MedPath

Apixaban for the Prevention of Stroke in Subjects With Atrial Fibrillation

Phase 3
Completed
Conditions
Atrial Fibrillation
Atrial Flutter
Interventions
Registration Number
NCT00412984
Lead Sponsor
Bristol-Myers Squibb
Brief Summary

The trial seeks to determine if apixaban, an investigational anticoagulant (blood-thinner) is as effective as standard therapy (warfarin) in preventing stroke and systemic embolism in subjects with atrial fibrillation and risk factors for stroke.

Detailed Description

Not available

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
20976
Inclusion Criteria
  • Males and females ≥ 18 yrs with atrial fibrillation (AF) and one or more of the following risk factors for stroke:
  • Age ≥ 75, previous stroke
  • transient ischemic attack (TIA) or Systemic Embolism (SE)
  • Symptomatic congestive heart failure or left ventricular dysfunction with left ventricular ejection fraction (LVEF) ≤ 40%
  • Diabetes mellitus or hypertension requiring pharmacological treatment
Exclusion Criteria

Not provided

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
1warfarin-
2apixaban-
Primary Outcome Measures
NameTimeMethod
Rate of Adjudicated Stroke or Systemic Embolism (SE) During the Intended Treatment Period"Intended Treatment Period" started on the day of randomization and ended at the efficacy cut-off date (date on which it was expected that the target number of primary efficacy events [448] would have occurred; set to 30-Jan-2011, prior to unblinding).

Rate=Number of adjudicated stroke or SE events per 100 patient years. Diagnosis of stroke=the nontraumatic focal neurological deficit lasting at least 24 hours, and includes ischemic stroke, hemorrhagic stroke, ischemic stroke with hemorrhagic conversion, stroke of uncertain type, and retinal ischemic event (embolism, infarction). Diagnosis of SE=clinical history consistent with an acute loss of blood flow to a peripheral artery (or arteries), supported by evidence of embolism from surgical specimens, autopsy, angiography, vascular imaging, or other objective testing.

Number of Participants With First Event of Ischemic/Unspecified Stroke, Hemorrhagic Stroke, or Systemic Embolism (SE) During the Intended Treatment PeriodTime to first event in "Intended Treatment Period": started on day of randomization, ended at efficacy cut-off date (date target number of primary efficacy events [448] was expected to have occurred; set to 30-Jan-2011, prior to unblinding).

All suspected efficacy events were adjudicated by the Central Events Committee (CEC). Diagnosis of stroke=the nontraumatic focal neurological deficit lasting at least 24 hours, and includes ischemic stroke, hemorrhagic stroke, ischemic stroke with hemorrhagic conversion, stroke of uncertain type, and retinal ischemic event (embolism, infarction). Diagnosis of SE=clinical history consistent with an acute loss of blood flow to a peripheral artery (or arteries), supported by evidence of embolism from surgical specimens, autopsy, angiography, vascular imaging, or other objective testing.

Secondary Outcome Measures
NameTimeMethod
Number of Participants With Event of Major (International Society on Thrombosis and Hemostasis [ISTH]) Bleeding During Treatment Period"Treatment Period" started with first dose of blinded study drug and ended 2 days after the last dose of blinded study drug. Mean duration of exposure to double-blind study drug was 1.7 years in each treatment group.

ISTH Bleeding Criteria: Major bleeding=a bleeding event that was: clinically overt bleeding accompanied by a decrease in hemoglobin (Hgb) of 2 g/dL or more, and/or a transfusion of 2 or more units of packed red blood cells; bleeding that occurred in at least 1 of the following critical sites: intracranial, intraspinal, intraocular (within the corpus of the eye; a conjunctival bleed is not an intraocular bleed), pericardial, intra-articular, intramuscular with compartment syndrome, and retroperitoneal; bleeding that was fatal.

Rate of Adjudicated Major (ISTH) Bleed Events During Treatment Period"Treatment Period" started with first dose of blinded study drug and ended 2 days after the last dose of blinded study drug. Mean duration of exposure to double-blind study drug was 1.7 years in each treatment group.

Rate=number of adjudicated major (ISTH) bleed events per 100 patient years. ISTH Bleeding Criteria: Major bleeding=a bleeding event that was: clinically overt bleeding accompanied by a decrease in hemoglobin (Hgb) of 2 g/dL or more and/or a transfusion of 2 or more units of packed red blood cells; bleeding that occurred in at least 1 of the following sites: intracranial, intraspinal, intraocular (within the corpus of the eye; a conjunctival bleed is not an intraocular bleed), pericardial, intra-articular, intramuscular with compartment syndrome, and retroperitoneal; bleeding that was fatal.

