Edoxaban Compared to Standard Care After Heart Valve Replacement Using a Catheter in Patients With Atrial Fibrillation (ENVISAGE-TAVI AF)
- Conditions
- Atrial Fibrillation
- Interventions
- Drug: Edoxaban-based RegimenDrug: VKA-based Regimen
- Registration Number
- NCT02943785
- Lead Sponsor
- Daiichi Sankyo
- Brief Summary
When the upper chambers of a person's heart receive or generate irregular electrical signals, it causes abnormal rhythm in the heartbeat. This is called atrial fibrillation.
Atrial fibrillation goes along with blood clots that may cause mainly strokes and less often other diseases, such as a heart attack. Some patients with atrial fibrillation have other heart disease, such as heart valves that may need to be replaced using catheters.
Often doctors give patients drugs that reduce those blood clots. These are either vitamin K antagonist (VKA) or direct anticoagulants, such as edoxaban. In these patients, it is unclear which of the drugs is better for reducing stroke without increasing severe bleedings.
- Detailed Description
Use of Edoxaban in patients with atrial fibrillation (AF) and indication to chronic oral anticoagulation (OAC) after transcatheter aortic valve implantation (TAVI)
Objective:
* To assess the effect of Edoxaban versus vitamin K antagonist (VKA) on net adverse clinical events (NACE), i.e., the composite of all-cause death, myocardial infarction (MI), ischemic stroke, systemic thromboembolism (SEE), valve thrombosis, and major bleeding (International Society on Thrombosis and Haemostasis \[ISTH\] definition).
* To assess the effect of Edoxaban versus VKA on major bleeding (ISTH definition).
Recruitment & Eligibility
- Status
- COMPLETED
- Sex
- All
- Target Recruitment
- 1426
- Meets protocol-specified criteria for qualification and contraception
- Is willing and able to comply with any restrictions related food, drink and medications
- Voluntarily consents to participate and provides written informed consent prior to any protocol-specific procedures
-
Has history or current use of over-the-counter medications, dietary supplements, or drugs (including nicotine and alcohol) outside protocol-specified parameters
-
Has signs, symptoms or history of any condition that, per protocol or in the opinion of the investigator, might compromise:
- the safety or well-being of the participant or study staff
- the safety or well-being of the participant's offspring (such as through pregnancy or breast-feeding)
- the analysis of results
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Arm && Interventions
Group Intervention Description Edoxaban-based Regimen Edoxaban-based Regimen Edoxaban-based regimen 60 mg and 30 mg film coated tablet for once-daily oral use, and 15 mg film coated tablet in case of transitioning at the end of treatment. Dosing must follow the locally approved label. VKA-based Regimen VKA-based Regimen VKA-based regimen oral VKA tablets as selected and provided by the site and used in accordance with the local label. The Investigator will monitor the patient and adjust the VKA dose to maintain the dose within target.
- Primary Outcome Measures
Name Time Method Number of Participants Who Experienced Net Adverse Clinical Events (Adjudicated Data) Based on ISTH Criteria in Participants Taking Edoxaban vs VKA Baseline through study completion, up to 36 months post-dose The composite endpoint net adverse clinical events (NACE) included all-cause death, myocardial infarction (MI), ischemic stroke, systemic embolic events (SEE), valve thrombosis, and major bleeding per definition of the International Society on Thrombosis and Haemostasis (ISTH\].
Number of Participants Who Experienced Major Bleeding (Adjudicated Data) Based on ISTH Criteria in Participants Taking Edoxaban vs VKA Baseline through study completion, up to 36 months post-dose ISTH Bleeding Criteria for Major Bleeding are defined as clinically overt bleeding that is associated with: a fall in hemoglobin of 2 g/dL (1.24 mmol/L) or more, or a transfusion of 2 or more units of whole blood or packed red blood cells, or symptomatic bleeding into a critical site or organ such as intracranial, intraspinal, intraocular, retroperitoneal, pericardial, intra-articular, or intramuscular with compartment syndrome, or a fatal outcome.
- Secondary Outcome Measures
Name Time Method Number of Participants Who Experienced Major Adverse Cardiac Events (MACE) in Participants Taking Edoxaban vs VKA (Adjudicated Data) Baseline through study completion, up to 36 months post-dose Major adverse cardiac events (MACE) is defined as the composite of all-cause death (excluding adjudicated non-cardiac death), MI, or repeat coronary revascularization of the target lesion.
