A Study to Learn How Well the Study Treatment Asundexian Works and How Safe it is Compared to Apixaban to Prevent Stroke or Systemic Embolism in People With Irregular and Often Rapid Heartbeat (Atrial Fibrillation), and at Risk for Stroke (OCEANIC-AF)

December 4, 2024 updated by: Bayer

A Multicenter, International, Randomized, Active Comparator-controlled, Double-blind, Double-dummy, Parallel-group, 2-arm, Phase 3 Study to Compare the Efficacy and Safety of the Oral FXIa Inhibitor Asundexian (BAY 2433334) With Apixaban for the Prevention of Stroke or Systemic Embolism in Male and Female Participants Aged 18 Years and Older With Atrial Fibrillation at Risk for Stroke

Researchers are looking for a better way to treat people with atrial fibrillation (AF) and prevent stroke or systemic embolism (blood clots travelling through the blood stream to plug another vessel).

Atrial fibrillation is a condition of having irregular and often rapid heartbeat. It can lead to the formation of blood clots in the heart which can travel through the blood stream to plug another vessel, and like this lead to serious and life-threatening conditions, such as a stroke. A stroke occurs because the brain tissue beyond the blockage no longer receives nutrients and oxygen so that brain cells die. As strokes arising from atrial fibrillation can involve extensive areas of the brain, it is important to prevent them.

Blood clots are formed in a process known as coagulation. Medications are already available to prevent the formation of blood clots. When taken by mouth (orally), they are known as oral anticoagulants (OACs) including apixaban. OACs decrease the risk of the above-mentioned serious and life-threatening conditions. The main side effect of OACs is an increase of the risk of bleeding.

The study treatment asundexian is a new type of anticoagulant currently under development to provide further treatment options. Asundexian aims to further improve the standard of care with regard to the risk of bleeding.

The main purpose of this study is to collect more data about how well asundexian works to prevent stroke and systemic embolism and how safe it is compared to apixaban in people with atrial fibrillation and at high risk for stroke.

To see how well the study treatment asundexian works researchers compare:

  • how long asundexian works well and
  • how long apixaban works well after the start of the treatment. Working well means that the treatments can prevent the following from happening:
  • stroke and/or
  • systemic embolism. The study will keep collecting data until a certain number of strokes or embolisms happen in the study.

To see how safe asundexian is, the researchers will compare how often major bleedings occur after taking the study treatments asundexian and apixaban, respectively. Major bleedings are bleedings that have a serious or even life-threatening impact on a person's health.

The study participants will be randomly (by chance) assigned to 1 of 2 treatment groups, A and B. Dependent on the treatment group, the participants will either take the study treatment asundexian by mouth once a day or apixaban by mouth twice a day for approximately 9 - 33 months.

Each participant will be in the study for approximately 9 - 34 months. There will be visits to the study site every 3 to 6 months and up to 7 phone calls. Those participants who do not want or are unable to have visits to the study site may join the study remotely in selected locations. The location name contains the abbreviation - DCT in such cases.

During the study, the study team will:

  • take blood samples
  • do physical examinations
  • examine heart health using an electrocardiogram (ECG)
  • check vital signs such as blood pressure and heart rate
  • do pregnancy tests
  • ask the participants questions about their quality of life
  • ask the participants questions about how they are feeling and what adverse events they are having.

An adverse event is any medical problem that a participant has during a study. Doctors keep track of all adverse events that happen in studies, even if they do not think the adverse events might be related to the study treatments.

Study Overview

Study Type

Interventional

Enrollment (Actual)