Number of Participants With Events of All-Cause Death During the Intended Treatment Period"Intended Treatment Period" started on the day of randomization and ended at the efficacy cut-off date (date on which it was expected that the target number of primary efficacy events [448] would have occurred; set to 30-Jan-2011, prior to unblinding).

Death was defined as all-cause mortality. All unobserved deaths were assumed to be cardiovascular in nature unless a non-cardiovascular cause could be clearly provided. Cardiovascular=deaths due to ischemic and hemorrhagic stroke, SE, myocardial infarction (MI), sudden death, heart failure, other cardiovascular, and unobserved deaths. Non-cardiovascular=all deaths due to a clearly documented non-cardiovascular cause (further classified into the categories: bleeding, study drug toxicity other than bleeding, malignancy, infection, trauma, and pulmonary causes of death).

Rate of Composite Stroke / Systemic Embolism / Major Bleeding in Warfarin/Vitamin K Antagonist (VKA) Naive Participants During the Intended Treatment Period"Intended Treatment Period" started on the day of randomization and ended at the efficacy cut-off date (date on which it was expected that the target number of primary efficacy events [448] would have occurred; set to 30-Jan-2011, prior to unblinding).
Rate of Adjudicated All-Cause Death During the Intended Treatment Period"Intended Treatment Period" started on the day of randomization and ended at the efficacy cut-off date (date on which it was expected that the target number of primary efficacy events [448] would have occurred; set to 30-Jan-2011, prior to unblinding).

All unobserved deaths were assumed to be cardiovascular in nature unless a non-cardiovascular cause could be clearly provided. Cardiovascular=deaths due to ischemic and hemorrhagic stroke, SE, MI, sudden death, heart failure, other cardiovascular, and unobserved deaths. Non-cardiovascular=all deaths due to a clearly documented non-cardiovascular cause (further classified into the categories: bleeding, study drug toxicity other than bleeding, malignancy, infection, trauma, and pulmonary causes of death).

Rate of Events of Major or Clinically Relevant Non-Major (CRNM) Bleed During Treatment Period"Treatment Period" started with first dose of blinded study drug and ended 2 days after the last dose of blinded study drug. Mean duration of exposure to double-blind study drug was 1.7 years in each treatment group.

Rate=number of major or CRNM bleed events per 100 patient years. Major=clinically overt and either 1) resulted in a decrease in hemoglobin of 2 g/dL or more, or 2) led to a transfusion of 2 or more units of packed red blood cells, or 3) occurred in a critical site, or 4) led to death. CRNM bleeding=clinically overt, but satisfied no additional criteria required to be adjudicated as a major bleeding event, and led to either 1) hospital admission for bleeding or 2) physician guided medical or surgical treatment for bleeding or 3) a change in antithrombotic therapy.

Rate of Ischemic or Unspecified Stroke, Hemorrhagic Stroke, Systemic Embolism (SE), and Myocardial Infarction (MI) (as Individual Endpoints) During the Intended Treatment Period"Intended Treatment Period" started on the day of randomization and ended at the efficacy cut-off date (date on which it was expected that the target number of primary efficacy events [448] would have occurred; set to 30-Jan-2011, prior to unblinding).

Diagnosis for an acute or evolving MI=elevation of creatine kinase-MB isoenzyme (CK-MB) or Troponin T or I ≥ 2 × the upper limit of normal (ULN), or if no CK-MB or troponin values are available, a total CK ≥ 2×ULN, or new, significant (≥0.04 s) Q waves in ≥2 contiguous leads. For descriptions of Stroke and SE, see Outcome Measure 1.

Rate of Ischemic or Unspecified Stroke, Hemorrhagic Stroke, Systemic Embolism (SE), Myocardial Infarction (MI) and All-Cause Death (ACD) (as Composite Endpoints) During the Intended Treatment Period"Intended Treatment Period" started on the day of randomization and ended at the efficacy cut-off date (date on which it was expected that the target number of primary efficacy events [448] would have occurred; set to 30-Jan-2011, prior to unblinding).

Diagnosis for an acute or evolving MI=elevation of CK-MB or Troponin T or I ≥ 2 × the ULN, or if no CK-MB or troponin values are available, a total CK ≥ 2×ULN, or new, significant (≥0.04 s) Q waves in ≥2 contiguous leads. For descriptions of Stroke and SE, see Outcome Measure 1. For description of ACD, see Outcome Measure 5.