Number of Participants Who Experienced Net Adverse Clinical Events (Adjudicated Data) Based on TIMI Criteria in Participants Taking Edoxaban vs VKA Baseline through study completion, up to 36 months post-dose The composite endpoint of net adverse event clinical events (NACE) included all-cause death, myocardial infarction (MI), ischemic stroke, systemic embolic events (SEE), valve thrombosis, and major bleeding based on Thrombolysis in Myocardial Infarction (TIMI) criteria. Bleeding by TIMI criteria was defined as the following: (1) Major, any intracranial hemorrhage or any clinically overt bleeding, (including bleeding evident in imaging studies) associated with a fall of hemoglobin (Hb) of ≥ 5g/dL or fatal bleeding and (2) Minor, any clinically overt bleeding associated with a fall in Hb ≥ 3g/dL but \< 5 g/dL.
Number of Participants Who Experienced Net Adverse Clinical Events (Adjudicated Data) Based on GUSTO Criteria in Participants Taking Edoxaban vs VKA Baseline through study completion, up to 36 months post-dose The composite endpoint of net adverse event clinical events (NACE) included all-cause death, MI, ischemic stroke, SEE, valve thrombosis, and major bleeding based on Global Utilization of Streptokinase and Tissue Plasminogen Activator for Occluded Coronary Arteries (GUSTO). GUSTO criteria was defined as the following: severe or life threatening: intracerebral hemorrhage or resulting in substantial hemodynamic compromise requiring treatment and moderate: requiring blood transfusion but not resulting in hemodynamic compromise.
Number of Participants Who Experienced Net Adverse Clinical Events (Adjudicated Data) Based on BARC Type 3 or 5 Criteria in Participants Taking Edoxaban vs VKA Baseline through study completion, up to 36 months post-dose The composite endpoint of net adverse event clinical events (NACE) included all-cause death, MI, ischemic stroke, SEE, valve thrombosis, and major bleeding based on Bleeding Academic Research Consortium (BARC) Type 3 or 5 criteria. Major bleeding by BARC criteria was defined as Type 3: clinical, laboratory, and/or imaging evidence of bleeding with provider responses; Type 3a: any transfusion with overt bleeding; overt bleeding plus Hb drop of 3 to \< 5 g/dL; Type 3b: overt bleeding plus Hb drop ≥ 5 g/dL; cardiac tamponade; bleeding requiring surgical intervention; bleeding requiring intravenous vasoactive drugs; Type 3c: intracranial hemorrhage; subcategories confirmed by autopsy, imaging, or lumbar puncture; intraocular bleed compromising vision; Type 5: fatal bleeding; Type 5a: probable fatal bleeding; no autopsy or imaging confirmation but clinically suspicious; Type 5b: definite fatal bleeding; overt bleeding or autopsy or imaging confirmation
Number of Participants Who Experienced a Composite of Adverse Events in Participants Taking Edoxaban vs VKA (Adjudicated Data) Baseline through study completion, up to 36 months post-dose A composite of clinical adverse events included cardiovascular death, MI ischemic stroke, SEE, valve thrombosis, and major bleeding as defined by ISTH criteria.
Number of Participants Who Experienced Stroke Events (Ischemic, Hemorrhagic, Undetermined) in Participants Taking Edoxaban vs VKA (Adjudicated Data) Baseline through study completion, up to 36 months post-dose Stroke events are categorized as any stroke, fatal stroke, and non-fatal stroke.
Number of Participants Who Experienced Major Adverse Cardiac and Cerebrovascular Events (MACCE) in Participants Taking Edoxaban vs VKA (Adjudicated Data) Baseline through study completion, up to 36 months post-dose Major adverse cardiac and cerebrovascular events (MACCE) is defined as the composite of all-cause death (excluding adjudicated non-cardiac death), MI, stroke (ischemic, hemorrhagic, or undetermined), or repeat coronary revascularization of the target lesion
Number of Participants Who Experienced Systemic Embolic Events in Participants Taking Edoxaban vs VKA (Adjudicated Data) Baseline through study completion, up to 36 months post-dose Systemic thromboembolism \[non-central nervous system\] is defined as abrupt vascular insufficiency of an extremity or organ associated with clinical or radiological evidence of arterial occlusion in the absence of other likely mechanisms, (e.g., trauma, atherosclerosis, instrumentation).