14830

Phase

  • Phase 3

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

      • Corrientes, Argentina, 3400
        • Instituto de Cardiologia de Corrientes Juana F. Cabral | Corrientes, Argentina
      • Santa Fe, Argentina, S3000FWO
        • Centro de Investigaciones Clinicas del Litoral | Santa Fe, Argentina
    • Buenos Aires
      • Bahía Blanca, Buenos Aires, Argentina, 8000
        • Instituto de Investigaciones Clinicas Bahia Blanca | Bahia Blanca, Argentina
      • General Arenales, Buenos Aires, Argentina, C1061AAS
        • Centro de Investigación y Prevención Cardiovascular
      • La Plata, Buenos Aires, Argentina, B1900
        • Hospital Italiano de La Plata | Clinical Research Department
      • Lanus, Buenos Aires, Argentina, B1824
        • Centro de Investigaciones Medicas Lanus | Buenos Aires, Argentina
      • Mar del Plata, Buenos Aires, Argentina, B7600FZ0
        • Instituto de Investigaciones Clinicas de Mar del Plata | Mar del Plata, Argentina
      • San Isidro, Buenos Aires, Argentina, B1642DCD
        • CardioAlem Investigaciones | San Isidro, Argentina
      • San Nicolás, Buenos Aires, Argentina, B2900DMH
        • Instituto de Investigaciones Clínicas (IIC) San Nicolas | San Nicolas de los Arroyos, Argentina
      • Temperley, Buenos Aires, Argentina, B1834GUK
        • Centro de Investigaciones Medicas Temperley | Buenos Aires, Argentina
      • Zárate, Buenos Aires, Argentina, B2800DGH
        • Instituto De Investigaciones Clinicas Zarate | Zarate, Argentina
    • Ciudad Auton. De Buenos Aires
      • Buenos Aires, Ciudad Auton. De Buenos Aires, Argentina, C1056ABJ
        • Centro de Investigaciones Metabolicas | Ciudad de Autonoma de Buenos Aires, Argentina
      • Caba, Ciudad Auton. De Buenos Aires, Argentina, C1018DES
        • CEDIC Centro de Investigación Clínica | Buenos Aires, Argentina
      • Villa Luro, Ciudad Auton. De Buenos Aires, Argentina, C1440CFD
        • Centro de Especialidades Medicas (Cemedic) | Cardiology Department
    • Santa Fe
      • Rosario, Santa Fe, Argentina, S2000DEJ
        • Consultorios Integrados Rosario | Instituto Medico de la Fundacion de Estudios Clinicos
      • Rosario, Santa Fe, Argentina, S2000DTB
        • Laboratorio de Hemostasia y Trombosis | Rosario, AR
    • Tucuman
      • San Miguel de Tucumán, Tucuman, Argentina, T4000ICL
        • Investigaciones Clinicas Tucuman | San Miguel de Tucuman, Argentina
      • Kingswood, Australia, 2747
        • Nepean Hospital
    • Australian Capital Territory
      • Garran, Australian Capital Territory, Australia, 2605
        • The Canberra Hospital
    • New South Wales
      • Blacktownn, New South Wales, Australia, 2148
        • Blacktown Hospital
      • Concord, New South Wales, Australia, 2139
        • Concord Repatriation General Hospital
      • Liverpool, New South Wales, Australia, 2170
        • South Western Sydney Local Health District | Liverpool Hospital - Stroke and Neurovascular Department
      • New Lambton, New South Wales, Australia, 2305
        • John Hunter Hospital
      • Wollongong, New South Wales, Australia, 2500
        • Illawarra Shoalhaven Local Health District
    • Queensland
      • Auchenflower, Queensland, Australia, 4066
        • Advara HealthCare Wesley
      • Birtinya, Queensland, Australia, 4575
        • Sunshine Coast University Hospital
      • Brisbane, Queensland, Australia, 4029
        • Royal Brisbane & Women's Hospital
      • Herston, Queensland, Australia, 4029
        • The Prince Charles Hospital
      • Redcliffe, Queensland, Australia, 4020
        • Redcliffe District Hospital
      • Southport, Queensland, Australia, 4215
        • Gold Coast University Hospital
      • Taringa QLD, Queensland, Australia, 4068
        • Core Research Group Pty Ltd. | Brisbane, Australia
    • South Australia
      • Adelaide, South Australia, Australia, 5000
        • Royal Adelaide Hospital
      • Adelaide, South Australia, Australia, 5000
        • Nightingale Research
      • Bedford Park, South Australia, Australia, 5042
        • Flinders Medical Centre
      • Leabrook, South Australia, Australia, 5068
        • Advara HealthCare Leabrook
      • Woodville South, South Australia, Australia, 5011
        • Queen Elizabeth Hospital AUS
    • Victoria
      • Ballarat, Victoria, Australia, 3350
        • Grampians Health Ballarat
      • Box Hill, Victoria, Australia, 3128
        • Eastern Health
      • Geelong, Victoria, Australia, 3220
        • Barwon Health
      • Hoppers Crossing, Victoria, Australia, 3029
        • Baker Heart and Diabetes Institute
      • Malvern, Victoria, Australia, 3144
        • Cabrini Malvern
      • Melbourne, Victoria, Australia, 3004
        • The Alfred Hospital
      • Parkville, Victoria, Australia, 3050
        • Royal Melbourne Hospital
      • Ringwood, Victoria, Australia, 3135
        • Advara HeartCare Melbourne
      • St Kilda East, Victoria, Australia, 3183
        • The Avenue Cardiovascular Centre
    • Western Australia
      • Murdoch, Western Australia, Australia, 6961
        • Fiona Stanley Hospital
      • Perth, Western Australia, Australia, 6150
        • Advara HealthCare Joondalup
      • Salzburg, Austria, 5020
        • Uniklinikum Salzburg|Innere Medizin II, Kardiologie
      • Wien, Austria, 1140
        • Hanusch Krankenhaus | 2. Medizinische Abteilung
      • Wien, Austria, 1190
        • Imed19-privat
    • Kärnten
      • Klagenfurt, Kärnten, Austria, 9020
        • Klinikum Klagenfurt | Innere Medizin und Kardiologie
    • Niederösterreich
      • Mistelbach, Niederösterreich, Austria, 2130
        • Landesklinikum Mistelbach|Kardiologie u. Internistische Med
      • St. Poelten, Niederösterreich, Austria, 3100
        • UK St. Poelten | Innere Med III
    • Oberösterreich
      • Braunau, Oberösterreich, Austria, 5280
        • Krankenhaus St. Josef Braunau | Innere Medizin I
      • Linz, Oberösterreich, Austria, 4020
        • Elisabethinen Linz | Kardiologie, Angiologie & Intensiv Med
      • Linz, Oberösterreich, Austria, 4021
        • Kepler UK Linz | Kardiologie & Intensivmedizin Campus III
      • Wels, Oberösterreich, Austria, 4600
        • Klinikum Wels-Grieskirchen | Innere Medizin II
    • Steiermark
      • Graz, Steiermark, Austria, 8036
        • MedUni Graz | Kardiologie
    • Tirol
      • Hall in Tirol, Tirol, Austria, 6060
        • Landeskrankenhaus Hall | Abteilung fuer Innere Medizin
      • Innsbruck, Tirol, Austria, 6020
        • MedUni Innsbruck | Kardiologie und Angiologie
    • Vorarlberg
      • Feldkirch, Vorarlberg, Austria, 6800
        • LKH Feldkirch | Innere Medizin I mit Kardiologie
    • Wien
      • Vienna, Wien, Austria, 1090
        • MedUni Wien | Innere Medizin II, Kardiologie
      • Vienna, Wien, Austria, 1210
        • Klinik Floridsdorf | Herz-, Gefaess- u. Kardio Ambulaz
      • Aalst, Belgium, 9300
        • Algemeen Stedelijk Ziekenhuis Campus Aalst
      • Aalst, Belgium, 9300
        • OL Vrouwziekenhuis - Campus Aalst
      • Antwerp, Belgium, 2020
        • ZNA Middelheim
      • Brasschaat, Belgium, 2930
        • Algemeen Ziekenhuis Klina | Cardiology Department
      • Brugge, Belgium, 8000
        • AZ Sint-Jan Brugge-Oostende | Sint-Jan - Cardiology
      • Bruxelles - Brussel, Belgium, 1200
        • CU Saint-Luc/UZ St-Luc
      • Dendermonde, Belgium, 9200
        • AZ Sint Blasius, Cardiology, Dendermonde
      • Duffel, Belgium, 2570
        • AZ Sint-Maarten
      • Genk, Belgium, 3600
        • Ziekenhuis Oost-Limburg | Genk, Sint-Jan campus - Cardiology Department
      • Gilly, Belgium, 6060
        • Grand Hôpital de Charleroi
      • Hasselt, Belgium, 3500
        • Jessa ziekenhuis
      • Liege, Belgium, 4000
        • Citadelle Hospital | Cardiology Department
      • Liège, Belgium, 4000
        • CHC MontLégia Neurology Department
      • Roeselare, Belgium, 8800
        • AZ Delta | Clinical Trial Center - Cardiology
      • Sint-Niklaas, Belgium, 9100
        • Vitaz | Sint-Niklaas Hospital - Cardiology Department
    • Antwerpen
      • Bonheiden, Antwerpen, Belgium, 2820
        • Imelda Vzw | Study Cardiology
      • Edegem, Antwerpen, Belgium, 2650
        • Antwerp University Hospital | Cardiology Department
      • Wilrijk, Antwerpen, Belgium, 2610
        • GZA Ziekenhuizen | Saint Augustine Campus - Cardiology Department
    • Namur
      • Yvoir, Namur, Belgium, 5530
        • University Hospital Louvain Namur | Godinne - Cardiology Department
    • Oost-Vlaanderen
      • Gent, Oost-Vlaanderen, Belgium, 9000
        • AZ St-Lucas Campus St-Lucas - Cardiology
      • Gent, Oost-Vlaanderen, Belgium, 9000
        • Maria Middelares General Hospital | Cardiology Department
    • Vlaams Brabant
      • Leuven, Vlaams Brabant, Belgium, 3000
        • UZ Leuven Gasthuisberg
    • West-Vlaanderen
      • Kortrijk, West-Vlaanderen, Belgium, 8500
        • Groeninge Algemeen Ziekenhuis | Campus Kennedylaan - Cardiology Departement
      • Minas Gerais, Brazil, 38400-368
        • Eurolatino Pesquisas Medicas | Uberlandia, MG
      • Rio de Janeiro, Brazil, 22.0080-040
        • Hospital Sao Lucas Copacabana | Clinical Research Department
      • Sao Paulo, Brazil, 01321-001
        • Hospital Alemao Oswaldo Cruz | Centro Internacional de Pesquisa
    • Bahia
      • Salvador, Bahia, Brazil, 40170-130
        • Hospital Cardio Pulmonar | Salvador, Brazil
    • Goiás
      • Goiânia, Goiás, Brazil, 74605-020
        • Hospital das Clinicas da Universidade Federal de Goias | Centro de Pesquisa em Cardiologia
    • Minas Gerais
      • Belo Horizonte, Minas Gerais, Brazil, 30150-240
        • Cardresearch Cardiologia Assistencial e de Pesquisa | Belo Horizonte, Brazil
      • Poços de Caldas, Minas Gerais, Brazil, 37706-106
        • Hospital Maternidade e Pronto Socorro Santa Lucia | Hospital do Coracao - Research Center
    • Parana
      • Curitiba, Parana, Brazil, 80045-170
        • Quanta Diagnostico Por Imagem | Research and Innovation Department
      • Curitiba, Parana, Brazil, 80730-150
        • Nucleo de Pesquisa Clinica | Curitiba, Brazil
      • Curitiba, Parana, Brazil, 80810-050
        • Centro Medico Sao Francisco | Curitiba, Brazil
      • Paraná, Parana, Brazil, 83430-000
        • Sociedade Hospitalar Angelina Caron | Departamento de Ensino e Pesquisa
    • Rio Grande Do Sul
      • Porto Alegre, Rio Grande Do Sul, Brazil, 90020-090
        • Irmandade da Santa Casa de Misericordia de Porto Alegre | Hospital Sao Francisco - Centro Medico Pesquisa Clinica Cardiologia
      • Porto Alegre, Rio Grande Do Sul, Brazil, 91350-200
        • FZ Pesquisa e Servicos em Cardiologia | Porto Alegre, Brazil
      • Porto Alegre, Rio Grande Do Sul, Brazil, 90035-903
        • Hospital de Clinicas de Porto Alegre | Clinical Research Center - Surgery Research Center
    • Santa Catarina
      • Blumenau, Santa Catarina, Brazil, 89010-500
        • CardioBlu | Unidade Sabin
    • Sao Paulo
      • Botucatu, Sao Paulo, Brazil, 18618-970
        • UNESP Faculdade de Medicina de Botucatu | UPECLIN
      • Campinas, Sao Paulo, Brazil, 13060-080
        • Campinas Clinical Research Institute (IPECC) | Campinas, Brazil
      • Marília, Sao Paulo, Brazil, 17515-000
        • Instituto do Coração de Marilia | Marilia, Brasil
      • Santo André, Sao Paulo, Brazil, 09030-010
        • Hospital e Maternidade Christovao da Gama | Santo Andre Medical Centre - Cardiology Department
      • São José do Rio Preto, Sao Paulo, Brazil, 15090-000
        • Hospital de Base | Integrated Research Center
      • São Paulo, Sao Paulo, Brazil, 04321-150
        • Hospital e Maternidade Sao Luiz
      • São Paulo, Sao Paulo, Brazil, 01221-020
        • Irmandade da Santa Casa de Misericordia de Sao Paulo | Hospital Central - Cardiology Department
      • São Paulo, Sao Paulo, Brazil, 01317-002
        • Hospital Samaritano Paulista | Clinical Research Department
      • São Paulo, Sao Paulo, Brazil, 04012-909
        • Instituto Dante Pazzanese de Cardiologia | Divisao de Pesquisa
