2)-VASc score was 2.6 (SD 1.4). Mean time in therapeutic range on warfarin was 70.8% (SD 27.4). The primary efficacy endpoint occurred in five (<1%) patients in the edoxaban group versus 11 (1%) in the enoxaparin-warfarin group (odds ratio [OR] 0.46, 95% CI 0.12-1.43). The primary safety endpoint occurred in 16 (1%) of 1067 patients given edoxaban versus 11 (1%) of 1082 patients given enoxaparin-warfarin (OR 1.48, 95% CI 0.64-3.55). The results were independent of the TEE-guided strategy and anticoagulation status.
Interpretation ENSURE-AF is the largest prospective randomised clinical trial of anticoagulation for cardioversion of patients with non-valvular atrial fibrillation. Rates of major and CRNM bleeding and thromboembolism were low in the two treatment groups.
Funding Daiichi Sankyo provided financial support for the study.
Filiaciones:
Goette, A:
St Vincenz Hosp, Cardiol & Intens Care Med, D-33098 Paderborn, Nordrhein Westf, Germany
Univ Hosp Magdeburg, Working Grp Mol Electrophysiol, Magdeburg, Germany
St Vincenz Hosp, Paderborn, Germany
Merino, JL:
Univ Europea, Hosp Univ La Paz, Arrhythmia & Robot Electrophysiol Unit, Madrid, Spain
Ezekowitz, MD:
Thomas Jefferson Univ, Sidney Kimmel Jefferson Med Coll, Dept Cardiovasc Med, Broomall, PA USA
Zamoryakhin, D:
Lankenau Med Ctr, Broomall, PA USA
Melino, M:
Daiichi Sankyo Pharma Dev, Clin Dev Cardiovas & Metab, Edison, NJ USA
Jin, J:
Daiichi Sankyo Pharma Dev, Biostat, Edison, NJ USA
Mercuri, MF:
Daiichi Sankyo Pharma Dev, Clin Dev Cardiovas & Metab, Edison, NJ USA
Grosso, MA:
Daiichi Sankyo Pharma Dev, Clin Dev Cardiovas & Metab, Edison, NJ USA
Fernandez, V:
Daiichi Sankyo Pharma Dev, Clin Dev Cardiovas & Metab, Edison, NJ USA
Al-Saady, N:
Cardiovasc Metab Covance, Maidenshead, England
Pelekh, N:
Covance, Clin Res, Kiev, Ukraine
Zenin, S:
Novosibirsk Reg Clin Cardiol Hosp, State Budget Healthcare Inst Novosibirsk Reg, Novosibirsk, Russia
Novosibirsk Reg Clin Cardiol Clin, Novosibirsk, Russia
Batushkin, V:
Kiev City Clin Hosp 5, Cardiol & Intens Care Dept, Kiev, Ukraine
Kiev City Clin Hosp 5, Kiev, Ukraine
Lip, GYH:
Univ Birmingham, City Hosp, Inst Cardiovasc Sci, Birmingham, W Midlands, England
Aalborg Univ, Dept Clin Med, Aalborg Thrombosis Res Unit, Aalborg, Denmark
Ezekowitz, M:
Thomas Jefferson Univ, Sidney Kimmel Jefferson Med Coll, Dept Cardiovasc Med, Broomall, PA USA
Gwechenberger, M:
Univ Vet Med Vienna, Vienna, Austria
Huber, K:
Wilhelminenspital Stadt Wien, Vienna, Austria
Purerfellner, H:
Krankenhaus Elisabethinen Linz, Linz, Austria
Roithinger, F:
Landesklinikum Modling, Modling, Austria
Scherr, D:
Med Univ Graz, Graz, Austria
Stuhlinger, M:
Med Univ Innsbruck, Innsbruck, Austria
Delforge, M:
Ctr Hosp Reg de Huy, Huy, Belgium
Rivero-Ayerza, M:
Ziekenhuis Oost Limburg, Limburg, Belgium
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AZ Turnhout VZW, Turnhout, Belgium
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AZ Sint Maarten, Mechelen, Belgium
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Jessa Ziekenhuis, Hasselt, Belgium
Willems, R:
UZ Leuven, Leuven, Belgium
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Multiprofile Dist Hosp Act Treatment Dr Stefan Ch, Veliko Tarnovo, Bulgaria
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Fifth Multiprofile Hosp Act Treatment Sofia EAD, Sofia, Bulgaria