Number of Warfarin/Vitamin K Antagonist (VKA) Naive Participants With Composite Stroke / Systemic Embolism (SE) / Major Bleeding During the Intended Treatment Period"Intended Treatment Period" started on the day of randomization and ended at the efficacy cut-off date (date on which it was expected that the target number of primary efficacy events [448] would have occurred; set to 30-Jan-2011, prior to unblinding).

For descriptions of Stroke and SE, see Outcome Measure 1. For description of Major bleeding, see Outcome Measure 3.

Number of Participants With Events of Major or Clinically Relevant Nonmajor (CRNM) Bleed During Treatment Period"Treatment Period" started with first dose of blinded study drug and ended 2 days after the last dose of blinded study drug. Mean duration of exposure to double-blind study drug was 1.7 years in each treatment group.

Major bleeding=bleeding that is clinically overt and that either resulted in a decrease in hemoglobin of 2 g/dL or more over a 24-hour period, led to a transfusion of 2 or more units of packed red blood cells, occurred in a critical site, or led to death. CRNM bleeding=bleeding that is clinically overt, that satisfies none of the additional criteria required for the event to be adjudicated as a major bleeding event, that led to either hospital admission for bleeding, physician-guided medical or surgical treatment for bleeding, or a change in antithrombotic therapy.

Number of Participants With All Bleeding Events During Treatment Period"Treatment Period" started with first dose of blinded study drug and ended 2 days after the last dose of blinded study drug. Mean duration of exposure to double-blind study drug was 1.7 years in each treatment group.

All bleeding events include major bleeding, CRNM bleeding (see Outcome Measure 12 Description for definitions), plus events of minor bleeding and fatal bleeding. Minor bleeding: All acute clinically overt bleeding events not meeting the criteria for either major bleeding or clinically relevant non-major bleeding will be classified as minor bleeding. Fatal bleeding is defined as a bleeding event that the Clinical Events Committee determines is the primary cause of death or contributes directly to death.

Rate of All Bleeding Events During Treatment Period"Treatment Period" started with first dose of blinded study drug and ended 2 days after the last dose of blinded study drug. Mean duration of exposure to double-blind study drug was 1.7 years in each treatment group.

Rate=number of all bleeding events per 100 patient years. "All bleeding events" include major bleeding, CRNM bleeding (see Outcome Measure 12 Description for definitions), plus events of minor bleeding and fatal bleeding. Minor bleeding: All acute clinically overt bleeding events not meeting the criteria for either major bleeding or clinically relevant non-major bleeding will be classified as minor bleeding. Fatal bleeding is defined as a bleeding event that the Clinical Events Committee determines is the primary cause of death or contributes directly to death.

Trial Locations

Locations (266)

David Charles Mishkel, Md, Pa

🇺🇸

Boca Raton, Florida, United States

Heart Care Center, P.C.

🇺🇸

East Syracuse, New York, United States

Elkhart Clinic, Llc

🇺🇸

Elkhart, Indiana, United States

Tupelo Neurology Clinic, Pa

🇺🇸

Tupelo, Mississippi, United States

Holston Medical Group

🇺🇸

Kingsport, Tennessee, United States

Heartplace

🇺🇸

Dallas, Texas, United States

Caritas St. Elizabeth'S Medical Center

🇺🇸

Boston, Massachusetts, United States

Nmff

🇺🇸

Chicago, Illinois, United States

The Methodist Hospital Neurology Institute

🇺🇸

Houston, Texas, United States

The Methodist Hospital

🇺🇸

Houston, Texas, United States

The Care Group, Llc.

🇺🇸

Indianapolis, Indiana, United States

St Francis Medical Group - Indiana Heart Physicians

🇺🇸

Indianapolis, Indiana, United States

University Of Minnesota

🇺🇸

Minneapolis, Minnesota, United States

The Carl & Edyth Lindner Center For R&E At The Christ Hosp

🇺🇸

Cincinnati, Ohio, United States

Bhs Specialty Network, Inc

🇺🇸

San Antonio, Texas, United States

Star Clinical Trails

🇺🇸

San Antonio, Texas, United States

Electrophysiology Associates, Pc

🇺🇸

Colorado Springs, Colorado, United States

New West Physicians Clinical Research

🇺🇸

Golden, Colorado, United States

South Denver Cardiology Associates Pc

🇺🇸

Littleton, Colorado, United States

Neccr Internal Medicine & Cardiology Associates,Llc

🇺🇸

Fall River, Massachusetts, United States

Connecticut Clinical Research, Llc

🇺🇸

Bridgeport, Connecticut, United States

Cardio Assoc Of Del Val, P.A.