      • São Paulo, Sao Paulo, Brazil, 13034-685
        • Hospital PUC-Campinas | Centro de Pesquisa Clínica Sao Lucas
    • Sergipe
      • Aracaju, Sergipe, Brazil, 49055-530
        • Centro de Pesquisa Clinica do Coração | Aracaju, Brasil
      • Blagoevgrad, Bulgaria, 2700
        • Multiprofile Hospital for Active Treatment Puls | Clinical Trial Center
      • Burgas, Bulgaria, 8000
        • Multidisciplinary Hospital for Active Treatment Heart and Brain Burgas | Cardiology Department
      • Kardzhali, Bulgaria, 6600
        • Medical Center Avitsena Kardzhali | Cardiology Clinic
      • Pernik, Bulgaria, 2300
        • SHATC Sveti Georgi - Pernik | Pernik, Bulgaria
      • Plovdiv, Bulgaria, 4000
        • Medical centre Hipokrat - N EOOD
      • Plovdiv, Bulgaria, 4004
        • Multiprofile Hospital for Active Treatment Sveta Karidad | Cardiology Department
      • Plovdiv, Bulgaria, 4000
        • Multiprofile Hospital for Active Treatment Medline | Cardiology Department
      • Ruse, Bulgaria, 7000
        • Medical Center Rusemed EOOD | Ruse, Bulgaria
      • Shumen, Bulgaria, 9700
        • Multiprofile Hospital for Active Treatment | Shumen - First Department of Internal Medicine
      • Silistra, Bulgaria, 7500
        • General Hospital Silistra | Department of Cardiology, Structure for Interventional Cardiology
      • Sofia, Bulgaria, 1202
        • Second Medical Center Sofia EOOD
      • Sofia, Bulgaria, 1233
        • Multiprofile Hospital for Active Treatment Knyaginya Klementina Sofia EAD | Cardiology Department
      • Sofia, Bulgaria, 1527
        • University Hospital for Active Treatment Tsaritsa Joanna - ISUL | Cardiology Clinic
      • Sofia, Bulgaria, 1618
        • Diagnostic-Consultative Center XX | Cardiology Department
      • Sofia, Bulgaria, 1309
        • Multiprofile Hospital for Active Treatment National Cardiology Hospital | Cardiology Department
      • Sofia, Bulgaria, 1618
        • Multiprofile Hospital for Active Treatment Sveta Sofia | Internal Diseases Department
      • Sofia, Bulgaria, 1142
        • Cardiohelp Medical Centre | Sofia, Bulgaria
      • Sofia, Bulgaria, 1202
        • Diagnostic Consultative Center Ascendent | Sofia, Bulgaria
      • Sofia, Bulgaria, 1606
        • The University General Hospital for Active Care and Emergency Medicine Pirogov | Cardiology Department
      • Stara Zagora, Bulgaria, 6000
        • Multiprofile Hospital for Active Treatment Trakiya Park | Cardiology Department
      • Stara Zagora, Bulgaria, 6010
        • Medical Center Zara-Med EOOD | Cardiology Department
      • Varna, Bulgaria, 9020
        • NOVA Clinic Medical Center | Varna, BG
      • Veliko Tarnovo, Bulgaria, 5000
        • Multiprofile Hospital for Active Treatment Dr. Stefan Cherkezov | Cardiology Department
      • Quebec, Canada, G1R 2J6
        • CHU de Quebec-Universite Laval
      • Québec, Canada, G1V 4G5
        • Institut universitaire de cardiologie et de pneumologie de Q
    • Alberta
      • Edmonton, Alberta, Canada, T6G 2B7
        • University of Alberta Hospital
      • Edmonton, Alberta, Canada, T5H 4B9
        • Edmonton Cardiology Consultants
    • British Columbia
      • Kamloops,, British Columbia, Canada, V2C 2T1
        • Interior Health - Royal Inland Hospital
      • New Westminster, British Columbia, Canada, V3L 3W4
        • Fraser Clinical Trials, Inc.
      • Vancouver, British Columbia, Canada, V5Z 1M9
        • Vancouver General Hospital
      • Victoria, British Columbia, Canada, V8R 1B2
        • Victoria Heart Institute Foundation
    • New Brunswick
      • Moncton, New Brunswick, Canada, E1G 1A7
        • G.A. Research Associates, Ltd.
    • Newfoundland and Labrador
      • St. John's, Newfoundland and Labrador, Canada, A1B3V6
        • Memorial University of Newfoundland
    • Nova Scotia
      • Halifax, Nova Scotia, Canada, B3H 3A7
        • QEII Health Sciences Centre
    • Ontario
      • Cambridge, Ontario, Canada, N1R 6V6
        • Cambridge Cardiac Care Center
      • Hamilton, Ontario, Canada, L8L 2X2
        • Hamilton Health Sciences
      • Hamilton, Ontario, Canada, L8M 1K7
        • Hamilton Medical Research Group
      • Hamilton, Ontario, Canada, L8M 1K7
        • Hamilton Med.Research Group - DCT
      • Hamilton, Ontario, Canada, L8N 4A6
        • St. Joseph's Healthcare - Hamilton
      • Hamilton, Ontario, Canada, L8L 2X2
        • McMaster University Medical Centre
      • London, Ontario, Canada, N5W 6A2
        • Milestone Research
      • London, Ontario, Canada, N6A5A5
        • London Health Sciences Centre | University Hospital - London Heart Rhythm Program - Cardiology
      • Oakville, Ontario, Canada, L6K 3W7
        • Oakville Cardiovascular Research
      • Oshawa, Ontario, Canada, L1J2K1
        • Dr. James Cha
      • Peterborough, Ontario, Canada, K9J 0B2
        • Kawartha Cardiology Clinical Trials
      • Scarborough, Ontario, Canada, M1B 4Z8
        • Heart Health Institute
      • St. Catharines, Ontario, Canada, L2S 0A9
        • Niagara Health - St. Catharines site
      • Toronto, Ontario, Canada, M4N 3M5
        • Sunnybrook Health Sciences Centre
      • Toronto, Ontario, Canada, M5B 1W8
        • St. Michael's Hospital
      • Toronto, Ontario, Canada, M5G 2C4
        • Toronto General Hospital UHN
      • Toronto, Ontario, Canada, M5S 1B2
        • Women's College Hospital | WCH Main Site - Women's College Research Institute - Cardiology Department
      • York, Ontario, Canada, M9N 1W4
        • Dr. Louis Yao
    • Quebec
      • Brossard, Quebec, Canada, J4Z 2K9
        • Viacar Recherches Cliniques Inc.
      • Chicoutimi, Quebec, Canada, G7H 5H6
        • CIUSSS Saguenay Lac-St-Jean
      • Laval, Quebec, Canada, H7M 3L9
        • Centre intégré de santé et de services sociaux de Laval, Hôp
      • Mirabel, Quebec, Canada, J7J 2K8
        • Centricity Research Mirabel Multispecialty
      • Montreal, Quebec, Canada, H2X 0C1
        • CHUM - Centre Hospitalier de l'Universite de Montreal
      • Montreal, Quebec, Canada, H4J 1C5
        • CIUSSS NÎM Hôpital Sacré-Coeur
      • Montreal, Quebec, Canada, H3G1A4
        • McGill University Health Centre - Glen Site
      • Montréal,, Quebec, Canada, H1T 1C8
        • Montreal Heart Institute
      • Sherbrooke, Quebec, Canada, J1H 5N4
        • CIUSSS de l'Estrie-CHUS, Hopital Fleurimont
      • Terrebonne, Quebec, Canada, J6V 2H2
        • CISSSL - Hopital Pierre-Le Gardeur
      • Trois-Rivieres, Quebec, Canada, G9A 4P3
        • Diex Research Trois-Rivières Inc.
      • Beijing, China, 100029
        • Beijing AnZhen Hospital, Capital Medical University
      • Beijing, China, 100730
        • Peking Union Medical College Hospital CAMS
      • Beijing, China, 100034
        • Peking University First Hospital
      • Beijing, China, 100029
        • China-Japan Friendship Hospital
      • Beijing, China, 100020
        • Beijing Chaoyang Hospital, Capital Medical University
      • Beijing, China, 100053
        • Xuanwu Hospital Capital Medical University
      • Beijing, China, 100730
        • Beijing Tongren Hospital, Capital Medical University (West)
      • Beijing, China, MISSING
        • Beijing Tsinghua Changgung Hospital
      • Shanghai, China, 200032
        • Zhongshan Hospital, Fudan University
      • Shanghai, China, 200040
        • Huashan Hospital, Fudan University
      • Shanghai, China, 200080
        • Shanghai General Hospital
      • Shanghai, China, 200333
        • Shanghai Putuo District Central Hospital
      • Tianjin, China, 300000
        • Tianjin People's Hospital
      • Tianjin, China, 300457
        • Teda International Cardiovascular Hospital
    • Fujian
      • Fuzhou, Fujian, China, TBC
        • The 1st Affiliated Hospital Fujian Medical University
      • Xiamen, Fujian, China, 361006
        • Xiamen Cardiovascular Hospital Xiamen University
    • Gansu
      • Lanzhou, Gansu, China, 730030
        • Lanzhou University Second Hospital
    • Guangdong
      • Guangzhou, Guangdong, China, 510405
        • The First Affiliated Hospital of Guangzhou University of TCM
      • Guangzhou, Guangdong, China, 510630
        • The First Affiliated Hospital of Jinan University
      • Guangzhou, Guangdong, China, 511400
        • Guangzhou Panyu Central Hospital
      • Guangzhou, Guangdong, China, 510000
        • Guangdong Provincial People's Hospital
      • Guangzhou, Guangdong, China, 510180
        • Guangzhou First People Hospital
      • Guangzhou, Guangdong, China, TBC
        • The 2nd Affiliated Hospital of Guangzhou Medical University
      • Huizhou, Guangdong, China, 516001
        • Huizhou Central People's Hospital
    • Guangxi
      • Liuzhou, Guangxi, China, 545005
        • Liuzhou Worker's Hospital
    • Hainan
      • Haikou, Hainan, China, 570311
        • Hainan Provincial People's Hospital
      • Sanya, Hainan, China, 572000
        • Hainan Third People's Hospital (Province Nongken Sanya Hopt)
    • Hebei
      • Cangzhou, Hebei, China, 61000
        • Cangzhou Central Hospital
      • Shijiazhuang, Hebei, China, 50000
        • The First Hospital of Hebei Medical Univesity
      • Zhangjiakou, Hebei, China, 075000
        • The First Affiliated Hospital of Hebei North University
    • Heilongjiang
      • Daqing, Heilongjiang, China, 163311
        • Daqing Oilfield General Hospital
      • Harbin, Heilongjiang, China, 150001
        • The First Affiliated Hospital of Harbin Medical University
      • Harbin, Heilongjiang, China, 150001
        • The 4th Affiliated Hospital of Harbin Medical University
    • Henan
      • Luoyang, Henan, China, 471000
        • 1st Affiliated Hospital of Henan Science and Technology Univ
      • Luoyang, Henan, China, 471002
        • Luoyang Third People's Hospital
      • Xinxiang, Henan, China, 453000
        • Xinxiang Central Hospital
    • Hubei
      • Wuhan, Hubei, China, 430014
        • The Central Hospital of Wuhan, Tongji Medl Collg Huazhong...
      • Wuhan, Hubei, China, 430030
        • Union Hospt Tongji Medical Colleg. Huazhong univ. Scien&Tech
      • Wuhan, Hubei, China, 430034
        • Puai Hospital,Tongji Medical College, Huazhong Univ Sci&Tech
      • Wuhan, Hubei, China, 430040
        • Renmin Hosp., Wuhan Univ.
    • Hunan
      • Changsha, Hunan, China, 410011
        • The Third Hospital of Changsha
      • Changsha, Hunan, China, 410000
        • The Third Xiangya Hospital of Central South University
    • Inner Mongolia
      • Baotou, Inner Mongolia, China, 14010
        • The First Affiliated Hospital of Baotou Medical College
      • Baotou, Inner Mongolia, China, 14040
        • Baotou Central Hospital
      • Hohhot, Inner Mongolia, China, 010017
        • Inner Mongolia People's Hospital
    • Jiangsu
      • Huai'An, Jiangsu, China, 223300
        • Huai'an First People's Hospital, Nanjing Medical University
      • JiangSu, Jiangsu, China, 212001
        • Affiliated Hospital of Jiangsu University
      • Nanjing, Jiangsu, China, 210006
        • Nanjing First Hospital
      • Nanjing, Jiangsu, China, 210009
        • Zhongda Hospital Southeast University
      • Nanjing, Jiangsu, China, 210000
        • The Second Affiliated Hospital of Nanjing Medical University
      • Nanjing, Jiangsu, China, 211103
        • Nanjing Jiangning Hospital
      • Taizhou, Jiangsu, China, MISSING
        • Taizhou People's Hospital
      • Yangzhou, Jiangsu, China, 225001
        • Northern Jiangsu People's Hospital
      • Yangzhou, Jiangsu, China, 225012
        • Affiliated Hospital of Yangzhou University (Yangzhou First People's Hospital)
    • Jiangxi
      • Nanchang, Jiangxi, China, 330006
        • The First Affiliated Hospital of Nanchang University
      • Nanchang, Jiangxi, China, 330006
        • Jiangxi Provincial People's Hospital
      • Nanchang, Jiangxi, China, 330009
        • The Third Hospital of Nanchang
      • Pingxiang, Jiangxi, China, 337055
        • Jiangxi Pingxiang People's Hospital
    • Jilin
      • Changchun, Jilin, China, 130031
        • China-Japan Union Hospital of Jilin University