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Univ Multiprofile Hosp Act Treatment Sveti Georgi, Sofia, Bulgaria
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Univ Multiprofile Hosp Act Treatment Tsaritsa Joa, Sofia, Bulgaria
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Univ Multiprofile Hosp Act Treatment Sveta Ekater, Sofia, Bulgaria
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Multiprofile Hosp Act Treatment Pazardzhik AD, Sofia, Bulgaria
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Specialized Hosp Act Treatment Cardiol EAD, Sofia, Bulgaria
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Multiprofile Hosp Act Treatment Sveti Ivan Rilski, Sofia, Bulgaria
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Multiprofile Hosp Act Treatment Burgas AD, Sofia, Bulgaria
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Diagnost Consultat Ctr Sveta Anna EOOD, Sofia, Bulgaria
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Multiprofile Hosp Act Treatment Dr Tota Venkova J, Sofia, Bulgaria
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Univ Multiprofile Hosp Act Treatment Alexandrovsk, Sofia, Bulgaria
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Second Multiprofile Hosp Act Treatment Sofia EAD, Sofia, Bulgaria
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Specialized Hosp Act Cardiol Treatment Cardiolife, Sofia, Bulgaria
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Nemocnice Slany, Slany, Czech Republic
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Ustoedni Vojenska Nemocnice Vojenska Fak Nemocnic, Prague, Czech Republic
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Inst Klin Expt Med, Prague, Czech Republic
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Nemocnice Eesky Krumlov As, Prague, Czech Republic
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Nemocnice Havliekuv Brod, Prague, Czech Republic
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Oblastni Nemocnice Kolin As, Prague, Czech Republic
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Fak Nemocnice Brno, Brno, Czech Republic
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Affidea Praha Sro, Brno, Czech Republic
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Holbaek Sygehus, Holbaek, Denmark
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Amager Hosp, Glostrup, Denmark
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Odense Univ Hosp, Svendborg Sygehus, Odense, Denmark
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Regionshosp Silkeborg, Silkeborg, Denmark
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Gentofte Univ Hosp, Gentofte, Denmark
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Slagelse Sygehus, Slagelse, Denmark
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Herning Reg Hosp, Herning, Denmark
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Reg Hosp Viborg, Viborg, Denmark
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Koge Sygehus, Koge, Denmark
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Frederiksberg Univ Hosp, Frederiksberg, Denmark
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Aalborg Univ, Aalborg, Denmark
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Bispebjerg Hosp, Bispebjerg, Denmark
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Hop St Antoine, St Antoine, France
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CHU Grenoble, Grenoble, France