🇺🇸

Sewell, New Jersey, United States

Mary K. Richards, Md Pa

🇺🇸

Little Rock, Arkansas, United States

Cardiovascular Institute Of The South

🇺🇸

Houma, Louisiana, United States

Washington Va Medical Center

🇺🇸

Washington, District of Columbia, United States

Cardiovascular Associates Of The Delware Valley, P.A.

🇺🇸

Elmer, New Jersey, United States

Rogue Valley Physicians - Clinical Research Group

🇺🇸

Medford, Oregon, United States

Dr. Rajesh Shroff

🇺🇸

Hot Springs, Arkansas, United States

William W Backus Hospital

🇺🇸

Norwich, Connecticut, United States

Chase Medical Research, Llc

🇺🇸

Waterbury, Connecticut, United States

Imperial Calcasieu Medical Group, Llp

🇺🇸

Lake Charles, Louisiana, United States

George Washington University Medical Faculty Associates

🇺🇸

Washington, District of Columbia, United States

Avera Medical Associates Clinic

🇺🇸

Pierre, South Dakota, United States

Stamford Therapeutics Consortium

🇺🇸

Stamford, Connecticut, United States

The William W. Backus Hospital

🇺🇸

Norwich, Connecticut, United States

Alfieri Cardiology

🇺🇸

Newark, Delaware, United States

Internal Medicine Of Greer

🇺🇸

Greer, South Carolina, United States

Cardiology Associates Of New Haven,Pc

🇺🇸

Guilford, Connecticut, United States

Medical Research Inst, Inc

🇺🇸

Slidell, Louisiana, United States

Medical Research Institute, Inc

🇺🇸

Slidell, Louisiana, United States

William Beaumont Hospital

🇺🇸

Royal Oak, Michigan, United States

Princeton Medical Institute

🇺🇸

Princeton, New Jersey, United States

Advanced Cardiovascular Health Specialists, Pc

🇺🇸

Livonia, Michigan, United States

St. Charles Health System, Inc.

🇺🇸

Bend, Oregon, United States

Henry Ford Hospital

🇺🇸

Detroit, Michigan, United States

Cor Clinical Research, Llc

🇺🇸

Oklahoma City, Oklahoma, United States

University Of Oklahoma Health Sciences Center

🇺🇸

Oklahoma City, Oklahoma, United States

Oklahoma Heart Hospital Physicians

🇺🇸

Oklahoma City, Oklahoma, United States

Denver Va Medical Center

🇺🇸

Denver, Colorado, United States

Aurora Denver Cardiology Associates, P.C.

🇺🇸

Denver, Colorado, United States

Clara V. Massey, Md

🇺🇸

Mobile, Alabama, United States

Birmingham Heart Clinic P.C.

🇺🇸

Birmingham, Alabama, United States

Internal Medicine Physicians Associates, P.C.

🇺🇸

Phoenix, Arizona, United States

Southern Arizona Va Health Care System

🇺🇸

Tucson, Arizona, United States

Advanced Clinical Reserach Institute

🇺🇸

Anaheim, California, United States

Capitol Interventional Cardiology

🇺🇸

Carmichael, California, United States

Jacksonville Heart Center, Pa

🇺🇸

Jacksonville, Florida, United States

Atlanta Institute For Medical Research, Inc

🇺🇸

Decatur, Georgia, United States

Columbus Cardiology Associates Pc

🇺🇸

Columbus, Georgia, United States

Jacksonville Heart Center, P.A.

🇺🇸

Jacksonville Beach, Florida, United States

Heart & Vascular Center Research, Inc.