      • Tonghua, Jilin, China, 134001
        • Tonghua Central Hospital
    • Liaoning
      • Jinzhou, Liaoning, China, 121001
        • The First Affiliated Hospital of Jinzhou Medical University
      • Panjin, Liaoning, China, 124010
        • Panjin Liaohe Oilfield GEM Flower Hospital
    • Ningxia
      • Yinchuan, Ningxia, China, 750004
        • General Hospital of Ningxia Medical University
      • Yinchuan, Ningxia, China, 750001
        • Yinchuan No.1 People's Hospital
    • Qinghai
      • Xining, Qinghai, China, 810001
        • Qinghai University Affiliated Hospital
    • Shaanxi
      • Xianyang, Shaanxi, China, 716000
        • Yan'an University Xianyang Hospital
    • Shandong
      • Jinan, Shandong, China, 250013
        • Jinan Central Hospital
      • Jinan, Shandong, China, TBC
        • Qilu Hosp., Shandong Univ.
      • Jinan, Shandong, China, 250033
        • The 2nd Affiliated Hospital of Shandong University
      • Jining, Shandong, China, 272011
        • Jining No.1 People's Hospital
      • Jining, Shandong, China, 272007
        • Affiliated Hospital of Jining Medical University
      • Taian, Shandong, China, 271099
        • Taian City Central Hospital
      • Zibo, Shandong, China, 250036
        • Zibo Central Hospital
    • Shanxi
      • Taiyuan, Shanxi, China, 30024
        • Shanxi Candiovascular Hospital
      • Taiyuan, Shanxi, China, 30032
        • Shanxi Bethune Hospital
      • Xi'an, Shanxi, China, 710068
        • Shaanxi provincial people's hospital
      • Yuncheng, Shanxi, China, 44099
        • Yuncheng Central Hospital
    • Sichuan
      • Chengdu, Sichuan, China, 610072
        • SichuanAcademyofMedicalSciences&SichuanProvincialPeople'sHos
      • Chengdu, Sichuan, China, 610041
        • West China Hospital,Sichuan University
      • Chengdu, Sichuan, China, 610021
        • Chengdu Second People's Hospital
      • Deyang, Sichuan, China, 618000
        • People's Hospital of Deyang City
    • Xinjiang
      • Urumchi, Xinjiang, China, MISSING
        • The First Affiliated Hospital of Xinjiang Medical University
    • Zhejiang
      • Hangzhou, Zhejiang, China, 310006
        • Affiliated Hangzhou First People's Hospital, Zhejiang Univ
      • Hangzhou, Zhejiang, China, 310000
        • The 1st Affiliated Hospital of Zhejiang University
      • Ningbo, Zhejiang, China, 315010
        • Ningbo First Hospital
      • Ningbo, Zhejiang, China, 31510
        • Hwa Mei Hospital, University of Chinese Academy Sciences
      • Taizhou, Zhejiang, China, 317099
        • Taizhou Hospital of Zhejiang Province
      • Wenzhou, Zhejiang, China, 325000
        • The First Affiliated Hospital of Wenzhou Medical University
      • Brno, Czechia, 63600
        • Vojenska nemocnice Brno
      • Brno, Czechia, 625 00
        • Fakultni nemocnice Brno
      • Brno, Czechia, 612 00
        • Kardiologicka ambulance Brno s.r.o.
      • Brno, Czechia, 639 00
        • Amkardia s.r.o.
      • Bruntal, Czechia, 792 01
        • Kardiologicka ambulance Cormedico
      • Ceske Budejovice, Czechia, 370 01
        • Nemocnice Ceske Budejovice, a.s. Department of kardiologie
      • Frydek-Mistek, Czechia, 73801
        • Mrozek kardiologie
      • Hodonin, Czechia, 69501
        • MATMED s.r.o.
      • Liberec, Czechia, 460 63
        • Krajska Nemocnice Liberec
      • Olomouc, Czechia, 77900
        • Fakultni Nemocnice Olomouc
      • Ostrava-Zabreh, Czechia, 700 30
        • MUDr. Michalik s.r.o.
      • Plzen, Czechia, 301 00
        • Fakultni Nemocnice Plzen
      • Praha, Czechia, 170 00
        • Medicon Poliklinika Holesovice
      • Praha 10, Czechia, 10034
        • Fakultní Nemocnice Královské Vinohrady
      • Praha 4, Czechia, 140 21
        • Institut Klinicke a Experimentalni Mediciny
      • Praha 5, Czechia, 150 06
        • Fakultni nemocnice v Motole
      • Slany, Czechia, 274 01
        • Nemocnice Slany
    • Hlavní Mesto Praha
      • Praha, Hlavní Mesto Praha, Czechia, 160 00
        • Cevni Kulatak
    • Moravskoslezský Kraj
      • Ostrava - Poruba, Moravskoslezský Kraj, Czechia, 708 68
        • Benedor s.r.o.
    • Zlínský Kraj
      • Zlin, Zlínský Kraj, Czechia, 760 01
        • Cardio Research s.r.o.
      • Aalborg, Denmark, 9000
        • Region Nordjylland | Aalborg University Hospital - Cardiology Department
      • Copenhagen, Denmark, 2300
        • Capital Region | Amager Hospital - Cardiology Outpatient Clinic
      • Esbjerg, Denmark, 6700
        • Sydvestjysk Sygehus Esbjerg | Kardiologisk Forskningsenhed
      • Frederiksberg, Denmark, 2000
        • Capital Region | Frederiksberg Hospital - Department of Cardiology Research
      • Hellerup, Denmark, 2900
        • Capital Region | Gentofte Hospital - Cardiology Research
      • Herlev, Denmark, 2730
        • Capital Region | Herlev Hospital - Department of Heart Disease
      • Herning, Denmark, 7400
        • Region Midtjylland | Regionshospitalet Godstrup - Clinic for Heart Research
      • Hilleroed, Denmark, 3400
        • Capital Region | Nordsjaellands Hospital - Hillerod - Cardiology Department
      • Hjørring, Denmark, DK-9800
        • Region Nordjylland | Hjoerring - Cardiology Department
      • Holbæk, Denmark, 4300
        • Region Sjælland | Holbaek Sygehus - Cardiology department
      • Hvidovre, Denmark, 2650
        • Capital Region | Hvidovre Hospital - Department of Cardiology
      • Kolding, Denmark, 6000
        • Sygehus Lillebaelt | Kolding Sygehus - Medicinske Sygdomme
      • Roskilde, Denmark, 4000
        • Sjællands Universitetshospital Roskilde - Hormon og stofskiftesygdomme
      • Svendborg, Denmark, 5700
        • Odense University Hospital | Svendborg Hospital - Cardiovascular Research Unit
      • Viborg, Denmark, 8800
        • Region Midtjylland | Viborg Regional Hospital - Cardiology - Heart Research
      • Århus N, Denmark, 8200
        • Region Midtjylland | Aarhus University Hospital - Heart Diseases - Clinical Research
      • Rapla, Estonia, 79515
        • Rapla Family Doctors Centre
      • Tallinn, Estonia, 10138
        • East Tallinn Central Hospital
      • Tallinn, Estonia, 10138
        • Dr Signe Alliksoo Family Doctors Practice
      • Tallinn, Estonia, 11911
        • Pirita Family Doctors Centre
      • Tallinn, Estonia, 13419
        • North Estonia Medical Centre Foundation
      • Tallinn, Estonia, 13419
        • Office of Arvo Rosenthal
      • Tallinn, Estonia, EE-10617
        • West Tallinn Central Hospital
      • Tartu, Estonia, 50406
        • Tartu University Hospital
      • Espoo, Finland, 2740
        • HUS Jorvin sairaala
      • Jyvaskyla, Finland, 40620
        • StudyCor Oy
      • Kokkola, Finland, 67200
        • Keski-Pohjanmaan keskussairaala
      • Kuopio, Finland, FIN- 70029
        • Kuopion Yliopistollinen Sairaala
      • Kuopio, Finland, 70210
        • Health Step Finland Oy
      • Lahti, Finland, 15850
        • Päijät-Hämeen keskussairaala
      • Oulu, Finland, 90220
        • Oulun yliopistollinen sairaala
      • Tampere, Finland, 33520
        • TAYS Sydänsairaala
      • Turku, Finland, 20100
        • Terveystalo Pulssi
      • Turku, Finland, 20520
        • Turun Yliopistollinen keskussairaala
      • Angers, France, 49933
        • Centre Hospitalier Universitaire - Angers
      • Bayonne, France, 64100
        • Centre Hospitalier Intercommunal de la Côte Basque-Bayonne
      • Bois-Guillaume, France, 76320
        • Hopital Charles Nicolle Chu Rouen
      • Brest, France, 29200
        • Hôpital La Cavale Blanche - CHU de Brest
      • Bron Cedex, France, 69677
        • Hôpital Louis Pradel - Bron
      • CAEN cedex 9, France, 14033
        • CHU de Caen - Hopital Cote de Nacre
      • Chambray-lès-Tours, France, 37170
        • Hôpital Trousseau - Tours
      • Cholet, France, 49325
        • Centre Hospitalier - Cholet
      • Creteil, France, 94010
        • Hôpital Henri Mondor
      • GRENOBLE Cedex 09, France, 38043
        • CHU Grenoble - Hôpital MICHALLON
      • LA ROCHE SUR YON cedex, France, 85925
        • Centre Hospitalier Departemental Vendee
      • Le Coudray, France, 28630
        • Centre Hospitalier Louis Pasteur
      • Lens, France, 62307
        • Centre Hospitalier du Docteur Schnaffer - Lens
      • Limoges Cedex, France, 87042
        • Hôpital Dupuytren
      • Montpellier, France, 34059
        • Hôpital Arnaud de Villeneuve - Montpellier
      • NANTES cedex 2, France, 44277
        • Nouvelles Cliniques Nantaises - Nantes
      • Nantes, France, 44035
        • Hôpital Guillaume et René Laennec - Nantes
      • Nice, France, 6002
        • Hôpital Pasteur - Nice
      • Nîmes, France, 30029
        • Hopital Carémeau - Nîmes
      • Paris, France, 75014
        • Institut Mutualiste Montsouris
      • Paris, France, 75651
        • Hôpital de la Pitié-Salpêtrière
      • Paris Cedex 15, France, 75908
        • HOPITAL EUROPEEN GEORGES POMPIDOU - Paris
      • Pessac, France, 33604
        • Hôpital Cardiologique - Pessac
      • Rennes, France, 35033
        • CHU Rennes, H Pontchaillou, Cardiologie
      • Saint Brieuc, France, 22000
        • Centre Hospitalier Régional - Saint Brieuc
      • Saint Denis, France, 93207
        • Centre de Cardiologie Nord - Saint Denis
      • Strasbourg, France, 67091
        • Hôpital Civil - Strasbourg
      • TOULOUSE cedex, France, 31059
        • Hôpital de Rangueil - Toulouse
      • Toulon, France, 83000
        • CHI Toulon - H La Seyne - Cardiologie
      • Toulouse, France, 31076
        • Clinique Pasteur - Toulouse
      • Tourcoing, France, 59280
        • Centre Hospitalier Gustave Dron - Tourcoing
      • Valenciennes, France, 59322
        • Centre Hospitalier - Valenciennes Cedex
      • Vandoeuvre-les-nancy, France, 54500
        • Centre hospitalier universitaire de NANCY
      • Hamburg, Germany, 20253
        • Klinische Forschung Hamburg GmbH
      • Hamburg, Germany, 20246
        • Uniklinikum Hamburg-Eppendorf|Klinik für Kardiologie
      • Hamburg, Germany, 22041
        • Cardiologicum Hamburg
    • Baden-Württemberg
      • Bad Krozingen, Baden-Württemberg, Germany, 79189
        • Universitaets Herzzentrum Bad Krozingen
      • Heidelberg, Baden-Württemberg, Germany, 69120
        • Uni-Klinikum Heidelberg | Kardiologie Angiologie Pneumologie
      • Lahr, Baden-Württemberg, Germany, 77933
        • MEDICLIN Herzzentrum Lahr|Kardiologie
      • Ludwigsburg, Baden-Württemberg, Germany, 71634
        • Cardio Centrum Ludwigsburg
      • Singen, Baden-Württemberg, Germany, 78224
        • Hegau-Bodensee-Klinikum Singen|I. Medizinische Klinik
    • Hessen
      • Fulda, Hessen, Germany, 36043
        • Klinikum Fulda gAG|Medizinische Klinik I
    • Niedersachsen
      • Hannover, Niedersachsen, Germany, 30625
        • Medizinische Hochschule Hannover|Kardiologie und Angiologie
    • Nordrhein-Westfalen
      • Aachen, Nordrhein-Westfalen, Germany, 52074
        • UniKlinikum Aachen|Kardio, Angio, Intensivmedizin
      • Dortmund, Nordrhein-Westfalen, Germany, 44137
        • St.Johannes-Hospital|Klinik fuer Innere Medizin I
      • Hagen, Nordrhein-Westfalen, Germany, 58135
        • Ev. Krankenhaus Hagen-Haspe|Kardiologie und Rhythmologie
      • Koeln, Nordrhein-Westfalen, Germany, 50733
        • St. Vinzenz-Hospital|Innere Medizin III, Kardiologie
      • Lüdenscheid, Nordrhein-Westfalen, Germany, 58515
        • Klinikum Lüdenscheid - Märkische Kliniken GmbH
      • Mönchengladbach, Nordrhein-Westfalen, Germany, 41063
        • Kliniken Maria Hilf GmbH
      • Remscheid, Nordrhein-Westfalen, Germany, 42859
        • Sana-Klinikum Remscheid|Kardio, Angio, Pneumo u. Intensivmed
      • Warendorf, Nordrhein-Westfalen, Germany, 48231
        • Josephs-Hospital|Kardiologie, Rhythmologie und Angiologie
      • Witten, Nordrhein-Westfalen, Germany, 58455
        • Forschungszentrum Ruhr KliFoCenter GmbH
    • Rheinland-Pfalz
      • Mainz, Rheinland-Pfalz, Germany, 55101
        • Universitätsmedizin der Johannes Gutenberg Universität Mainz