Number of Participants Who Experienced Myocardial Infarctions (MI) in Participants Taking Edoxaban vs VKA (Adjudicated Data) Baseline through study completion, up to 36 months post-dose Peri-procedural MI was defined as new ischemic symptoms or signs and elevated cardiac biomarkers within 72 hours after index procedure, consisting of at least one sample post-procedure with a peak value exceeding 15x as the upper reference limit (URL) for troponin or 5x for CK-MB. Spontaneous MI is defined as any one of the following: Detection of rise and/or fall of cardiac biomarkers with at least one value above the 99th percentile URL, together with the evidence of myocardial ischemia with at least one of the following: Symptoms of ischemia; ECG changes indicative of new ischemia; New pathological Q-waves in at least two contiguous leads; Imaging evidence of a new loss of viable myocardium or new wall motion abnormality; Sudden, unexpected cardiac death, involving cardiac arrest, often with symptoms suggestive of myocardial ischemia, and accompanied by new ST elevation or new left bundle branch block, and/or evidence of fresh thrombus; Pathological findings of an acute MI.
Number of Participants Who Experienced Valve Thrombosis in Participants Taking Edoxaban vs VKA (Adjudicated Data) Baseline through study completion, up to 36 months post-dose Valve thrombosis was defined as any thrombus attached to or near an implanted valve that occludes part of the blood flow path, interferes with valve function, or is sufficiently large to warrant treatment.
Trial Locations
- Locations (230)
Loma Linda University Medical Center
🇺🇸Loma Linda, California, United States
University of Arizona Sarver Heart Center
🇺🇸Tucson, Arizona, United States
Arkansas Site Management Services
🇺🇸Little Rock, Arkansas, United States
Santa Barbara Cottage Hospital
🇺🇸Santa Barbara, California, United States
Cedar-Sinai Heart Institute
🇺🇸Los Angeles, California, United States
UCLA Cardiovascular Center
🇺🇸Los Angeles, California, United States
Cardiology Associate Research
🇺🇸Daytona Beach, Florida, United States
International Research Partners, LLC.
🇺🇸Doral, Florida, United States
Medstar Washington Hospital Center
🇺🇸Washington, District of Columbia, United States
Watson Clinic Center for Research
🇺🇸Lakeland, Florida, United States
Memorial Healthcare Systems
🇺🇸Hollywood, Florida, United States
UF Health Jacksonville
🇺🇸Jacksonville, Florida, United States
Tallahassee Research Institute, Inc.
🇺🇸Tallahassee, Florida, United States
Rush University Medical Center
🇺🇸Chicago, Illinois, United States
Carle Foundation Hospital
🇺🇸Urbana, Illinois, United States
University of Iowa Hospitals and Clinics
🇺🇸Iowa City, Iowa, United States
Baystate Health
🇺🇸Springfield, Massachusetts, United States
Sparrow Clinical Research Institute
🇺🇸Lansing, Michigan, United States
Michigan Heart, St. Joseph Mercy Health System
🇺🇸Ypsilanti, Michigan, United States
MidMichigan Medical Center Midland
🇺🇸Midland, Michigan, United States
University of Massachusetts Memorial Medical Center
