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

Thoeng, J:
 AZ Turnhout VZW, Turnhout, Belgium

Vervoort, G:
 AZ Sint Maarten, Mechelen, Belgium

Vijgen, J:
 Jessa Ziekenhuis, Hasselt, Belgium

Willems, R:
 UZ Leuven, Leuven, Belgium

Benov, H:
 Multiprofile Dist Hosp Act Treatment Dr Stefan Ch, Veliko Tarnovo, Bulgaria

Dimov, B:
 Fifth Multiprofile Hosp Act Treatment Sofia EAD, Sofia, Bulgaria

Nikolov, F:
 Univ Multiprofile Hosp Act Treatment Sveti Georgi, Sofia, Bulgaria

Godev, A:
 Univ Multiprofile Hosp Act Treatment Tsaritsa Joa, Sofia, Bulgaria

Jorgova-Makedonska, J:
 Univ Multiprofile Hosp Act Treatment Sveta Ekater, Sofia, Bulgaria

Lazov, P:
 Multiprofile Hosp Act Treatment Pazardzhik AD, Sofia, Bulgaria

Marchev, S:
 Specialized Hosp Act Treatment Cardiol EAD, Sofia, Bulgaria

Mihov, L:
 Multiprofile Hosp Act Treatment Sveti Ivan Rilski, Sofia, Bulgaria

Petranov, S:
 Multiprofile Hosp Act Treatment Burgas AD, Sofia, Bulgaria

Raev, D:
 Diagnost Consultat Ctr Sveta Anna EOOD, Sofia, Bulgaria

Stoyanov, M:
 Multiprofile Hosp Act Treatment Dr Tota Venkova J, Sofia, Bulgaria

Tarnovska-Kadreva, R:
 Univ Multiprofile Hosp Act Treatment Alexandrovsk, Sofia, Bulgaria

Todorov, G:
 Second Multiprofile Hosp Act Treatment Sofia EAD, Sofia, Bulgaria

Tumbev, H:
 Specialized Hosp Act Cardiol Treatment Cardiolife, Sofia, Bulgaria

Cermak, O:
 Nemocnice Slany, Slany, Czech Republic

Jarkovsky, P:
 Ustoedni Vojenska Nemocnice Vojenska Fak Nemocnic, Prague, Czech Republic