      • Worms, Rheinland-Pfalz, Germany, 67550
        • Klinikum Worms gGmbH|Kardiologie und Angiologie
    • Saarland
      • Voelklingen, Saarland, Germany, 66333
        • Siteworks Pruefzentrum Voelklingen
    • Sachsen
      • Dresden, Sachsen, Germany, 01069
        • Klinische Forschung Dresden | Dresden, Germany
      • Dresden, Sachsen, Germany, 1067
        • Krankenhaus Dresden-Friedrichstadt
      • Dresden, Sachsen, Germany, 1099
        • Praxisklinik Herz und Gefaesse|Kardiologische Ambulanz
      • Leipzig, Sachsen, Germany, 4103
        • Uniklinik Leipzig / Kardiologie
      • Markkleeberg, Sachsen, Germany, 04416
        • Praxis Hr. Dr. med. Jens Taggeselle
      • Wermsdorf, Sachsen, Germany, 4779
        • Kardiologische Praxis Hr. Dr. A. Al-Zoebi
    • Thüringen
      • Jena, Thüringen, Germany, 7747
        • Uniklinik Jena / Kardiologie
      • Alexandroupolis, Greece, 68100
        • University General Hospital of Alexandroupolis
      • Athens, Greece, 11527
        • G. GENNIMATAS General State Hospital of Athens
      • Athens, Greece, 11521
        • Naval Hospital of Athens
      • Athens, Greece, 115 27
        • Hippokration General Hospital of Athens
      • Athens, Greece, 11528
        • General Hospital of Athens "Alexandra"
      • Athens, Greece, 11527
        • Laiko General Hospital of Athens
      • Athens, Greece, 10676
        • General Hospital of Athens "Evangelismos"
      • Chaidari, Greece, 12462
        • University General Hospital of Athens "Attikon"
      • Elefsina, Greece, 19018
        • Thriassio General Hospital of Elefsina
      • Heraklion, Greece, 711 10
        • University General Hospital of Heraklion
      • Ioannina, Greece, 45500
        • University General Hospital of Ioannina
      • Ioannina, Greece, 45500
        • Univ. General Hospital of Ioannina
      • Larissa, Greece, 41110
        • University General Hospital of Larissa
      • Larissa, Greece, 41110
        • Univ. General Hospital of Larissa
      • Marousi, Greece, 15123
        • Mitera Hospital
      • Nea Ionia, Greece, 14233
        • Konstantopoulio General Hospital of Nea Ionia - AGIA OLGA
      • Patra, Greece, 26504
        • University General Hospital of Patra
      • Thessaloniki, Greece, 54642
        • Hippokration General Hospital of Thessaloniki
      • Thessaloniki, Greece, 54636
        • AHEPA University General Hospital of Thessaloniki
      • Voula, Greece, 16673
        • General Hospital Asklepieio Voulas
    • Attica
      • Kifisia, Attica, Greece, 14561
        • KAT General Hospital of Athens
      • Balatonfured, Hungary, 8230
        • Cardiomobile Egeszsegugyi Szolgaltato Kft.
      • Budapest, Hungary, 1088
        • Semmelweis University
      • Budapest, Hungary, 1145
        • Budapesti Uzsoki Utcai Kórház
      • Budapest, Hungary, 1024
        • Budapesti Jahn Ferenc Del-pesti Korhaz es Rendelointezet
      • Debrecen, Hungary, 4025
        • Belinus Bt.
      • Gyor, Hungary, 9024
        • Kardio Egeszseghaz - Dr Amer Sayour Egyeni Vallakozo
      • Gyula, Hungary, 5700
        • Trial Pharma Kft. Gyula
      • Kaposvar, Hungary, 7400
        • Somogy Vármegyei Kaposi Mór Oktató Kórház
      • Komarom, Hungary, 2900
        • Komaromi Selye Janos Korhaz
      • Miskolc, Hungary, 3526
        • Borsod-Abauj-Zemplen Varmegyei Korhaz es Egyetemi Oktatokorhaz
      • Mosonmagyarovar, Hungary, 9200
        • TaNa Med Kft.
      • Nagykanizsa, Hungary, 8800
        • Nagykanizsai Kanizsai Dorottya Korhaz
      • Nyiregyhaza, Hungary, 4400
        • Medifarma-98 Egeszsegugyi, Kereskedelmi es Szolgaltato Kft.
      • Nyiregyhaza, Hungary, 4405
        • Borbanya Praxis Bt.
      • Oroshaza, Hungary, 5900
        • Dr. Nagy Laszlo Egyeni Egeszsegugyi Vallalkozo
      • Oroshaza, Hungary, 5900
        • Dr. Laszlo Elek Korhaz es Rendelointezet, Oroshaza
      • Pecs, Hungary, 7624
        • Pecsi Tudomanyegyetem Klinikai Kozpont
      • Pecs, Hungary, 7623
        • Coromed Smo Kft
      • Szekesfehervar, Hungary, 8000
        • Complex Rendelo Med Zrt.
      • Szekszárd, Hungary, 7100
        • Tolna Varmegyei Balassa Janos Korhaz
      • Szombathely, Hungary, 9700
        • Vas Varmegyei Markusovszky Egyetemi Oktatokorhaz
      • Zalaegerszeg, Hungary, 8900
        • Belvarosi Egeszseghaz Kft.
      • Hyderabad, India, 500032
        • Asian Institute of Gastroenterology (AIG Hospital)
      • Pune, India, 411 011
        • King Edward Memorial (KEM) Hospital - Pune
    • Kerala
      • Kochi, Kerala, India, 682017
        • Lisie Hospital
    • Maharashtra
      • Nashik, Maharashtra, India, 422005
        • Vijan Cardiac & Critical Care Centre
      • Afula, Israel, 1834111
        • HaEmek Medical Center | Internal Medicine C Department - Research Unit
      • Ashdod, Israel, 7747629
        • Samson Assuta Ashdod University Hospital | Cardiology Department
      • Ashkelon, Israel, 7830604
        • Barzilai Ashkelon University Medical Center | Cardiology Department
      • Beer Sheva, Israel, 8410101
        • Clalit Health | Soroka Medical Center - Internal Medicine Department
      • Beer Sheva, Israel, 8410101
        • Clalit Health | Soroka Medical Center - Cardiology Department
      • Beer Sheva, Israel, 8489507
        • Assuta Hospital Be'er Sheva | Heart Institute - Clinics
      • Hadera, Israel, 3810101
        • Hillel Yaffe Medical Center | Cardiology Department
      • Haifa, Israel, 3339419
        • Bnai Zion Medical Center | Cardiology Department
      • Haifa, Israel, 3109601
        • Rambam Health Care Campus | Cardiology Department - Cardiology Research Unit
      • Haifa, Israel, 3436212
        • Carmel Medical Center | Cardiology Department - Cardiac Catheterization Unit
      • Holon, Israel, 5822012
        • Edith Wolfson Medical Center | Internal Medicine Department
      • Jerusalem, Israel, 9112001
        • Hadassah Hebrew University Hospital Ein Kerem
      • Jerusalem, Israel, 9103102
        • Shaare Zedek Medical Center | The Jesselson Integrated Heart Center - Cardiology Department
      • Jerusalem, Israel, 9112001
        • Clalit Health | Meir Medical Center - Division of Cardiology - Electrophysiology and Arrhythmias Unit
      • Lower Galilee, Israel, 15208
        • Poria Medical Center | Cardiovascular Department
      • Nahariya, Israel, 2210001
        • Galilee Medical Center | Cardiology Department
      • Petach Tikva, Israel, 4941492
        • Rabin Medical Center | Beilinson Hospital - Internal Medicine C Department
      • Petah Tikva, Israel, 4941492
        • Rabin Medical Center | Clinical Trials Unit - Cardiology Department
      • Rehovot, Israel, 7610001
        • Kaplan Medical Center | Cardiology Department - Heart Institute Research
      • Rishon LeZion, Israel, 6093000
        • Shamir Medical Center | Cardiology Department
      • Tel Aviv, Israel, 6423906
        • Tel-Aviv Sourasky Medical Center
      • Tel Aviv, Israel, 6423906
        • Tel Aviv Sourasky Medical Center | Ichilov General Hospital - Cardiology Department
      • Zefat, Israel, 1311001
        • Ziv Medical Center | Cardiology Department
    • Abruzzo
      • Chieti, Abruzzo, Italy, 66013
        • ASL2 Lanciano-Vasto-Chieti
    • Campania
      • Caserta, Campania, Italy, 81100
        • A.O Sant'Anna-San Sebastiano
      • Naples, Campania, Italy, 80131
        • A.O.U. Policlinico Federico II Napoli
      • Napoli, Campania, Italy, 80131
        • A.O.R.N. Ospedali dei Colli (Monaldi-Cotugno-CTO)
    • Emilia-Romagna
      • Bologna, Emilia-Romagna, Italy, 40133
        • Azienda Unita Sanitaria Locale Di Bologna_Ospedale Maggiore Pizzardi - Cardiologia
      • Ferrara, Emilia-Romagna, Italy, 44124
        • A.O.U. di Ferrara
      • Modena, Emilia-Romagna, Italy, 41100
        • A.O.U. Di Modena - Policlinico
      • Parma, Emilia-Romagna, Italy, 43126
        • A.O.U. di Parma
    • Lazio
      • Roma, Lazio, Italy, 157
        • Asl Roma 2
      • Roma, Lazio, Italy, 161
        • A.O.U. Policlinico Umberto I
    • Lombardia
      • Bergamo, Lombardia, Italy, 24127
        • Asst Papa Giovanni XXIII
      • Brescia, Lombardia, Italy, 25085
        • ASST del Garda
      • Milano, Lombardia, Italy, 20138
        • IRCCS Centro Cardiologico Monzino
      • Milano, Lombardia, Italy, 20132
        • Ospedale San Raffaele s.r.l. - Cardiologia Clinica
      • Rozzano, Lombardia, Italy, 20089
        • Humanitas Mirasole S.p.A. - Centro Trombosi e Malattie Emorragiche
      • Varese, Lombardia, Italy, 21049
        • ASST Sette Laghi
    • Marche
      • Ancona, Marche, Italy, 60126
        • A.O.U. Ospedali Riuniti "Umberto I - G.M.Lancisi - G.Salesi"
      • Ascoli Piceno, Marche, Italy, 63074
        • ASUR Marche - Area Vasta 5
    • Piemonte
      • Novara, Piemonte, Italy, 28100
        • A.O.U. Maggiore della Carità
    • Puglia
      • Bari, Puglia, Italy, 70021
        • Ente Ecclesiastico Ospedale Generale Regionale Miulli
      • Foggia, Puglia, Italy, 71122
        • A.O.U. Ospedali Riuniti Foggia
    • Sicilia
      • Messina, Sicilia, Italy, 98124
        • A.O.U. Policlinico G. Martino
    • Toscana
      • Arezzo, Toscana, Italy, 52044
        • AUSL Toscana Sud-Est
      • Firenze, Toscana, Italy, 50134
        • A.O.U. Careggi
      • Pisa, Toscana, Italy, 56126
        • A.O.U. Pisana
    • Umbria
      • Perugia, Umbria, Italy, 6129
        • A.O. di Perugia
    • Veneto
      • Padova, Veneto, Italy, 35128
        • A.O.U. di Padova
      • Treviso, Veneto, Italy, 31015
        • ULSS2 Marca Trevigiana
      • Venezia, Veneto, Italy, 30174
        • ULSS3 Serenissima
      • Fukui, Japan, 910-8526
        • Fukui Prefectural Hospital
      • Fukui, Japan, 910-0067
        • Fukui General Clinic
      • Fukuoka, Japan, 814-0180
        • Fukuoka University Hospital
      • Fukuoka, Japan, 814-8522
        • Fukuoka University Nishijin Hospital
      • Fukuoka, Japan, 815-8588
        • Kyushu Central Hospital
      • Fukuoka, Japan, 811-0213
        • Social Medical Corporation The Chiyukai Foundation Fukuoka Wajiro Hospital
      • Gifu, Japan, 500-8384
        • Gifu Heart Center
      • Hiroshima, Japan, 730-8518
        • Hiroshima City Hiroshima Citizens Hospital
      • Kagoshima, Japan, 892-0822
        • Tenyoukai Central Clinic
      • Kagoshima, Japan, 892-0853
        • Kagoshima Medical Center
      • Kochi, Japan, 780-8522
        • Chikamori Hospital
      • Kumamoto, Japan, 860-8518
        • Kumamoto Kinoh Hospital
      • Kyoto, Japan, 607-8062
        • Rakuwakai Otowa Hospital
      • Kyoto, Japan, 612-8555
        • National Hospital Organization Kyoto Medical Center
      • Miyazaki, Japan, 880-2102
        • Miyazaki Medical Association Hospital
      • Oita, Japan, 870-8511
        • Oita Prefectural Hospital
      • Okayama, Japan, 700-0804
        • The Sakakibara Heart Institute of Okayama
      • Okayama, Japan, 7008557
        • CMIC HealthCare Institute Co. Ltd. | Local IAA OCGMC - Okayama City Civic Hospital - Clinical Trial Centre
      • Okayama, Japan, 7028055
        • CMIC HealthCare Institute Co. Ltd. | Okayama Rosai Hospital - Clinical Trial Centre
      • Osaka, Japan, 550-0006
        • Nippon Life Hospital
      • Osaka, Japan, 530-0012
        • Osaka Saiseikai Nakatsu Hospital
      • Osaka, Japan, 538-0044
        • Kitada Clinic
      • Osaka, Japan, 553-0003
        • Japan Community Health care Organization Osaka Hospital
      • Osaka, Japan, 543-0035
        • Osaka Police Hospital | Clinical Research and Trial Center
      • Saga, Japan, 849-0917
        • Saga Memorial Hospital
      • Saitama, Japan, 331-8577
        • Sainokuni Higashiomiya Medical Center
      • Saitama, Japan, 338-0837
        • Sanai Hospital
      • Saitama, Japan, 339-0033
        • Iwatsuki-minami Hospital
      • Shizuoka, Japan, 420-8630
        • Shizuoka City Shizuoka Hospital
      • Wakayama, Japan, 640-8158
        • Saiseikai Wakayama Hospital | Pharmaceutical department
    • Aichi
      • Kasugai, Aichi, Japan, 486-8510
        • Kasugai Municipal Hospital