🇺🇸Worcester, Massachusetts, United States
HealthEast Medical Research Institute
🇺🇸Saint Paul, Minnesota, United States
Essentia Health
🇺🇸Duluth, Minnesota, United States
Clinical Investigators LLC
🇺🇸Saint Louis, Missouri, United States
New Mexico Heart Institute
🇺🇸Albuquerque, New Mexico, United States
NY Presbyterian - Brooklyn Methodist Hospital
🇺🇸Brooklyn, New York, United States
St. Francis Hospital
🇺🇸East Hills, New York, United States
St. Joseph's Physicians
🇺🇸East Syracuse, New York, United States
Rochester General Hospital
🇺🇸Geneva, New York, United States
Northshore Community Hospital
🇺🇸Manhasset, New York, United States
Mt. Sinai Hospital
🇺🇸New York, New York, United States
Stony Brook University Medical Center
🇺🇸Stony Brook, New York, United States
Promedica Toledo Hospital
🇺🇸Toledo, Ohio, United States
East Carolina Heart Institute
🇺🇸Greenville, North Carolina, United States
Southern Oregon Cardiology
🇺🇸Medford, Oregon, United States
St. Luke's University Health Network
🇺🇸Bethlehem, Pennsylvania, United States
Doylestown Health Cardiothoracic Surgery
🇺🇸Doylestown, Pennsylvania, United States
Penn State Health, Milton S. Hershey Medical Center
🇺🇸Hershey, Pennsylvania, United States
WellSpan York Hospital
🇺🇸York, Pennsylvania, United States
Geisinger Wyoming Valley Medical Center
🇺🇸Wilkes-Barre, Pennsylvania, United States
Pinnacle Health
🇺🇸Wormleysburg, Pennsylvania, United States
Black Hills Cardiovascular Research
🇺🇸Rapid City, South Dakota, United States
Inova Heart and Vascular Institute
🇺🇸Falls Church, Virginia, United States
Providence Sacred Heart Medical Research Center
🇺🇸Spokane, Washington, United States
Universitätsklinik für Innere Medizin II
🇦🇹Vienna, Austria
ASZ Aalst - Aalst campus
🇧🇪Aalst, Belgium
University of Alberta Hospital
🇨🇦Edmonton, Alberta, Canada
Newmarket Cardiac Surgery Research Incorporated
🇨🇦Newmarket, Ontario, Canada
Sunnybrook Health Sciences Centre
🇨🇦Toronto, Ontario, Canada
London Health Sciences Centre
🇨🇦London, Ontario, Canada
University Health Network
🇨🇦Toronto, Ontario, Canada
Kingston Health Sciences Centre
🇨🇦Kingston, Ontario, Canada
Montreal Heart Institute
🇨🇦Montréal, Quebec, Canada
Hamilton General Hospital
🇨🇦Hamilton, Canada
Universitè Laval
🇨🇦Québec, Canada
CHU d'Angers
🇫🇷Angers, France
Clinique Saint Augustin
🇫🇷Bordeaux, France
Institut Coeur Poumon - CHRU de Lille
🇫🇷Lille, France
Hopital Henri Mondor
🇫🇷Créteil, France
Clinique du Millenaire Service de Cardiologie Interventionelle
🇫🇷Montpellier, France
CHU Arnaud de Villeneuve
🇫🇷Montpellier, France
Hopital Bichat
🇫🇷Paris, France
Institut Mutualiste Montsouris
🇫🇷Paris, France
Nouvel Hopital Civil
🇫🇷Strasbourg, France
CHU de Bordeaux Hopital du Haut Leveque
🇫🇷Pessac, France
Clinique Saint-Hilaire
🇫🇷Rouen, France
CHU de Rouen
🇫🇷Rouen, France
Clinique Pasteur / GCVI
🇫🇷Toulouse, France
Kerckhoff-Klinik
🇩🇪Bad Nauheim, Germany
Herz und Gefaess Klinik
🇩🇪Bad Neustadt An Der Saale, Germany
Charite Universitatsmedizin Berlin
🇩🇪Berlin, Germany
Segeberger Kliniken
🇩🇪Bad Segeberg, Germany