🇺🇸

Sarasota, Florida, United States

Luis Tami, Md

🇺🇸

Hollywood, Florida, United States

St. Vincent'S Ambulatory Care, Inc

🇺🇸

Jacksonville, Florida, United States

Nature Coast Clinical Research

🇺🇸

Inverness, Florida, United States

Healthworx

🇺🇸

Hollywood, Florida, United States

Melbourne Internal Medicine Associates

🇺🇸

Melbourne, Florida, United States

Fox Valley Clinical Research Center, Llc

🇺🇸

Aurora, Illinois, United States

Cardiology Consultants

🇺🇸

Pensacola, Florida, United States

Columbus Cardiology Associates,Pc

🇺🇸

Columbus, Georgia, United States

Loyola University Medical Center

🇺🇸

Maywood, Illinois, United States

Lutheran Medical Group, Llc

🇺🇸

Fort Wayne, Indiana, United States

Cpt. James A Lovell Federal Health Care Center

🇺🇸

North Chicago, Illinois, United States

Premier Healthcare, Llc

🇺🇸

Bloomington, Indiana, United States

The Care Group, Llc

🇺🇸

Indianapolis, Indiana, United States

Mcfarland Clinic Pc

🇺🇸

Ames, Iowa, United States

Cardiology Associates, Inc.

🇺🇸

South Bend, Indiana, United States

Midwest Cardiology Associates , P.C.

🇺🇸

Overland Park, Kansas, United States

Cardiology Center, Llc

🇺🇸

Marrero, Louisiana, United States

Alexandria Cardiology Clinic

🇺🇸

Alexandria, Louisiana, United States

Smith, Patel & Amkieh, Llc

🇺🇸

Lacombe, Louisiana, United States

Louisiana Heart Center

🇺🇸

Slidell, Louisiana, United States

Ventura Cardio. Cond. Med. Group, Inc.

🇺🇸

Ventura, Louisiana, United States

Franklin Square Hospital

🇺🇸

Baltimore, Maryland, United States

Midatlantic Cardiovascular Associates, Pa

🇺🇸

Westminster, Maryland, United States

Central Maine Heart & Vascular Institute

🇺🇸

Lewiston, Maine, United States

Clinical Associates Research

🇺🇸

Reisterstown, Maryland, United States

Medical College Of Wisconsin

🇺🇸

Milwaukee, Wisconsin, United States

Pentucket Medical Associates

🇺🇸

Haverhill, Massachusetts, United States

University Of Missouri

🇺🇸

Columbia, Missouri, United States

Lahey Clinic Medical Center

🇺🇸

Burlington, Massachusetts, United States

Thoracic And Cardiovascular Healthcare Foundation

🇺🇸

Lansing, Michigan, United States

Minneapolis Va Medical Center

🇺🇸

Minneapolis, Minnesota, United States

Michigan Heart, P.C.

🇺🇸

Ypsilanti, Michigan, United States

North Memorial Health Care

🇺🇸

Robbinsdale, Minnesota, United States

Olive Branch Family Medical Center

🇺🇸

Olive Branch, Mississippi, United States

Va Southern Nevada Healthcare System

🇺🇸

Las Vegas, Nevada, United States

Internal Medical Associates of Grand Island, P.C

🇺🇸

Grand Island, Nebraska, United States

Nebraska Heart Institute

🇺🇸

Hastings, Nebraska, United States

Internal Medical Associates Of Grand Island, P.C

🇺🇸

Grand Island, Nebraska, United States

Comprehensive Clinical Research

🇺🇸

Berlin, New Jersey, United States

University Of New Mexico/University Hospital

🇺🇸

Albuquerque, New Mexico, United States

Central New Jersey Cardiology

🇺🇸

South Plainfield, New Jersey, United States

Cardiovascular Associates Of The Delaware Valley, P.A.

🇺🇸

Haddon Heights, New Jersey, United States

Abq Health Partners, Llc

🇺🇸

Albuquerque, New Mexico, United States

Albany Assoc. In Cardiology

🇺🇸

Albany, New York, United States

Albany Associates In Cardiology

🇺🇸

Albany, New York, United States

Suburban Cardiology

🇺🇸

Williamsville, New York, United States

Long Island Heart Associates

🇺🇸

Mineola, New York, United States

Saratoga Cardiology Associates, Pc

🇺🇸

Saratoga Springs, New York, United States

Community Health Care, Inc.

🇺🇸

Canal Fulton, Ohio, United States

Jack C. Va Medical Center

🇺🇸

Muskogee, Oklahoma, United States

Christopher M. Johnson, D.O.

🇺🇸

Bucyrus, Ohio, United States

Asheville Cardiology Associates

🇺🇸

Asheville, North Carolina, United States

Plaza Medical Group, Pc

🇺🇸

Oklahoma City, Oklahoma, United States

South Oklahoma Heart Research

🇺🇸

Oklahoma City, Oklahoma, United States

Toledo Cardiology Consultants

🇺🇸

Toledo, Ohio, United States

Family Practice Center Of Wadsworth, Inc.