      • Nagoya, Aichi, Japan, 457-8510
        • Japan Community Healthcare. Organization Chukyo Hospital
      • Nagoya, Aichi, Japan, 466-8650
        • Japanese RedCross Aichi Medical Center Nagoya Daini Hospital
    • Aichi-ken
      • Toyota-City, Aichi-ken, Japan, 470-0396
        • Japan Culture and Welfare Federation of Agricultural Cooperatives | Toyota Kosei Hospital
    • Chiba
      • Funabashi-city, Chiba, Japan, 274-8503
        • Chiba Tokushukai Hospital | Clinical Trial Center
      • Inzai, Chiba, Japan, 270-1694
        • Nippon Medical School Chiba Hokusoh Hospital | Clinical Trial Office
      • Kisarazu, Chiba, Japan, 292-8535
        • Kimitsu Chuo Hospital
      • Sakura, Chiba, Japan, 285-8741
        • Toho University Sakura Medical Center
    • Ehime
      • Matsuyama, Ehime, Japan, 790-0067
        • Matsuyama Shimin Hospital
    • Fukuoka
      • Fukutsu, Fukuoka, Japan, 811-3298
        • Munakata Suikokai General Hospital | Cardiology Department
      • Itoshima, Fukuoka, Japan, 819-1104
        • Nakamura Cardiovascular Clinic
      • Kitakyushu, Fukuoka, Japan, 802-8555
        • Kokura Memorial Hospital
      • Kitakyusyu, Fukuoka, Japan, 805-8508
        • Steel Memorial Yawata Hospital
      • Nakagawa, Fukuoka, Japan, 811-1244
        • Go Neurosurgical Clinic
      • Onga-gun, Fukuoka, Japan, 811-4342
        • Onga Nakama Medical Association Onga Hospital
      • Yanagawa-city, Fukuoka, Japan, 832-0077
        • Yanagawa Hospital
    • Fukuoka-ken
      • Tateyashiki, Mizumakimachi, On, Fukuoka-ken, Japan, 807-0051
        • Fukuoka Shinmizumaki Hospital | Clinical Trial Management Office
    • Fukushima-ken
      • Shirakawa-city, Fukushima-ken, Japan, 105-0021
        • Japan Culture and Welfare Federation of Agricultural Cooperatives | ShirakawaKosei General Hospital
    • Gunma
      • Takasaki, Gunma, Japan, 370-0829
        • National Hospital Organization Takasaki General Medical Center
    • Hiroshima
      • Aki-gun, Hiroshima, Japan, 735-8585
        • Mazda Motor Corporation Mazda Hospital
    • Hokkaido
      • Asahikawa, Hokkaido, Japan, 070-8610
        • Asahikawa City Hospital
      • Hakodate, Hokkaido, Japan, 041-8512
        • Hakodate National Hospital
      • Hakodate, Hokkaido, Japan, 041-8680
        • Hakodate Municipal Hospital
      • Sapporo, Hokkaido, Japan, 003-0026
        • Matsuda Cardiovascular Clinic
      • Sapporo, Hokkaido, Japan, 006-8555
        • Teine Keijinkai Hospital
      • Sapporo, Hokkaido, Japan, 062-0003
        • Hanaoka Seishu Memorial Hospital
      • Sapporo, Hokkaido, Japan, 063-0826
        • Miyanosawa Clinic of Internal Medicine and Cardiology
      • Sapporo, Hokkaido, Japan, 064-8570
        • Miyanomori Memorial Hospital
      • Sapporo, Hokkaido, Japan, 065-0033
        • Sapporo Higashi Tokushukai Hospital
      • Sapporo, Hokkaido, Japan, 006-0852
        • Mita Internist and Cardiology Clinic | Hokkaido, Japan
      • Tomakomai, Hokkaido, Japan, 053-8506
        • Oji General Hospital
      • Tomakomai, Hokkaido, Japan, 053-8567
        • Tomakomai City Hospital
    • Hyogo
      • Akashi-city, Hyogo, Japan, 674-0063
        • Akashi Medical Center | Hyogo, Japan
      • Amagasaki, Hyogo, Japan, 660-8550
        • Hyogo Prefectural Amagasaki General Medical Center
      • Himeji, Hyogo, Japan, 670-8560
        • Hyogo Prefectural HarimaHimeji General Medical Center
      • Kawanishi, Hyogo, Japan, 666-0125
        • The Veritas Hospital
      • Kobe, Hyogo, Japan, 650-0047
        • Kobe City Medical Center General Hospital
      • Takarazuka, Hyogo, Japan, 665-0873
        • Higashi Takarazuka Satoh Hospital
    • Ibaraki
      • Higashiibaraki, Ibaraki, Japan, 311-3193
        • National Hospital Organization Mito Medical Center
      • Kasama, Ibaraki, Japan, 309-1793
        • Ibaraki Prefectural Central Hospital
      • Mito, Ibaraki, Japan, 311-4198
        • Mito Saiseikai General Hospital
      • Toride, Ibaraki, Japan, 302-0022
        • JA Toride Medical Center
      • Tsuchiura, Ibaraki, Japan, 300-0028
        • Tsuchiura Kyodo General Hospital
    • Ishikawa
      • Kahoku-gun, Ishikawa, Japan, 920-0293
        • Kanazawa Medical University Hospital
      • Kanazawa, Ishikawa, Japan, 920-8530
        • Ishikawa Prefectural Central Hospital
      • Kanazawa, Ishikawa, Japan, 920-8650
        • National Hospital Organization Kanazawa Medical Center | Clinical Trial Management Office
      • Komatsu, Ishikawa, Japan, 923-8560
        • Komatsu Municipal Hospital
    • Ishikawa Ken
      • Hakusan city, Ishikawa Ken, Japan, 924-8588
        • Public Central Hospital of Matto Ishikawa | Clinical Trial Management Office
    • Iwate
      • Morioka, Iwate, Japan, 020-0066
        • Iwate Prefectural Central Hospital
    • Kagawa
      • Takamatsu, Kagawa, Japan, 760-8557
        • Kagawa Prefectural Central Hospital
      • Toyohama-Cho,Kanonji-City, Kagawa, Japan, 769-1695
        • Mitoyo General Hospital | Kagawa, Japan
    • Kagoshima
      • Kanoya, Kagoshima, Japan, 893-0015
        • Oosumikanoya Hospital
    • Kanagawa
      • Fujisawa, Kanagawa, Japan, 251-8550
        • Fujisawa City Hospital
      • Miura-gun, Kanagawa, Japan, 240-0116
        • Hayama Heart Center | Clinical Trial Center
      • Yokohama, Kanagawa, Japan, 232-0024
        • Yokohama City University Medical Center
      • Yokohama, Kanagawa, Japan, 247-8581
        • Yokohama Sakae Kyosai Hospital
    • Mie
      • Suzuka-shi, Mie, Japan, 513-8630
        • Japan Culture and Welfare Federation of Agricultural Cooperatives | Suzuka Chuo General Hospital
    • Miyagi
      • Sendai, Miyagi, Japan, 981-3133
        • Sendai Cardiovascular Center
    • Miyagi-ken
      • Sendai-city, Miyagi-ken, Japan, 983-8512
        • Tohoku Medical and Pharmaceutical University Hospital | Center for Clinical Research Promotion and Development
    • Nagano
      • Azumino, Nagano, Japan, 399-8292
        • Japan Red Cross Society Azumino Hospital
      • Iida-city, Nagano, Japan, 395-8505
        • Iida Hospital
      • Kitaazumi-gun, Nagano, Japan, 399-8695
        • North Alps Medical Center Azumi Hospital
      • Komoro, Nagano, Japan, 384-8588
        • Asama Nanroku Komoro Medical Center | Komoro, Japan
      • Suwa, Nagano, Japan, 392-8510
        • Japanese Red Cross Society Suwa Hospital
    • Nagano-ken
      • Nakano-City, Nagano-ken, Japan, 383-8505
        • Japan Culture and Welfare Federation of Agricultural Cooperatives | Hokushin General Hospital
    • Okinawa
      • Naha, Okinawa, Japan, 902-8511
        • R.I.A.C Naha City Hospital
      • Urasoe, Okinawa, Japan, 901-2102
        • Urasoe General Hospital | Clinical Research Support Center
    • Osaka
      • Kishiwada, Osaka, Japan, 596-0042
        • Kishiwada Tokushukai Hospital
      • Suita, Osaka, Japan, 565-0862
        • Osaka Saiseikai Senri Hospital
      • Umeda Kita-Ku, Osaka-shi, Osaka, Japan, 5320001
        • Sakurabashi Watanabe Future Medical Hospital | Department of Cardiology
      • Yao-city, Osaka, Japan, 581-0011
        • Yao Tokushukai General Hospital | Clinical Research Center
    • Saitama
      • Ageo, Saitama, Japan, 362-8588
        • Ageo Central General Hospital
      • Kawaguchi, Saitama, Japan, 333-0842
        • Kawaguchi Cardiovascular and Respiratory Hospital
    • Shiga
      • Omihachiman, Shiga, Japan, 523-0082
        • Omihachiman Community Medical Center
    • Shimane
      • Hamada, Shimane, Japan, 697-8511
        • National Hospital Organization Hamada Medical Center
    • Tochigi
      • Shimotsuga-gun, Tochigi, Japan, 321-0293
        • Dokkyo Medical University Hospital
    • Tokyo
      • Bunkyo-ku, Tokyo, Japan, 113-8519
        • Tokyo Medical and Dental University Hospital
      • Chuo-ku, Tokyo, Japan, 103-0027
        • CliniPro Co.,Ltd. | Tokyo-Eki Center-building Clinic - Tokyo, Japan
      • Hachioji, Tokyo, Japan, 192-0918
        • Minamino Cardiovascular Hospital
      • Hachioji, Tokyo, Japan, 193-0811
        • Tokyo Angel Hospital | Clinical Trial Department
      • Itabashi-ku, Tokyo, Japan, 173-8610
        • Nihon University Itabashi Hospital
      • Machida, Tokyo, Japan, 194-0023
        • Machida Municipal Hospital
      • Meguro-ku, Tokyo, Japan, 152-8902
        • National Hospital Organization Tokyo Medical Center
      • Minato-ku, Tokyo, Japan, 108-0073
        • Tokyo Saiseikai Central Hospital | Clinical Research Center
      • Shinjuku-ku, Tokyo, Japan, 169-0073
        • Tokyo Yamate Medical Center
      • Suginami-ku, Tokyo, Japan, 168-0065
        • NewHeart Watanabe Institute
      • Tachikawa, Tokyo, Japan, 190-0014
        • National Hospital Organization Disaster Medical Center
    • Yamaguchi
      • Shunan, Yamaguchi, Japan, 745-8522
        • JCHO Tokuyama Central Hospital
    • Yamanashi
      • Kofu, Yamanashi, Japan, 400-8506
        • Yamanashi Prefectural Central Hospital
      • Busan, Korea, Republic of, 49201
        • Dong-A University Hospital
      • Daegu, Korea, Republic of, 42601
        • Keimyung University Dongsan Medical Center
      • Gwangju, Korea, Republic of, 501-757
        • Chonnam National University Hospital
      • Incheon, Korea, Republic of, 21565
        • Gachon University Gil Medical Center
      • Seoul, Korea, Republic of, 138-736
        • Asan Medical Center
      • Seoul, Korea, Republic of, 03722
        • Severance Hospital, Yonsei University Health System
      • Seoul, Korea, Republic of, 156-755
        • Chung-Ang University Hospital
      • Seoul, Korea, Republic of, 6351
        • Samsung Medical Center
      • Seoul, Korea, Republic of, 02841
        • Korea University Anam Hospital
    • Busan Gwang''yeogsi
      • Busan, Busan Gwang''yeogsi, Korea, Republic of, 49241
        • Pusan National University Hospital
    • Daegu Gwang''yeogsi
      • Daegu, Daegu Gwang''yeogsi, Korea, Republic of, 41944
        • Kyungpook National University Hospital
    • Gang''weondo
      • Wonju, Gang''weondo, Korea, Republic of, 26426
        • Yonsei University Wonju Christian Hospital
    • Gyeonggido
      • Anyang-si, Gyeonggido, Korea, Republic of, 14068
        • Hallym University Sacred Heart Hospital
      • Seongnam-si, Gyeonggido, Korea, Republic of, 13620
        • Seoul National University Bundang Hospital
      • Seongnam-si, Gyeonggido, Korea, Republic of, 13496
        • Bundang CHA Hospital
      • Seoul, Gyeonggido, Korea, Republic of, 137-701
        • The Catholic University of Korea Seoul St. Mary'S Hospital
      • Suwon, Gyeonggido, Korea, Republic of, 443-721
        • Ajou University Hospital
      • Uijeongbu-si, Gyeonggi-do, Gyeonggido, Korea, Republic of, 11765
        • Uijeongbu St. Mary's Hospital
    • Seoul Teugbyeolsi
      • Seoul, Seoul Teugbyeolsi, Korea, Republic of, 03312
        • The Catholic Univ. of Korea Eunpyeong St. Mary's Hospital
      • Seoul, Seoul Teugbyeolsi, Korea, Republic of, 3080
        • Seoul National University Hospital
      • Daugavpils, Latvia, LV-5417
        • Daugavpils Regional Hospital
      • Daugavpils, Latvia, LV-5401
        • Doctor's Practice in Cardiology
      • Daugavpils, Latvia, LV-5401
        • SIA ARI Med
      • Kuldiga, Latvia, LV-3301
        • Rutas Eglites GP Practice
      • Liepaja, Latvia, LV-3414
        • Liepaja Regional Hospital
      • Ogre, Latvia, LV-5001
        • Lija Mora physician practice
      • Riga, Latvia, LV-1002
        • P. Stradins Clinical University hospital
      • Riga, Latvia, LV-1001
        • 1st Riga Clinical Hospital
      • Riga, Latvia, LV-1011
        • Health Center Adoria
      • Riga, Latvia, LV-1012
        • Health Center 4
      • Riga, Latvia, LV-1038
        • Riga East Clinical University Hospital "Gailezers"
      • Riga, Latvia, LV-1050
        • APS Clinic
      • Valmiera, Latvia, LV-4201
        • Vidzemes Hospital
      • Ventspils, Latvia, LV-3601
        • Gita Rancane - cardiology private practice
      • Kaunas, Lithuania, LT-44320
        • LUHS Kauno Hospital (Laisves ave.)