Gesundheit Nord gGmbH
🇩🇪Bremen, Germany
Klinikum der Stadt Ludwigshafen
🇩🇪Dortmund, Germany
St. Johannes - Hospital
🇩🇪Dortmund, Germany
Universitätsklinikum Düsseldorf
🇩🇪Düsseldorf, Germany
Heart Center Dresden, University Clinic Technical University Dresden
🇩🇪Dresden, Germany
Elisabeth Krankenhaus Essen Klinik fur Kardiologie und Angiologie
🇩🇪Essen, Germany
Klinikum Fulda gAG
🇩🇪Fulda, Germany
Asklepios St. Georg Abteilung fuer Kardiologie
🇩🇪Hamburg, Germany
Universitatsklinikum Halle (Saale)
🇩🇪Halle, Germany
Heidelberg University Hospital
🇩🇪Heidelberg, Germany
MediClin Herzzentrum Lahr/Baden
🇩🇪Lahr, Germany
Universitatsmedizin Mainz, Zentrum fur Kardiologie
🇩🇪Mainz, Germany
Herzzentrum Leipzig
🇩🇪Leipzig, Germany
Klinikum rechts der Isar der Technischen Universitat Munchen
🇩🇪Muenchen, Germany
Universitatsklinikum Essen, Klinik fur Kardiologie
🇩🇪München, Germany
Deutsches Herzzentrum Munchen
🇩🇪München, Germany
Klinikum Oldenburg AöR
🇩🇪Oldenburg, Germany
Uniklinikum Regensburg, Med II
🇩🇪Regensburg, Germany
Krankenhaus der Barmherzigen
🇩🇪Trier, Germany
Universitaetsklinikum Tuebingen Medizinische Klinik, Abteilung III
🇩🇪Tuebingen, Germany
Universitatsklinikum Ulm
🇩🇪Ulm, Germany
Helios Herzzentrum Wuppertal
🇩🇪Wuppertal, Germany
Universitatsklinikum Wurzburg
🇩🇪Würzburg, Germany
Ospedali Riuniti Torrette Di Ancona
🇮🇹Ancona, Italy
Policlinico Sant'Orsola-Malpighi
🇮🇹Bologna, Italy
ASST Spedali Civili di Brescia-UO Cardiologia
🇮🇹Brescia, Italy
AOU Policlinico Vittorio Emanuele
🇮🇹Catania, Italy
Magna Graecia University
🇮🇹Catanzaro, Italy
Ospedale S. Croce e Carle
🇮🇹Cuneo, Italy
Citta di Lecce Hospital
🇮🇹Lecce, Italy
ASST Ovest Milanese - Presidio Ospedallero di Legnana
🇮🇹Legnano, Italy
Ospedale San Raffaele
🇮🇹Milano, Italy
ASST Grande Ospedale Metropolitano Niguarda
🇮🇹Milano, Italy
Clinica Mediterranea
🇮🇹Napoli, Italy
A.A Dei Colli Monaldi UOC Cardiologia Interventistica
🇮🇹Napoli, Italy
Azienda Ospedaliera di Padova
🇮🇹Padova, Italy
Centro Cuore Morgagni
🇮🇹Pedara, Italy
Azienda Ospedaliero-Universitaria Pisana
🇮🇹Pisa, Italy
AO San Camillo Forlanini
🇮🇹Rome, Italy
IRCCS Policlinico San Donato
🇮🇹San Donato Milanese, Italy
Azienda Ospedaliero-Universitaria Policlinico Umberto I
🇮🇹Rome, Italy
Ospedale Sant'Andrea - U.O.S. Emodinamica Cardiologia Interventistica
🇮🇹Rome, Italy
AOU S.Giovanni Di Dio e Ruggi D'Aragona
🇮🇹Salerno, Italy
UOC Emodinamica III
🇮🇹Siena, Italy
Kokura Memorial Hospital
🇯🇵Kitakyushu, Fukuoka, Japan
Ogaki Municipal Hospital
🇯🇵Ōgaki, Gifu, Japan
Teikyo University Hospital
🇯🇵Tokyo, Itabashi, Japan
Tokai University Hospital
🇯🇵Isehara, Kanagawa, Japan
Sendai Kousei Hospital
🇯🇵Sendai, Miyagi, Japan
New Tokyo Hospital
🇯🇵Chiba, Japan
Toyama University Hospital
🇯🇵Toyama, Japan
Seoul National University Hospital
🇰🇷Seoul, Jongno-gu, Korea, Republic of
Seoul St. Mary's Hospital
🇰🇷Seoul, Seocho-gu, Korea, Republic of
Yonsei University Severance Hospital
🇰🇷Seoul, Seodaemun-gu, Korea, Republic of
Korean University Anam Hospital
🇰🇷Seoul, Seongbuk-gu, Korea, Republic of
Asan Medical Center
🇰🇷Seoul, Songpa-gu, Korea, Republic of