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CHU Hop Timone, Marseille, France
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CHU Angers, Angers, France
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Hop Louis Pasteur, CHU Nice, Nice, France
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Hop St Andre, CHU Hop Bordeaux, St Andre, France
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Ctr Hosp Sud Francilien, Corbeil Essonnes, France
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Hop Nord, Nord, France
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Ctr Hosp St Joseph St Luc, St Luc, France
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Ctr Cardiol Nord, Nord, France
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Univ Herzzentrum Freiburg Bad Krozingen, Freiburg, Germany
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Cardio Ctr Ludwigsburg Bietigheim, Bietigheim, Germany
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Klinikum Coburg GmbH, Coburg, Germany
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Vivantes Klinikum Neukolln, Berlin, Germany
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SLK Kliniken Heilbronn GmbH, Heilbronn, Germany
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Klinikum St Georg GmbH, Leipzig, Germany
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St Johannes Hosp, Dortmund, Germany
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Diakonie Krankenhaus Wehrda, Marburg, Germany
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Univ Klinikum Heidelberg, Heidelberg, Germany
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Univ Hosp Regensburg, Regensburg, Germany
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Krankenhaus Dresden Friedrichstadt, Friedrichstadt, Germany
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Univ Giessen & Marburg GmbH, Giessen, Germany
Stellbrink, C:
Klinikum Bielefeld Mitte, Bielefeld, Germany
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Klinikum Univ Munchen, Munich, Germany
Willems, S:
Univ Hamburg Eppendorf, Hamburg, Germany
vom Dahl, J:
Kliniken Maria Hilf GmbH, Monchengladbach, Germany
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Petz Aladar Cty Teaching Hosp, Gyor, Hungary
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Debreceni Egyet Klin Kozpont, Kozpont, Hungary
Laszlo, S:
Szegedi Tudomanyegyet, Belgyogyaszati Klin, Szeged, Hungary
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Zala Megyei Korhaz, Zalaegerszeg, Hungary
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Kanizsai Dorottya Korhaz, Nagykanizsa, Hungary
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Semmelweis Univ, Heart & Vasc Ctr, Budapest, Hungary
Semmelweis Univ, Budapest, Hungary
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Bacs Kiskun Megyei Korhaz, Kecskemet, Hungary
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Vas Megyei Markusovszky Korhaz Nonprofit Zrt, Szombathely, Hungary
Palinkas, A:
CSMEK Hodmezovasarhel, Hodmezovasarhely, Hungary
Simor, T:
Pecsi Tudomanyegyetem Klin Kozpont, Pecs, Hungary
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Budai Irgalmasrendi Korhaz, Budapest, Hungary
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Fejer Megyei Szent Gyorgy Egyet Oktato Korhaz, Szekesfehervar, Hungary