      • Kaunas, Lithuania, LT-47144
        • LUHS Kauno Hospital (Josvainiu str.)
      • Kaunas, Lithuania, LT-49287
        • Kardiolitos klinikos / BMP
      • Kaunas, Lithuania, LT-49449
        • Saules family medicine center
      • Kaunas, Lithuania, LT-50161
        • Hospital of LT University of Health Sciences Kaunas Clinics
      • Kaunas, Lithuania, LT-50177
        • InMedica clinic Zaliakalnis
      • Kaunas, Lithuania, 45462
        • Mariu klinika JSC
      • Klaipeda, Lithuania, LT-91131
        • Kardiologijos ir reabilitacijos klinika
      • Klaipeda, Lithuania, LT-92231
        • Klaipeda Republican Hospital
      • Klaipeda, Lithuania, LT-92288
        • Klaipeda Seamen's Hospital Cardiology Department I
      • Klaipeda, Lithuania, LT-92288
        • Klaipedos Jurininku Ligonine
      • Siauliai, Lithuania, 76231
        • Siauliai Republican Hospital
      • Vilnius, Lithuania, LT-08661
        • Vilnius University Hospital Santaros Klinikos
      • Vilnius, Lithuania, LT-08431
        • InMedica Clinic Santariskes
      • Alor Setar, Malaysia, 5460
        • Hospital Sultanah Bahiyah
      • Cheras, Malaysia, 56000
        • University Hospital Kebangsaan Malaysia
      • Johor Bahru, Malaysia, 80100
        • Hospital Sultanah Aminah
      • Kelantan, Malaysia, 15200
        • Hospital Raja Perempuan Zainab Ii
      • Kelantan, Malaysia, TBC
        • Hospital Universiti Sains Malaysia
      • Kuala Lumpur, Malaysia, 59100
        • University Malaya Medical Centre
      • Kuala Lumpur, Malaysia, 50400
        • Institute Jantung Negara
      • Pahang, Malaysia, 25100
        • Hospital Tengku Ampuan Afzan
      • Pulau Pinang, Malaysia, 13700
        • Hospital Seberang Jaya
      • Sarawak, Malaysia, 94300
        • Sarawak Heart Centre
      • Sarawak, Malaysia, 93400
        • Sarawak General Hospital
      • Selangor, Malaysia, 43000
        • Hospital Serdang
      • Selangor, Malaysia, 42300
        • Hospital Al-Sultan Abdullah (UiTM Hospital)
      • Selangor, Malaysia, 43400
        • Hospital Sultan Abdul Aziz Shah
      • Seremban, Malaysia, 70300
        • Seremban Hospital Neurology
      • Amstelveen, Netherlands, 1186 AM
        • Ziekenhuis Amstelland
      • Amsterdam, Netherlands, 1105 AZ
        • Amsterdam UMC | Heart Centre - Curius Research Department
      • Apeldoorn, Netherlands, 7334 DZ
        • Gelre Apeldoorn Ziekenhuizen | Cardiology Department
      • Arnhem, Netherlands, 6815 AD
        • Rijnstate | Arnhem - Cardiology Department - Cardio Research
      • Beverwijk, Netherlands, 1942 LE
        • Rode Kruis Ziekenhuis
      • Blaricum, Netherlands, 1261 AN
        • Tergooiziekenhuizen-Blaricum
      • Breda, Netherlands, 4818 CK
        • Amphia Breda | Department of Cardiology, BMC Research
      • Den Haag, Netherlands, 2512 VA
        • Medisch Centrum Haaglanden, Locatie Westeinde
      • Den Haag, Netherlands, 2545 AA
        • HagaZiekenhuis | Cardiology Department
      • Dirksland, Netherlands, 3247 BW
        • The Van Weel-Bethesda Hospital | Research Department
      • Dordrecht, Netherlands, 3318 AT
        • Albert Schweitzer Ziekenhuis | Dordwijk - Cardiology Department
      • Eindhoven, Netherlands, 5623 EJ
        • Catharina Hospital | Cardiology Department
      • Emmen, Netherlands, 7824 AA
        • Treant locatie Scheper
      • Enschede, Netherlands, 7611 JH
        • Medisch Spectrum Twente | Thorax Centrum Twente - Foundation Cardiovascular Research and Education Enschede
      • Gorinchem, Netherlands, 4204 AA
        • Rivas | Beatrix Hospital Gorinchem - Cardiology Department
      • Groningen, Netherlands, 9713 GZ
        • Universitair Medisch Centrum Groningen
      • Groningen, Netherlands, 9728 NT
        • Martini Ziekenhuis, Locatie van Swieten
      • Haarlem, Netherlands, 2035 RC
        • Spaarne Gasthuis | Haarlem Zuid - Cardiology
      • Hardenberg, Netherlands, 7772 SE
        • Saxenburgh Medisch Centrum | Cardiology Department
      • Roosendaal, Netherlands, 4708 AE
        • Bravis Ziekenhuis | Roosendaal - Cardiology Department
      • Tiel, Netherlands, 4002 WP
        • Ziekenhuis Rivierenland | Cardiology Research Department
      • Venlo, Netherlands, 5912 BL
        • VieCuri - Medisch Centrum voor Noord-Limburg locatie Venlo
      • Zaandam, Netherlands, 1502 DV
        • Zaans Medisch Centrum | Hartvaatcentrum
    • Zeeland
      • Goes, Zeeland, Netherlands, 4462RA
        • Admiraal de Ruyterziekenhuis
      • Bodø, Norway, 8092
        • Nordlandssykehuset Bodø Cardio
      • Drammen, Norway, 3004
        • Vestre Viken HF - Drammen Sykehus Cardiology
      • Elverum, Norway, 2409
        • Sykehuset Innlandet HF Elverum
      • Fredrikstad, Norway, NO-1603
        • Sykehus Østfold Kalnes Cardio
      • Gjettum, Norway, 1346
        • Vestre Viken HF - Bærum Sykehus Cardiology
      • Gjøvik, Norway, 2819
        • Sykehuset i Gjøvik Medisinsk
      • Harstad, Norway, 9406
        • UNN Harstad Medisinsk avdeling
      • Lillehammer, Norway, 2609
        • Sykehuset Lillehammer Medicine
      • Molde, Norway, 6407
        • Molde Sjukehus Medisinsk
      • Nordbyhagen, Norway, 1478
        • Akershus University Hospital Cardiology Department
      • Oslo, Norway, 27
        • Rikshospitalet Cardiology
      • Oslo, Norway, 319
        • Diakonhjemmets sykehus
      • Oslo, Norway, 450
        • OUS Ullevål Cardiology
      • Skedsmokorset, Norway, 2020
        • Skedsmo Medisinske Senter
      • Stavanger, Norway, 4011
        • Stavanger UHospital Cardiology
      • Tromsø, Norway, 9038
        • UNN Tromsø Cardiology Dep.
      • Ålesund, Norway, 6026
        • Ålesund Sykehus, Kardiologisk Seksjon
      • Bialystok, Poland, 15-276
        • Uniwersytecki Szpital Kliniczny W Bialymstoku
      • Bialystok, Poland, 15-704
        • KLIMED Marek Klimkiewicz
      • Bydgoszcz, Poland, 85-065
        • MICS Centrum Medyczne Bydgoszcz
      • Bydgoszcz, Poland, 85-231
        • Centrum Medyczne Kermed
      • Gdansk, Poland, 80-214
        • Uniwersyteckie Centrum Kliniczne
      • Grodzisk Mazowiecki, Poland, 05 825
        • Samodzielny Publiczny Specjalistyczny Szpital Zachodni
      • Katowice, Poland, 40-156
        • CLINICAL MEDICAL RESEARCH Sp. z o. o.
      • Katowice, Poland, 40-748
        • Vita Longa Sp. z o.o.
      • Krakow, Poland, 31-271
        • Unicardia Specjalistyczne Centrum Leczenia Ch.Serca i Naczyn
      • Lodz, Poland, 90-338
        • Centrum Terapii Wspolczesnej
      • Lodz, Poland, 91-034
        • CM MED-GASTR Sp. z o.o.
      • Lowicz, Poland, 99-400
        • Centrum Medyczne Ogrodowa G. i M. Kania Lekarze i Lekarze Dentysci Spólka Partnerska z siedziba w Skierniewicach
      • Lublin, Poland, 20-049
        • 1 Wojskowy Szpital Kliniczny Z Poliklinika SPZOZ W Lublinie
      • Lublin, Poland, 20-857
        • NZOZ "Twoja Przychodnia" Sp. z o.o.
      • Olsztyn, Poland, 10-117
        • Etyka Osrodek Badan Klinicznych
      • Olsztyn, Poland, 10-010
        • FutureMeds sp. z o. o.
      • Piaseczno, Poland, 05-500
        • Nzoz Heureka
      • Piotrkow Trybunalski, Poland, 97-300
        • Irmed Klimkiewicz, Rudziewicz-Kowalska Sp.j.
      • Poznan, Poland, 60-529
        • SOLUMED Centrum Medyczne
      • Pulawy, Poland, 24-100
        • Velocity Pulawy
      • Rzeszow, Poland, 35-205
        • EMED Centrum Uslug Medycznych
      • Skierniewice, Poland, 96-100
        • Clinmedica Research Sp. Z O.O.
      • Staszow, Poland, 28-200
        • "Nowe Zdrowie-Ck" Kieltucki I Wspolnicy Spolka Jawna
      • Warszawa, Poland, 00-465
        • NBR Polska Tomasz Klodawski
      • Warszawa, Poland, 02-637
        • Narodowy Instytut Geriatrii, Reumatologii i Rehabilitacji
      • Zamosc, Poland, 22-400
        • KO-MED Centra Kliniczne Zamosc
      • Braga, Portugal, 4710-243
        • Centro Clinico Academico Braga | Braga, Portugal
      • Coimbra, Portugal, 3004-561
        • Centro Hospitalar e Universitario de Coimbra, E.P.E. | Department of Cardiology, Research Unit
      • Guilhufe, Portugal, 4564-007
        • Centro Hospitalar de Tamega e Sousa | Hospital Padre Americo - Cardiology Department
      • Leiria, Portugal, 2410-197
        • Centro Hospitalar de Leiria | Santo Andre Hospital - Research Center
      • Lisboa, Portugal, 1500-458
        • Lusiadas | Hospital Lusiadas Lisboa - Lusiadas Knowledge Center
      • Lisboa, Portugal, 1500-650
        • Luz Saude | Hospital da Luz Lisboa - Centro de Investigacao Clinica
      • Lisboa, Portugal, 1449-005
        • Centro Hospitalar de Lisboa Ocidental | Clinical Research Department
      • Porto, Portugal, 4434-502
        • Centro Hospitalar Vila Nova de Gaia e Espinho | Unit 1 - Clinical Research Center
      • Porto, Portugal, 4200-319
        • Centro Hospitalar Universitario de Sao Joao | Polo Porto - Centro de Investigacao e Ensaios Clinicos
      • Setúbal, Portugal, 2900-722
        • Luz Saude | Hospital da Luz Setubal - Clinical Research Department
      • Vila Real, Portugal, 5000-508
        • Centro Hospitalar De Tras os Montes e Alto Douro | Hospital Sao Pedro - Centro de Investigacao Clinica
    • Braga
      • Guimaraes, Braga, Braga, Portugal, 4835-044
        • Hospital da Senhora da Oliveira | Clinical Research Department
    • Castelo Branco
      • Covilha, Castelo Branco, Portugal, 6200-251
        • Centro Hospitalar Universitario Cova de Beira | Clinical Research Department
    • Lisboa
      • Lisbon, Lisboa, Portugal, 1649-035
        • Centro Hospitalar Universitario de Lisboa Norte | Heart and Vessels Department
      • Vila Franca de Xira, Lisboa, Portugal, 2600-009
        • Hospital de Vila Franca de Xira | Centro de Desenvolvimento e Investigacao
    • Porto
      • Matosinhos, Porto, Portugal, 4464-513
        • Hospital Pedro Hispano | Clinical Research Center
    • Santarém
      • Riachos, Santarém, Portugal, 2350-325
        • Ucardio | Cardiology Department
    • Setúbal
      • Almada, Setúbal, Portugal, 2805-267
        • Hospital Garcia de Orta | Research Department
      • Baia Mare, Romania, 430031
        • Sp. Judetean de Urgenta Dr. Constantin Opris Baia Mare
      • Braila, Romania, 810318
        • Emergency County Hospital, Braila
      • Brasov, Romania, 500102
        • S.C Thera Card S.R.L
      • Brasov, Romania, 500283
        • S.C. Centrul Medical de Diagnostic si Tratament Ambulator Neomed SRL
      • Bucharest, Romania, 22322
        • Emergency Institute for Cardiovascular Diseases
      • Bucharest, Romania, 42122
        • Spitalul Clinic de Urgenta Sf. Ioan
      • Bucuresti, Romania, 20125
        • Spitalul Clinic Colentina
      • Bucuresti, Romania, 50098
        • Spitatul Universitar de Urgenta Bucaresti
      • Cluj Napoca, Romania, 400001
        • Niculae Stancioiu Heart Institute Cluj-Napoca
      • Cluj Napoca, Romania, 400300
        • Spitalul Clinic de Recuperare Cluj-Napoca
      • Iasi, Romania, 700111
        • Sfantul Spiridon Emergency Clinical County Hospital
      • Iasi, Romania, 700732
        • S.C. CARDIOMED S.R.L. Iasi
      • Pitesti, Romania, TBC
        • S.C. Sal Med SRL
      • Satu Mare, Romania, 440192
        • Spitalul Județean de Urgență Satu Mare
      • Suceava, Romania, 720237
        • Spitalul de urgenta Sf. Ioan Cel Nou
      • Targu Mures, Romania, 540124
        • S.C. Cardio Med S.R.L.
      • Targu Mures, Romania, 540136
        • Emergency Institute of Cardiovascular Diseases & Transplant
      • Timisoara, Romania, 300310
        • Timisoara Institute of Cardiovascular Diseases
    • Dolj
      • Cluj-Napoca, Dolj, Romania, 400015
        • Cardiomed S.R.L
    • Mures
      • Targu Mures, Mures, Romania, TBC
        • CMI. Dr. Podoleanu Cristian
    • Timis
      • Timisoara, Timis, Romania, 300254
        • Municipal Clinical Emergency Hospital of Timisoara
      • Singapore, Singapore, 119074
        • National University Hospital
      • Singapore, Singapore, 308433
        • Tan Tock Seng Hospital
      • Singapore, Singapore, 529889
        • Changi General Hospital
      • Singapore, Singapore, 544886