Academic Medical Center
🇳🇱Amsterdam, Netherlands
HagaZiekenhuis
🇳🇱Den Haag, Netherlands
Medisch Centrum Leeuwarden
🇳🇱Leeuwarden, Netherlands
Uniwersytecki Szpital Kliniczny w Bialymstoku
🇵🇱Białystok, Poland
University Clinical Centre in Gdańsk
🇵🇱Gdańsk, Poland
Szpital Kliniczny Przemienienia Pańskiego Uniwersytetu Medycznego im. Karola Marcinkowskiego w Poznaniu
🇵🇱Poznań, Poland
Hospital Universitario Virgen Macarena
🇪🇸Sevilla, Andalucia, Spain
Hospital Universitario Central de Asturias
🇪🇸Oviedo, Asturias, Spain
Hospital Universitari Germans Trias I Pujol
🇪🇸Badalona, Barcelona, Spain
Hospital Universitario Donostia
🇪🇸Donostia, Gipuzkoa, Spain
Complexo hospitalario universitario de Santiago de Compostela
🇪🇸A Coruña, Spain
Hospital General Universitario de Alicante
🇪🇸Alicante, Spain
Hospital Universitario Vall d'Hebron
🇪🇸Barcelona, Spain
Hospital Clinico y Provincial de Barcelona
🇪🇸Barcelona, Spain
Complejo Asistencial de Granada
🇪🇸Grenada, Spain
Complexo Hospitalario Universitario de A Coruna
🇪🇸La Coruña, Spain
Hospital La Luz QuironSalud
🇪🇸Madrid, Spain
Hospital Universitario La Princesa
🇪🇸Madrid, Spain
Hospital Universitario Ramón y Cajal
🇪🇸Madrid, Spain
Hospital Clinico San Carlos
🇪🇸Madrid, Spain
Hospital Universitario La Paz
🇪🇸Madrid, Spain
Valdecilla Hospital
🇪🇸Santander, Spain
Hospital Virgen de la Arrixaca
🇪🇸Murcia, Spain
Hospital Universitario Virgen de la Victoria
🇪🇸Málaga, Spain
Hospital Clinico de Valencia
🇪🇸Valencia, Spain
Hospital Universitario Virgen del Rocio
🇪🇸Sevilla, Spain
Hospital Clinico Universitario de Valladolid
🇪🇸Valladolid, Spain
Universitatsspital Basel
🇨🇭Basel, Switzerland
Hospital Universitario Alvaro Cunqueiro
🇪🇸Vigo, Spain
Hopitaux Universitaires de Geneve
🇨🇭Geneve, Switzerland
Bern University Hospital
🇨🇭Bern, Switzerland
BSUH, Cardiac Research Unit
🇬🇧Brighton, England, United Kingdom
Cardiocentro Ticino
🇨🇭Lugano, Switzerland
Papworth Hospital NHS Foundation Trust
🇬🇧Cambridge, England, United Kingdom
Trent Cardiac Centre
🇬🇧Nottingham, England, United Kingdom
Oxford University Hospitals, John Radcliffe Hospital
🇬🇧Oxford, England, United Kingdom
Northern General Hospital
🇬🇧Sheffield, England, United Kingdom
University Hospital of Wales, Heath Park
🇬🇧Cardiff, Wales, United Kingdom
University Hospitals of Leicester NHS Trust
🇬🇧Leicester, United Kingdom
Derriford Hospital
🇬🇧Plymouth, United Kingdom
Houston Methodist Research Institute
🇺🇸Houston, Texas, United States
University of Texas Health Science Center Houston
🇺🇸Houston, Texas, United States
Virginia Mason Medical Center
🇺🇸Seattle, Washington, United States
St. Vincent Heart Center
🇺🇸Indianapolis, Indiana, United States
Azienda Socio Sanitaria Territoriale di Lecco
🇮🇹Lecco, Italy
Fondazione Toscana Gabriele Monasterio
🇮🇹Massa, Italy
AOU Careggi, Interventistica Cardiologica Strutturale
🇮🇹Rome, Italy
Istituto Clinico Humanitas
🇮🇹Rozzano, Italy
Centro Cardiologico Monzino IRCCS
🇮🇹Milano, Italy
Fondazione IRCCS Policlinico San Matteo
🇮🇹Pavia, Italy
IRCCS Policlinico San Matteo
🇮🇹Pavia, Italy
IRCCS-ASMN Reggio Emilia