🇺🇸

Wadsworth, Ohio, United States

Castlerock Clinical Research Consultants, Llc

🇺🇸

Tulsa, Oklahoma, United States

Lillestol Research Llc

🇺🇸

Fargo, North Dakota, United States

St. Charles Health System, Inc

🇺🇸

Bend, Oregon, United States

Hillsboro Cardiology Pc

🇺🇸

Hillsboro, Oregon, United States

Oregon Medical Group - Clinical Research

🇺🇸

Eugene, Oregon, United States

Blair Medical Associates, Inc.

🇺🇸

Altoona, Pennsylvania, United States

Abington Medical Specialists

🇺🇸

Abington, Pennsylvania, United States

Heritage Cardiology Assoc.

🇺🇸

Camp Hill, Pennsylvania, United States

Central Bucks Cardiology

🇺🇸

Doylestown, Pennsylvania, United States

Kandra, Fierer, Kuskin Associates

🇺🇸

Harrisburg, Pennsylvania, United States

Pivotal Clinical Research, Llc

🇺🇸

Hatfield, Pennsylvania, United States

Internal Medicine And Lipid Mgmt.

🇺🇸

Erie, Pennsylvania, United States

Lycoming Internal Medicine Inc.

🇺🇸

Jersey Shore, Pennsylvania, United States

Guthrie Clinic Ltd.

🇺🇸

Sayre, Pennsylvania, United States

Lowcountry Medical Group, Llc

🇺🇸

Beaufort, South Carolina, United States

Preferred Primary Care Physicians

🇺🇸

Uniontown, Pennsylvania, United States

Guthrie Medical Group, P.C.

🇺🇸

Sayre, Pennsylvania, United States

Cardiology Consultants Of Philadelphia

🇺🇸

Yardley, Pennsylvania, United States

Amarillo Heart Clinical Research Institute Inc.

🇺🇸

Amarillo, Texas, United States

Lowcountry Medical Group

🇺🇸

Beaufort, South Carolina, United States

Columbia Heart Clinic

🇺🇸

Columbia, South Carolina, United States

Palmetto Nephrology Pa

🇺🇸

Orangeburg, South Carolina, United States

S. Carolina Pharmaceutical Research

🇺🇸

Spartanburg, South Carolina, United States

Knoxville Heart Group

🇺🇸

Knoxville, Tennessee, United States

Volunteer Research Group

🇺🇸

Knoxville, Tennessee, United States

Tennessee Center For Clinical Trials

🇺🇸

Tullahoma, Tennessee, United States

Corsicana Medical Research, Pllc

🇺🇸

Corsicana, Texas, United States

Northwest Houston Cardiology, Pa

🇺🇸

Houston, Texas, United States

Covenant Clinical Research, Pa

🇺🇸

San Antonio, Texas, United States

Roanoke Heart Institute, Plc

🇺🇸

Roanoke, Virginia, United States

Northwest Heart Center

🇺🇸

Tomball, Texas, United States

University Of Texas Health Science Center At Tyler

🇺🇸

Tyler, Texas, United States

Rockwood Clinic Research Cent.

🇺🇸

Spokane, Washington, United States

Aurora Health Care

🇺🇸

Milwaukee, Wisconsin, United States

Walla Walla Clinic

🇺🇸

Walla Walla, Washington, United States

Lynn N. Smith, Md

🇺🇸

Lewisburg, West Virginia, United States

Heart Center, Inc.

🇺🇸

Huntsville, Alabama, United States

Jacksonville Cardiovascular Center

🇺🇸

Jacksonville, Florida, United States

Alpha Medical Research

🇺🇸

Oviedo, Florida, United States

Jacksonville Center For Clinical Research

🇺🇸

Jacksonville, Florida, United States

Wellstar Cardiovascular Medicine, Pc

🇺🇸

Marietta, Georgia, United States

Cvms Research Institute, Llc

🇺🇸

Jupiter, Florida, United States

Research, Inc.

🇺🇸

Vero Beach, Florida, United States

Georgia Heart Specialists, L.L.C.

🇺🇸

Covington, Georgia, United States

Physicians Regional Medical Group

🇺🇸

Naples, Florida, United States

Cardiovascular Specialits, Pc

🇺🇸

Atlanta, Georgia, United States

Augusta Cardiology Clinic, P.C.