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Hadassah Univ Med Ctr, Jerusalem, Israel
Hayek, T:
Rambam Med Ctr, Haifa, Israel
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Barzilai Govt Hosp, Ashqelon, Israel
Mazen, E:
Emek Med Ctr, Afula, Israel
Shechter, M:
Chaim Sheba Med Ctr, Ramat Gan, Israel
Shochat, M:
Hillel Yaffe Med Ctr, Hadera, Israel
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Tel Aviv Sourasky Med Ctr, Tel Aviv, Israel
Zimlichman, R:
Edith Wolfson Med Ctr, Holon, Israel
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Azienda Osped Univ Bologna Policlin S Orsola Malp, Bologna, Italy
De Caterina, R:
Osped SS Annunziata, Naples, Italy
Di Pasquale, G:
Osped Maggiore CA Pizzardi, Bologna, Italy
Fattore, L:
Osped San Giuseppe Melorio, Santa Maria Capua Vetere, Italy
Grimaldi, M:
Ente Ecclesiastico Osped Gen Reg F Miulli, Acquaviva Delle Fonti, Italy
Gulizia, M:
Presidio Osped Garibaldi Nesima, Catania, Italy
Mazzone, C:
Ctr Cardiovasc, Catania, Italy
Themistoclakis, S:
Osped dellAngelo, Venice, Italy
Volpe, M:
Azienda Osped St Andrea, Rome, Italy
Allaart, C:
VU Univ Med Ctr, Leiden, Netherlands
de Groot, J:
Acad Med Ctr, Ctr Heart, Dept Cardiol, Clin Electrophysiol, Amsterdam, Netherlands
Acad Med Ctr AMC, Amsterdam, Netherlands
Elvan, A:
Isala, Zwolle, Netherlands
Folkeringa, R:
Med Ctr Leeuwarden, Leeuwarden, Netherlands
Hazeleger, R:
VieCuri, Venray, Netherlands
Jansen, W:
Tergooi Hilversum, Hilversum, Netherlands
Nierop, P:
St Franciscus Gasthuis, Rotterdam, Netherlands
Willems, A:
Sint Lucas Andreas Ziekenhuis, Amsterdam, Netherlands
de Ruiter, G:
Onze Lieve Vrouw Hosp, Amsterdam, Netherlands
Czarnecka, D:
Univ Hosp Krakow, Krakow, Poland
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Samodzielny Publ Zaklad Opieki Zdrowotnej Pulawac, Pulawy, Poland
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Inst Kardiol, Krakow, Poland
Jaworska, K:
Wojewodzki Szpital Zespolony Ludwika Rydygiera To, Torun, Poland
Loboz-Grudzien, K:
Lower Silesian Specialist Hosp Tadeusz Marciniak, Ctr Emergency Med, Wroclaw, Poland
Niezgoda, K:
Elblaski Szpital Specjalisty Przychodnia Elblagu, Elblag, Poland
Ptaszynski, P:
Med Univ Lodz, Lodz, Poland
Wysokinski, A:
Samodzielny Publ Szpital Klin 4 SPSK4, Lublin, Poland
Bartos, D:
Spitalul Clin Urgenta Bucuresti, Bucharest, Romania
Bengus, C:
Spitalul Clin Urgenta Sfantul Pantelimon, Bucharest, Romania
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Ctr Clin Urgenta Boli Cardiovasc Armatei, Bucharest, Romania
Chioncel, O:
Inst Urgenta Pentru Boli Cardiovasc Prof Dr CC Il, Bucharest, Romania
Coman, IM:
Inst Urgenta Pentru Boli Cardiovasc Prof Dr CC Il, Bucharest, Romania
Crisu, D:
Ctr Med Consultmed, Bucharest, Romania
Dan, GA:
Spitalul Clin Colentina, Bucharest, Romania
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Inst Urgenta Pentru Boli Cardiovasc & Transplant, Targu Mures, Romania
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Ctr Clin Urgenta Boli Cardiovasc Armatei, Bucharest, Romania
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Spitalul Clin Coltea, Bucharest, Romania
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Spitalul Clin Municipal Urgenta Timisoara, Timisoara, Romania
Militaru, C:
Spitalul Clin Judetean Urgenta Craiova, Craiova, Romania
Minescu, B:
Spitalul Judetean Urgenta Braila, Urgenta Braila, Romania
Podoleanu, CCG:
Spitalul Clin Judetean Mures, Targu Mures, Romania
Pop, C:
Spitalul Judetean Urgenta Dr Constantin Opris Bai, Baia Mare, Romania
Popescu, MI:
Spitalul Clin Judetean Urgenta Oradea, Urgenta Oradea, Romania
Rosu, RO:
Spitalul Clin Recuperare Cluj Napoca, Cluj Napoca, Romania
Tase, A:
Spitalul Judetean Urgenta Arges, Urgenta Arges, Romania
Voicu, OC:
Spitalul Judetean Urgenta Targoviste, Urgenta Targoviste, Romania
Belenky, D:
City Hosp Ambulance 2, State Budget Inst Hlth Novosibirsk Oblast, Novosibirsk, Russia
Bolshakova, O:
Fed Almazov Med Res Ctr, St Petersburg, Russia
Chumakova, G:
Altai Reg Clin Hosp, Barnaul, Russia
Demko, A:
Sci Clin Ctr Russian Railways JSC, Moscow, Russia
Goloshchekin, B:
City Hosp 15, St Petersburg State Budget Inst Healthcare, St Petersburg, Russia
Kostenko, V:
St Petersburg II Dzhanelidze Res Inst Emergency M, St Petersburg, Russia
Kuznetsov, V:
Tyumen Cardiol Ctr, Tyumen, Russia
Libov, I:
SBHI Clin Oncol Dispensary 1 Minist Healthcare Kr, Krasnodar, Russia
Nevzorova, V:
Vladivostok Clin Hosp 1, Vladivostok, Russia
Nikolaev, K:
City Clin Hosp 34, State Budgetary Inst Healthcare, Novosibirsk, Russia
Popov, S:
Res Inst Cardiol, Tomsk, Russia
Shubik, Y:
Natl Med Surg Ctr, Moscow, Russia
Staroverov, I:
Yaroslavl Reg Clin Hosp, Yaroslavl, Russia
Timofeev, A:
SBHI Clin Oncol Dispensary 1 Minist Healthcare Kr, Krasnodar, Russia
Valladares, FA:
Complejo Hosp Univ Ourense, Orense, Spain
Lopez, MA:
Hosp Virgen Nieves, Granada, Spain
Arenal, A:
Hosp Gen Univ Gregorio Maranon, Madrid, Spain
Gonzalez, VB:
San Juan Alicante Univ Hosp, Alicante, Spain
Cosin-Sales, J:
Hosp Arnau Vilanova, Lleida, Spain
Gonzalez-Juanatey, JR:
CHUS, Hosp Clin Univ, Santiago De Compostela, Spain
Rubio, AM:
Parc Tauli Sabadell Hosp Univ, Barcelona, Spain
Martinez, JG:
Hosp Gen Univ Alicante, Alicante, Spain
Falconi, E:
Hosp Univ La Paz, Madrid, Spain
Mont, L:
Hosp Clin Barcelona, Barcelona, Spain
Bermejo, MAP:
Hosp Santa Caterina, Girona, Spain
Sabate, X:
Hosp Univ Bellvitge, Barcelona, Spain
Camano, MV:
Povisa Hosp, Vigo, Spain
Vida, M:
Hosp Torrecardenas, Almeria, Spain
Vinolas, X:
Hosp Santa Creu & Sant Pau, Barcelona, Spain
Gomez, JLZ:
Hosp Univ Ramon & Cajal, Madrid, Spain
Lindquist, CB:
Univ Uppsala Hosp, Uppsala, Sweden
Fredholm, O:
Helsingborgs Lasaret, Helsingborg, Sweden
Savelieva, I:
St Georges Univ Hosp NHS Fdn Trust, St Georges Hosp, London, England
Haywood, G:
Plymouth Hosp NHS Trust, Derriford Hosp, Plymouth, Devon, England
Aggarwal, R:
Basildon & Thurrock Univ Hosp NHS Fdn Trust, Basildon, England
Siteman Canc Ctr, Ctr Adv Med, St Louis, MO USA
Bakhai, A:
Barnet & Chase Farm Hosp NHS Trust, Barnet Hosp, Barnet, England
Balasubramaniam, R:
Royal Bournemouth & Christchurch Hosp NHS Fdn Tru, Bournemouth, Dorset, England
Betts, T:
Oxford Univ Hosp NHS Trust, John Radcliffe Hosp, Oxford, England
Campbell, P:
Royal Gwent Hosp, Newport, Gwent, Wales
Choy, AM:
NHS Tayside, Dundee, Scotland
Davis, G:
Aintree Univ Hosp NHS Fdn Trust, Liverpool, Merseyside, England
Izzat, L:
Prince Philip Hosp, Llanelli, Wales
Kadr, H:
Barking Havering & Redbridge Univ Hosp NHS Trust, Queens Hosp, London, England
Lindsay, S:
Bradford Teaching Hosp NHS Fdn Trust, Bradford Royal Infirm, Bradford, W Yorkshire, England
Lip, G:
Univ Birmingham, City Hosp, Inst Cardiovasc Sci, Birmingham, W Midlands, England
Aalborg Univ, Dept Clin Med, Aalborg Thrombosis Res Unit, Aalborg, Denmark