Kautzner, J:
 Inst Klin Expt Med, Prague, Czech Republic

Lukac, B:
 Nemocnice Eesky Krumlov As, Prague, Czech Republic

Nadenickova, P:
 Kromioizska Nemocnice As, Prague, Czech Republic

Peterka, K:
 Nemocnice Havliekuv Brod, Prague, Czech Republic

Slaby, J:
 Oblastni Nemocnice Kolin As, Prague, Czech Republic

Spinar, J:
 Fak Nemocnice Brno, Brno, Czech Republic

Vesely, J:
 Oblastni Nemocnice Nachod As, Brno, Czech Republic

Vitovec, M:
 Affidea Praha Sro, Brno, Czech Republic

Zavada, F:
 Oblastni Nemocnice Pribram As, Brno, Czech Republic

Al-Hashimi, S:
 Holbaek Sygehus, Holbaek, Denmark

Bronnum-Schou, J:
 Amager Hosp, Glostrup, Denmark

Egstrup, K:
 Odense Univ Hosp, Svendborg Sygehus, Odense, Denmark

Frost, L:
 Regionshosp Silkeborg, Silkeborg, Denmark

Gislason, G:
 Gentofte Univ Hosp, Gentofte, Denmark

Lomholdt, J:
 Slagelse Sygehus, Slagelse, Denmark

Malczynski, J:
 Herning Reg Hosp, Herning, Denmark

Moller, DS:
 Reg Hosp Viborg, Viborg, Denmark

Nielsen, T:
 Koge Sygehus, Koge, Denmark

Raymond, I:
 Frederiksberg Univ Hosp, Frederiksberg, Denmark

Riahi, S:
 Aalborg Univ, Aalborg, Denmark

Tuxen, C:
 Bispebjerg Hosp, Bispebjerg, Denmark

Cohen, A:
 Hop St Antoine, St Antoine, France

Cottin, Y:
 Hop Bocage, CHU Dijon, Dijon, France

Defaye, P:
 CHU Grenoble, Grenoble, France

Deharo, JC:
 CHU Hop Timone, Marseille, France

Depuis, JM:
 CHU Angers, Angers, France

Elbaz, M:
 Hop Rangueil, Rangueil, France

Ferrari, E:
 Hop Louis Pasteur, CHU Nice, Nice, France

Gosse, P:
 Hop St Andre, CHU Hop Bordeaux, St Andre, France

Goube, P:
 Ctr Hosp Sud Francilien, Corbeil Essonnes, France

Paganelli, F:
 Hop Nord, Nord, France

Pineau, J:
 Ctr Hosp St Joseph St Luc, St Luc, France

Piot, O:
 Ctr Cardiol Nord, Nord, France

Biermann, J:
 Univ Herzzentrum Freiburg Bad Krozingen, Freiburg, Germany

Bosch, R:
 Cardio Ctr Ludwigsburg Bietigheim, Bietigheim, Germany

Brachmann, J:
 Klinikum Coburg GmbH, Coburg, Germany

Darius, H:
 Vivantes Klinikum Neukolln, Berlin, Germany

Dengler, T:
 SLK Kliniken Heilbronn GmbH, Heilbronn, Germany

Hartmann, A:
 Klinikum St Georg GmbH, Leipzig, Germany

Kreis, I:
 St Johannes Hosp, Dortmund, Germany

Lamparter, S:
 Diakonie Krankenhaus Wehrda, Marburg, Germany

Licka, M:
 Univ Klinikum Heidelberg, Heidelberg, Germany

Maier, L:
 Univ Hosp Regensburg, Regensburg, Germany

Schellong, S:
 Krankenhaus Dresden Friedrichstadt, Friedrichstadt, Germany

Schmitt, J:
 Univ Giessen & Marburg GmbH, Giessen, Germany

Stellbrink, C:
 Klinikum Bielefeld Mitte, Bielefeld, Germany

Walkili, R:
 Klinikum Univ Munchen, Munich, Germany

Willems, S:
 Univ Hamburg Eppendorf, Hamburg, Germany

vom Dahl, J:
 Kliniken Maria Hilf GmbH, Monchengladbach, Germany

Dezsi, A:
 Petz Aladar Cty Teaching Hosp, Gyor, Hungary

Edes, I:
 Debreceni Egyet Klin Kozpont, Kozpont, Hungary

Laszlo, S:
 Szegedi Tudomanyegyet, Belgyogyaszati Klin, Szeged, Hungary

Lupkovics, G:
 Zala Megyei Korhaz, Zalaegerszeg, Hungary

Matoltsy, A:
 Kanizsai Dorottya Korhaz, Nagykanizsa, Hungary

Merkely, B:
 Semmelweis Univ, Heart & Vasc Ctr, Budapest, Hungary

 Semmelweis Univ, Budapest, Hungary

Nagy, A:
 Bacs Kiskun Megyei Korhaz, Kecskemet, Hungary

Nagy, L:
 Vas Megyei Markusovszky Korhaz Nonprofit Zrt, Szombathely, Hungary

Palinkas, A:
 CSMEK Hodmezovasarhel, Hodmezovasarhely, Hungary

Simor, T:
 Pecsi Tudomanyegyetem Klin Kozpont, Pecs, Hungary

Tomcsanyi, J:
 Budai Irgalmasrendi Korhaz, Budapest, Hungary

Toth, L:
 Fejer Megyei Szent Gyorgy Egyet Oktato Korhaz, Szekesfehervar, Hungary

Alcalai, R:
 Hadassah Univ Med Ctr, Jerusalem, Israel

Hayek, T:
 Rambam Med Ctr, Haifa, Israel

Katz, A:
 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

Zeltser, D:
 Tel Aviv Sourasky Med Ctr, Tel Aviv, Israel

Zimlichman, R:
 Edith Wolfson Med Ctr, Holon, Israel

Boriani, G:
 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

Gniot, J:
 Samodzielny Publ Zaklad Opieki Zdrowotnej Pulawac, Pulawy, Poland

Januszewicz, A:
 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

Bolohan, R:
 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

Dobreanu, D:
 Inst Urgenta Pentru Boli Cardiovasc & Transplant, Targu Mures, Romania

Dumitrescu, S:
 Ctr Clin Urgenta Boli Cardiovasc Armatei, Bucharest, Romania

Gurghean, A:
 Spitalul Clin Coltea, Bucharest, Romania

Lighezan, D:
 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.
ISSN: 01406736





LANCET
Editorial
Lancet Publishing Group, STE 800, 230 PARK AVE, NEW YORK, NY 10169 USA, Reino Unido
Tipo de documento: Article
Volumen: 388 Número: 10055
Páginas: 1995-2003
WOS Id: 000385954800029
ID de PubMed: 27590218

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