🇮🇹Reggio Emilia, Italy
Azienda Ospedaliera Integrata di Verona
🇮🇹Verona, Italy
University of Alabama at Birmingham
🇺🇸Birmingham, Alabama, United States
University of California - San Francisco
🇺🇸San Francisco, California, United States
Oklahoma Heart Hospital Research Foundation
🇺🇸Oklahoma City, Oklahoma, United States
Providence Heart and Vascular Institute
🇺🇸Portland, Oregon, United States
SCRI - Centennial Medical Center
🇺🇸Nashville, Tennessee, United States
Medizinische Universitaet Graz
🇦🇹Graz, Austria
Maine Medical Center
🇺🇸Scarborough, Maine, United States
Renown Regional Medical Center
🇺🇸Reno, Nevada, United States
CAMC Memorial Hospital
🇺🇸Charleston, West Virginia, United States
Jackson Heart Clinic
🇺🇸Jackson, Mississippi, United States
Hackensack University Medical Center
🇺🇸Hackensack, New Jersey, United States
Universitaetsklinik fuer Innere Medizin III
🇦🇹Innsbruck, Austria
Klinikum Klagenfurt am Worthersee
🇦🇹Klagenfurt, Austria
Jessa Ziekenhuis- Campus Virga Jessa
🇧🇪Hasselt, Belgium
AZ Delta Roeselare
🇧🇪Roeselare, Belgium
Sapporo Higashi Tokushukai Hospital
🇯🇵Sapporo, Hokkaido, Japan
ZNA - Stuivenberg Ziekenhuis Netwerk Antwerpen
🇧🇪Antwerpen, Belgium
Nagoya Heart Center
🇯🇵Toyohashi, Aichi, Japan
UZA - Universtiair Ziekenhuis Antwerpen
🇧🇪Edegem, Belgium
St. Marianna University School of Medicine Hospital
🇯🇵Kawasaki, Kanagawa, Japan
Osaka City University Hospital
🇯🇵Abeno Ward, Osaka, Japan
Keio University Hospital
🇯🇵Shinjuku City, Tokyo, Japan
Erasmus Medical Center
🇳🇱Rotterdam, Netherlands
Clinic Wels-Grieskirchen GmbH
🇦🇹Grieskirchen, Austria
Krankenhaus Hietzing mit Neurologischem Zentrum Rosenhugel
🇦🇹Vienna, Austria
Wilhelminenspital
🇦🇹Wien, Austria
Hospital Erasme
🇧🇪Brussels, Belgium
ZOL Genk, Campus Sint-Jan
🇧🇪Genk, Belgium
CHU de Liege
🇧🇪Liège, Belgium
Tsukuba Medical Center Hospital
🇯🇵Amakubo, Ibaraki, Japan
University Medical Center Groningen
🇳🇱Groningen, Netherlands
Iwate Medical University Hospital
🇯🇵Morioka, Iwate Prefecture, Japan
Toyohashi Heart Center
🇯🇵Aichi, Japan
Saiseikai Yokohamashi Tobu Hospital
🇯🇵Yokohama, Kanagawa, Japan
Kishiwada Tokushukai Hospital
🇯🇵Kishiwada, Osaka, Japan
Shonan Kamakura General Hospital
🇯🇵Kanagawa, Japan
Royal Edinburgh Infirmary
🇬🇧Edinburgh, England, United Kingdom
Guys St Thomas Hospital
🇬🇧London, England, United Kingdom
Horizon Health Network
🇨🇦Saint John, Canada
Immanuel Klinikum Bernau Herzzentrum Brandenburg
🇩🇪Berlin, Germany
Universitaetsklinik Schleswig-Holstein Campus Kiel
🇩🇪Kiel, Germany
Moses H. Cone Memorial Hospital Operating Corporation d/b/a Cone Health
🇺🇸Greensboro, North Carolina, United States
Mayo Clinic Rochester
🇺🇸Rochester, Minnesota, United States
Aurora St. Luke's Medical Center
🇺🇸Milwaukee, Wisconsin, United States
Washington Adventist Hospital
🇺🇸Takoma Park, Maryland, United States
Seton Heart Institute
🇺🇸Austin, Texas, United States
Legacy Heart Center
🇺🇸Plano, Texas, United States
Medical Facility Associates
🇺🇸Washington, District of Columbia, United States
The Valley Hospital
🇺🇸Paramus, New Jersey, United States