🇺🇸

Augusta, Georgia, United States

Illinois Heart & Lung Research Center, Sc

🇺🇸

Normal, Illinois, United States

Fort Wayne Cardiology

🇺🇸

Fort Wayne, Indiana, United States

Cardiology Associates, Pc

🇺🇸

Binghamton, New York, United States

Huntington Hospital

🇺🇸

Huntington, New York, United States

Carolina Cardiology Associates, Pa

🇺🇸

High Point, North Carolina, United States

West Chester Cardiology, Pc

🇺🇸

West Chester, Pennsylvania, United States

Office Of Dr. Kozinn

🇺🇸

Williamsville, New York, United States

Soltero Cardiovascular Research Center

🇺🇸

Dallas, Texas, United States

Heart Center Of North Texas

🇺🇸

Fort Worth, Texas, United States

Wilford Hall Medical Center

🇺🇸

Lackland Air Force Base, Texas, United States

Tyler Cardiovascular Consultants

🇺🇸

Tyler, Texas, United States

Sentara York Clinical Research

🇺🇸

Norfolk, Virginia, United States

Edward Balli, Md, Pa

🇺🇸

Seguin, Texas, United States

Northeast Georgia Heart Center, Pc

🇺🇸

Gainesville, Georgia, United States

Clinical Investigation Specialists, Inc

🇺🇸

Gurnee, Illinois, United States

Bruce L. Platt, Md

🇺🇸

Buffalo, New York, United States

Ricardo Bedoya, M.D.

🇺🇸

Jupiter, Florida, United States

Kernodle Clinic, Inc.

🇺🇸

Burlington, North Carolina, United States

Niranjan Seshadri, Md

🇺🇸

Sarasota, Florida, United States

Akron Cardiology Consultants

🇺🇸

Akron, Ohio, United States

Alabama Internal Medicine Pc

🇺🇸

Birmingham, Alabama, United States

Cardiovascular Associates, Pc

🇺🇸

Birmingham, Alabama, United States

Southwest Heart

🇺🇸

Tucson, Arizona, United States

Pima Research Foundation

🇺🇸

Tucson, Arizona, United States

Alaska Heart Institute

🇺🇸

Anchorage, Alaska, United States

Mobile Heart Specialists, Pc

🇺🇸

Mobile, Alabama, United States

Act/Cardiovascular Research Institute

🇺🇸

Beverly Hills, California, United States

Escondido Cardiology Associates, Inc.

🇺🇸

Escondido, California, United States

La Mesa Cardiac Center, A Medical Group

🇺🇸

La Mesa, California, United States

William D. Bowden, D.O.

🇺🇸

Healdsburg, California, United States

Coastal Cardiology

🇺🇸

Mission Viejo, California, United States

Va Greater Los Angeles Healthcare System

🇺🇸

Los Angeles, California, United States

Kenneth W. Carr Md

🇺🇸

Oceanside, California, United States

Desert Med Grp Inc, Dba Desert Oasis Healthcare Med Group

🇺🇸

Palm Springs, California, United States

Arrhythmia Consultants Of The Central Coast Medical Group

🇺🇸

Santa Barbara, California, United States

Northern California Medical Associates

🇺🇸

Santa Rosa, California, United States

Sacramento Heart And Vascular Medical Associates

🇺🇸

Sacramento, California, United States

Desert Cardiology Consultants Medical Group, Inc

🇺🇸

Rancho Mirage, California, United States

Regional Cardiolody Associates

🇺🇸

Sacramento, California, United States

Northern California Research

🇺🇸

Sacramento, California, United States

Cardivasclular Consultants Medical Group

🇺🇸

Walnut Creek, California, United States

Shiva Heart Center Medical Group

🇺🇸

Wildomar, California, United States

Progressive Clinical Research

🇺🇸

Vista, California, United States

Bridgeport Hospital

🇺🇸

Bridgeport, Connecticut, United States

Medical Specialist Of The Palm Beach

🇺🇸

Atlantis, Florida, United States

Miami International Cardiology Consultants

🇺🇸

Miami, Florida, United States

Cardiovascular Specialist Of South Florida

🇺🇸

Davie, Florida, United States

The Heart And Vascular Institute Of Florida

🇺🇸

Saint Petersburg, Florida, United States

Daytona Heart Group

🇺🇸

Daytona Beach, Florida, United States

Cardiology Associates Of Fort Lauderdale, P.A.