Sandwell & West Birmingham Hosp NHS Trust, Birmingham City Hosp, Birmingham, W Midlands, England
More, R:
Blackpool Teaching Hosp NHS Fdn Trust, Blackpool Victoria Hosp, Blackpool, England
Ng, GA:
Univ Hosp Leicester NHS Trust, Glenfield Hosp, Leicester, Leics, England
Payne, G:
Doncaster Royal Infirm, Doncaster, England
Schilling, R:
Barts Hlth NHS Trust, Whipps Cross Univ Hosp, London, England
Tayebjee, M:
Leeds Teaching Hosp NHS Trust, Leeds Gen Infirm, Leeds, W Yorkshire, England
Travill, C:
Luton & Dunstable Univ Hosp NHS Fdn Trust, Luton, Beds, England
Rishko, M:
Uzhgorod Natl Univ, Uzhgorod, Ukraine
Batushkin, V:
Kiev City Clin Hosp 5, Cardiol & Intens Care Dept, Kiev, Ukraine
Kiev City Clin Hosp 5, Kiev, Ukraine
Fushtey, I:
Ordzhonikidze Dist Cent Hosp, Pokrov, Ukraine
Karpenko, O:
Kyiv City Clin Hosp 1, Kiev, Ukraine
Karpenko, Y:
Odessa Reg Cardiol Dispensary, Odessa, Ukraine
Klantsa, A:
Khmelnytskyi Reg Hosp, Khmelnytskyi, Ukraine
Kraiz, I:
Tsentralnaya Klinicheskaya Bolnitsa, Donetsk, Ukraine
Kushnir, M:
Zhytomyr Reg Clin Hosp, Dept Cardiol, Chervonogo Khresta Str, Zhytomyr, Ukraine
Zhitomir Reg Clin Hosp, Zhytomyr, Ukraine
Kutniy, O:
Municipal Inst Cent City Hosp 2, Zhytomyr, Ukraine
Parkhomenko, A:
MAS Ukraine, Natl Sci Ctr MD Strazhesko Inst Cardiol, Kiev, Ukraine
Petrovskyy, R:
Ivano Frankivsk Reg Clin Hosp, Ivano Frankivsk, Ukraine
Reshotko, D:
Oleksandrivska Clin Hosp, Kiev, Ukraine
Stanislavchuk, M:
Vinnitsa Reg Clin Hosp NI Pirogov, Vinnitsa, Ukraine
Sychov, O:
MAS Ukraine, Natl Sci Ctr MD Strazhesko Inst Cardiol, Kiev, Ukraine
Tseluyko, V:
Kharkiv City Clin Hosp 8, Kharkov, Ukraine
Vasylets, V:
City Clin Hosp 9, Dnipro, Ukraine
Minakova, PO:
Inst Gen & Emergency Surg, Kharkov, Ukraine
Volkov, D:
Inst Gen & Emergency Surg, Kharkov, Ukraine
Zharinov, O:
Kyiv City Heart Ctr, Kiev, Ukraine
Zhurba, S:
Cherkasy Reg Cardiol Ctr, Cherkassy, Ukraine
Aggarwal, R:
Basildon & Thurrock Univ Hosp NHS Fdn Trust, Basildon, England
Siteman Canc Ctr, Ctr Adv Med, St Louis, MO USA
Bahu, M:
Phoenix Cardiovasc Res Grp LLC, Phoenix, AZ USA
Bashir, F:
Affiliated Cardiologists Arizona, Phoenix, AZ USA
Berk, M:
Cardiovasc Res Inst Dallas, Dallas, TX USA
Cheirif, J:
Texas Hlth Presbyterian Hosp Dallas, Dallas, TX USA
Clay, A:
Cardiol Physicians PA, Newark, DE USA
Crenshaw, J:
Jackson Clin, Jackson, TN USA
Ellenbogen, K:
Virginia Commonwealth Univ VCU Med Ctr, Richmond, VA USA
Ganeshram, V:
Wichita Falls Heart Clin PLLC, Wichita, KS USA
Halpern, S:
Radiant Res Ctr, Phoenix, AZ USA
Heiman, M:
Cardiol Associates Fairfield Cty P C, Fairfield, CT USA
Henderson, D:
Cardiol Res Associates, Daytona Beach, FL USA
Ho, A:
Riverside Community Hosp, Riverside, CA USA
Kovach, T:
Heart & Vasc Inst Florida, Clearwater, FL USA
Mckenzie, M:
Baylor Univ Med Ctr, Dallas, TX USA
Nadar, V:
Capital Area Res LLC, Camp Hill, PA 17011 USA
Penny-Peterson, E:
Penn State Milton S Hershey Med Ctr, Hershey, PA USA
Rao, S:
Butler Hlth Providers, Butler, PA USA
Sawhney, N:
Arch Hlth Partners, Poway, CA USA
Shaoulian, E:
Pacific Coast Cardiol & Res, Newport Beach, CA USA
Sheikh, K:
Brevard Cardiovasc Res Associates Inc, Rockledge, FL USA
Torres-Heisecke, R:
Tyler Cardiovasc Consultants PA, Tyler, TX USA
Weiss, R:
Maine Res Associates, Auburn, ME USA
London North West Healthcare NHS Trust, Northwick Park Hosp, London, England.
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