🇺🇸

Fort Lauderdale, Florida, United States

The Heart & Vascular Institute Of Florida

🇺🇸

Clearwater, Florida, United States

Broward General Medical Center

🇺🇸

Fort Lauderdale, Florida, United States

Florida Heart Associates

🇺🇸

Fort Myers, Florida, United States

Community Clinical Research Center

🇺🇸

Anderson, Indiana, United States

Central Cardiology Assoc.

🇺🇸

Elizabethtown, Kentucky, United States

Cardiology Associates

🇺🇸

Canton, Ohio, United States

Owensboro Heart & Vascular

🇺🇸

Owensboro, Kentucky, United States

Johns Hopkins Bayview Medical Center

🇺🇸

Baltimore, Maryland, United States

Charles River Medical Associates

🇺🇸

Natick, Massachusetts, United States

Cardiovascular Specialists Of Central Maryland, P.A.

🇺🇸

Columbia, Maryland, United States

Burlington Medical Associates

🇺🇸

Billerica, Massachusetts, United States

Sjh Cardiology Associates

🇺🇸

Liverpool, New York, United States

Pinehurst Medical Center, Inc

🇺🇸

Pinehurst, North Carolina, United States

Eminence Research, Llc

🇺🇸

Oklahoma City, Oklahoma, United States

Center For Atrial Fibrillation

🇺🇸

Houston, Texas, United States

Southeastern Research Associates, Inc

🇺🇸

Anderson, South Carolina, United States

Upstate Cardiology

🇺🇸

Greenville, South Carolina, United States

Francisco R. Maislos

🇺🇸

Houston, Texas, United States

Regional Medical Center And Diagnostic Clinics

🇺🇸

Humble, Texas, United States

Woodlands North Houston Heart Center

🇺🇸

Houston, Texas, United States

The University Of Texas Md Anderson Cancer Center

🇺🇸

Houston, Texas, United States

North Dallas Research Associates

🇺🇸

McKinney, Texas, United States

Dcol Center For Clinical Research

🇺🇸

Longview, Texas, United States

North Texas Medical Research

🇺🇸

Plano, Texas, United States

Legacy Heart Center

🇺🇸

Plano, Texas, United States

The Univ. Of Texas Health Science Ctr. At Tyler

🇺🇸

Tyler, Texas, United States

Utah Cardiology P.C

🇺🇸

Layton, Utah, United States

Cardiovascular Associates

🇺🇸

Virginia Beach, Virginia, United States

Daniel William Gottlieb, Md

🇺🇸

Burien, Washington, United States

Cardiology Associates Of Green Bay Ltd-Bellin Hospital

🇺🇸

Green Bay, Wisconsin, United States

Daniel W. Gottlieb, Md, Ps

🇺🇸

Burien, Washington, United States

Local Institution

🇬🇧

Glasgow, United Kingdom

Cardiology Assc. Of Waukesha

🇺🇸

Waukesha, Wisconsin, United States

Florida Heart Group

🇺🇸

Orlando, Florida, United States

Va Medical Center

🇺🇸

Louisville, Kentucky, United States

Norton Cardiovascular Associates

🇺🇸

Louisville, Kentucky, United States

Truman Medical Center

🇺🇸

Kansas City, Missouri, United States

Saint Luke'S Lipid And Diabetes Research Center

🇺🇸

Kansas City, Missouri, United States

Medical University Of South Carolina

🇺🇸

Charleston, South Carolina, United States

Midatlantic Cardiovascular Associates, P.A.

🇺🇸

Baltimore, Maryland, United States

Medical Research Initiatives

🇺🇸

Richmond, Virginia, United States

Florida Research Network, Llc

🇺🇸

Gainesville, Florida, United States

New Lexington Clinic, P.S.C.

🇺🇸

Lexington, Kentucky, United States

St. Mary'S Hospital

🇺🇸

Madison, Wisconsin, United States

St.Mary'S Hospital

🇺🇸

Madison, Wisconsin, United States

St. Luke'S Cardiology

🇺🇸

Jacksonville, Florida, United States

Buffalo Heart Group, Llp

🇺🇸

Buffalo, New York, United States

Bruce L. Platt Md, Pc

🇺🇸

Buffalo, New York, United States

Michigan Heart And Vascular Specialists

🇺🇸

Petoskey, Michigan, United States

Dali, Sammi

🇺🇸

Michigan City, Indiana, United States

Great Lakes Heart Center Of Alpena

🇺🇸

Alpena, Michigan, United States

Rhode Island Hospital

🇺🇸

Providence, Rhode Island, United States

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