        • Sengkang General Hospital
      • Singapore, Singapore, 169609
        • National Heart Centre Singapore
      • Singapore, Singapore, 609606
        • Ng Teng Fong General Hospital
      • Singapore, Singapore, 519457
        • SingHealth Polyclinics - Pasir Ris
      • Bardejov, Slovakia, 085 01
        • Alian s.r.o.
      • Bratislava, Slovakia, 821 07
        • GALENUM s.r.o.
      • Bratislava, Slovakia, 84107
        • Kardiosanus | Bratislava, Slovakia
      • Brezno, Slovakia, 977 01
        • Nemocnica s poliklinikou Brezno, n.o.
      • Kosice, Slovakia, 040 11
        • KARDIO R s.r.o.
      • Kosice, Slovakia, 04001
        • Medical Group Kosice s.r.o. | Kosice, Slovakia
      • Levice, Slovakia, 93401
        • KARDIO-ANGIO s.r.o.
      • Levoca, Slovakia, 05401
        • KardioLEV s.r.o.
      • Lucenec, Slovakia, 984 01
        • Internal and Diabetes Clinic - IN-DIA s.r.o. | Lucenec, Slovakia
      • Lucenec, Slovakia, 98401
        • KARDIO 1 | Lucenec, Slovakia
      • Lucenec, Slovakia, 984 01
        • KardioMed | Outpatient Cardiology and Internal Medicine II Clinic
      • Namestovo, Slovakia, 02901
        • ORALEK, s.r.o.
      • Nitra, Slovakia, 949 88
        • Specializovana nemocnica sv. Svorada Zobor, n.o.
      • Nitra, Slovakia, 949 01
        • Kardiocentrum Nitra | Cardiology Clinic - Outpatient Department
      • Nove Zamky, Slovakia, 940 02
        • KaCH, s.r.o.
      • Piestany, Slovakia, 92101
        • BENIMED s.r.o.
      • Presov, Slovakia, 08001
        • Medispol s.r.o.
      • Presov, Slovakia, 08001
        • Medikard | Department of Internal Medicine
      • Svidnik, Slovakia, 08901
        • Interna SK s.r.o.
      • Trnava, Slovakia, 91701
        • Kardiologicka ambulancia Trnava, MUDr. Vladimir Macek
      • Zilina, Slovakia, 01001
        • MEDIVASA s.r.o.
      • A Coruña, Spain, 15006
        • University Hospital of A Coruna | Cardiology department
      • Alicante, Spain, 03010
        • Hospital General Universitario Doctor Balmis de Alicante | Cardiology Department
      • Barcelona, Spain, 08025
        • Hospital de la Santa Creu i Sant Pau | Cardiology Department
      • Barcelona, Spain, 08035
        • Vall d'Hebron Barcelona Hospital Campus | Vall d'Hebron Hospital Universitario - Cardiology Department
      • Barcelona, Spain, 8023
        • Hospital Quironsalud Barcelona | Internal Medicine Department
      • Madrid, Spain, 28046
        • Hospital Universitario La Paz | Cardiology Department - AF, Stroke Prevention
      • Madrid, Spain, 28046
        • Hospital Universitario La Paz | IdiPAZ - Neurology Department
      • Madrid, Spain, 28034
        • Hospital Universitario Ramon y Cajal | Departamento de Medicina Interna
      • Madrid, Spain, 28041
        • Hospital Universitario 12 de Octubre | Cardiology Department
      • Murcia, Spain, 30120
        • Hospital Clinico Universitario Virgen de la Arrixaca | Cardiology Department
      • Sevilla, Spain, 41013
        • Hospital Universitario Virgen del Rocio | Hospital General - Departamento de Cardiologia y Cirugia Cardiovascular
      • Valencia, Spain, 46026
        • La Fe University and Polytechnic Hospital | Cardiology Department
      • Valencia, Spain, 46014
        • Hospital General Universitario de Valencia | Cardiology Department
    • A Coruña
      • Ferrol, A Coruña, Spain, 15405
        • Complejo Hospitalario Universitario de Ferrol | Hospital Naval - Unidad de Hipertensión Arterial
      • Santiago de Compostela, A Coruña, Spain, 15706
        • Hospital Clinico Universitario de Santiago de Compostela | Cardiology Department
    • Asturias
      • Oviedo, Asturias, Spain, 33006
        • Hospital Universitario Central de Asturias | Servicio de Cardiologia
    • Barcelona
      • L'Hospitalet de Llobregat, Barcelona, Spain, 08907
        • Hospital Universitari de Bellvitge | Bellvitge Biomedical Research Institute - Cardiology - AF, Stroke Prevention
    • Cádiz
      • Sanlucar de Barrameda, Cádiz, Spain, 11540
        • Jose Manuel Pascual Pascual S.A. | Hospital Virgen del Camino - Internal Medicine Department
      • Villamartin, Cádiz, Spain, 11650
        • Jose Manuel Pascual Pascual S.A. | Hospital Virgen de las Montanas - Internal Medicine Department
    • Madrid [es-m]
      • Madrid, Madrid [es-m], Spain, 28006
        • Hospital Universitario de La Princesa | Internal Medicine Department
    • Málaga
      • Malaga, Málaga, Spain, 29010
        • Hospital Universitario Virgen de la Victoria | Cardiology Department
    • Sevilla
      • Lebrija, Sevilla, Spain, 41740
        • Hospital Alta Resolucion de Lebrija | Cardiology Service Department
      • Utrera, Sevilla, Spain, 41710
        • Hospital Alta Resolucion de Utrera | Cardiology Service Department
      • Borås, Sweden, 501 82
        • Södra Älvsborgs Sjukhus
      • Falun, Sweden, 791 82
        • Falu Lasarett
      • Göteborg, Sweden, 416 85
        • SU/Östra
      • Helsingborg, Sweden, TBC
        • Helsingborgs Lasarett
      • Linköping, Sweden, 581 85
        • Universitetssjukhuset i Linköping
      • Lund, Sweden, 222 21
        • Clemenstorget Hjärtmottagning
      • Lund, Sweden, 222 42
        • Skanes universitetssjukhus
      • Mölndal, Sweden, 431 80
        • SU/Mölndal
      • Norrköping, Sweden, 601 82
        • Vrinnevisjukhuset
      • Skellefteå, Sweden, 931 86
        • Skellefteå lasarett
      • Stockholm, Sweden, 171 76
        • Karolinska Universitetssjukhuset
      • Stockholm, Sweden, 182 88
        • Danderyds Sjukhus
      • Stockholm, Sweden, 118 83
        • Sodersjukhuset AB
      • Stockholm, Sweden, 141 86
        • Karolinska Universitetssjukhuset Huddinge Stockholm
      • Umea, Sweden, 901 85
        • Norrlands Universitetssjukhus, Umea
      • Uppsala, Sweden, TBC
        • Akademiska Sjukhuset
      • Västerås, Sweden, 721 89
        • Västmanlands Sjukhus Västerås
      • Örebro, Sweden, 701 85
        • Universitetssjukhuset Örebro
      • Bern, Switzerland, 3010
        • Inselspital Universitatsspital Bern
      • Lugano, Switzerland, 6900
        • Cardiocentro Ticino
      • Zürich, Switzerland, 8091
        • UniversitätsSpital Zürich
    • Aargau
      • Aarau, Aargau, Switzerland, 5001
        • Kantonsspital Aarau
      • Baden, Aargau, Switzerland, 5404
        • Kantonsspital Baden
    • Basel-Stadt
      • Basel, Basel-Stadt, Switzerland, 4056
        • Universitätsspital Basel
    • Sankt Gallen
      • Saint Gallen, Sankt Gallen, Switzerland, 1009
        • Kantonsspital St. Gallen
      • Changhua, Taiwan, 50006
        • Changhua Christian Hospital
      • Hsinchu, Taiwan, 300
        • Mackay Memorial Hospital - Hsinchu Branch
      • Hualien, Taiwan, 970
        • Buddhist Tzu-Chi General Hospital, Hualien
      • Kaohsiung, Taiwan, 82445
        • E-Da Hospital
      • Kaohsiung, Taiwan, 833
        • Chang Gung Memorial Hospital Kaohsiung
      • Kaohsiung City, Taiwan, 813414
        • Veterans General Hospital
      • Taichung, Taiwan, 40705
        • Taichung Veterans General Hospital
      • Taichung, Taiwan, 404327
        • China Medical University Hospital
      • Taichung, Taiwan, 402306
        • Chung Shan Medical University Hospital
      • Tainan, Taiwan, 704
        • National Cheng Kung University Hospital
      • Taipei, Taiwan, 100
        • National Taiwan University Hospital
      • Taipei, Taiwan, 104
        • Mackay Memorial Hospital
      • Taipei, Taiwan, 11217
        • Taipei Veterans General Hospital
      • Taipei, Taiwan, 111
        • Shin Kong Wu Ho-Su Memorial Hospital
      • Taipei, Taiwan, 106
        • Cathay General Hospital
      • Taipei, Taiwan, 116
        • Taipei Municipal Wanfang Hospital
      • Taipei, Taiwan, 110
        • Taipei Medical University | Clinical Research Center
      • Taipei City, Taiwan, 114
        • Tri-Service General Hospital
      • Taoyuan, Taiwan, 33305
        • Chang Gung Memorial Hospital at Linkou
    • Ilan
      • Yilan, Ilan, Taiwan, 260006
        • National Yang Ming Chiao Tung University Hospital
    • Kaohsiung
      • Kaohsiung City, Kaohsiung, Taiwan, 807377
        • Kaohsiung Medical University Chung-Ho Memorial Hospital
    • Tainan
      • Taikang, Tainan, Taiwan, 71004
        • Chi Mei Medical Center
    • Taipei
      • New Taipei City, Taipei, Taiwan, 25160
        • Mackay Memorial Hospital Tamsui Branch
      • Afyonkarahisar, Turkey, 3218
        • Afyonkarahisar Saglik Bilimleri Universitesi
      • Ankara, Turkey, 6800
        • Health Ministry Of Türkiye Republic Ankara Bilkent City Hospital
      • Ankara, Turkey, 6490
        • Baskent Universitesi Tip Fakultesi Hastanesi
      • Antalya, Turkey, 7059
        • Akdeniz Universitesi Tip Fakultesi Hastanesi
      • Corum, Turkey, 19030
        • Hitit Universitesi Tip Fakultesi
      • Erzurum, Turkey, 25240
        • Ataturk Universitesi Tip Fakultesi
      • Eskisehir, Turkey, 26480
        • Eskisehir Osmangazi Universitesi Tip Fakultesi
      • Istanbul, Turkey, 34098
        • Istanbul Universitesi Cerrahpasa - Kardiyoloji Anabilim Dali
      • Istanbul, Turkey, 34899
        • Marmara Uni. Tip Fak. Pendik EAH Kardiyoloji
      • Istanbul, Turkey, TBC
        • Istanbul Mehmet Akif Ersoy Gogus Kalp Damar Cerrahisi E.A.H.
      • Izmir, Turkey, 35100
        • Dokuz Eylul Universitesi Tip Fakultesi
      • Izmir, Turkey, 35575
        • Izmir Ekonomi Universitesi Medikal Point Hastanesi
      • Kayseri, Turkey, 38039
        • Erciyes Universitesi Tip Fakultesi
      • Kocaeli, Turkey, 41380
        • Kocaeli Universitesi Tip Fakultesi
      • Kutahya, Turkey, 43040
        • Kutahya Saglik Bilimleri Uni. Evliya Celebi Egitim ve Arasti
      • Samsun, Turkey, 55090
        • Saglik Bilimleri Univ. Samsun EAH Kardiyoloji Departmani
      • Yüregir, Turkey, 1370
        • Adana Sehir Egitim ve Arastirma Hastanesi
      • Cardiff, United Kingdom, CF5 4AD
        • Ely Bridge Medical Centre
      • Liverpool, United Kingdom, L14 3PE
        • Heart and Chest Hospital
      • London, United Kingdom, W6 8RF
        • Charing Cross Hospital
      • London, United Kingdom, SE5 9RS
        • King's College Hospital - NHS Foundation Trust
      • Wirral, United Kingdom, CH62 6EE
        • Future Meds - Bromborough
    • Cambridgeshire
      • Ely, Cambridgeshire, United Kingdom, CB7 5SQ
        • Staploe Medical Centre
    • Cheshire
      • Chester, Cheshire, United Kingdom, CH2 1UL
        • Countess of Chester Hospital
    • Derbyshire
      • Chesterfield, Derbyshire, United Kingdom, S44 5BL
        • Chesterfield Royal Hospital
    • Devon
      • Torbay, Devon, United Kingdom, TQ2 7AA
        • Torbay Hospital
    • Dorset
      • Poole, Dorset, United Kingdom, BH15 2JB
        • Poole Hospital NHS Trust
    • Glasgow City
      • Glasgow, Glasgow City, United Kingdom, G4 0SF
        • Glasgow Royal Infirmary | Stroke Unit
    • Hampshire
      • Basingstoke, Hampshire, United Kingdom, RG24 9NA
        • North Hampshire Hospital
    • Hertfordshire
      • Stevenage, Hertfordshire, United Kingdom, SG1 4AB
        • Lister Hospital
    • Kent
      • Margate, Kent, United Kingdom, CT9 4AN
        • Queen Elizabeth the Queen Mother Hospital
    • Leicestershire
      • Leicester, Leicestershire, United Kingdom, LE3 9QP
        • University Hospitals Leicester
    • London
      • Harrow, London, United Kingdom, HA1 3UJ
        • Northwick Park Hospital
    • North Ireland
      • Craigavon, North Ireland, United Kingdom, BT63 5QQ
        • Craigavon Area Hospital
    • Northumberland
      • Ashington, Northumberland, United Kingdom, NE63 9JJ
        • Wansbeck General Hospital
    • Tyne And Wear
      • Newcastle, Tyne And Wear, United Kingdom, NE7 7DN
        • Freeman Hospital
    • West Midlands
      • Birmingham, West Midlands, United Kingdom, B21 9RY
        • Soho Health Centre, Future Meds
      • Dudley, West Midlands, United Kingdom, DY1 2HQ
        • Russells Hall Hospital
    • West Sussex
      • Chichester, West Sussex, United Kingdom, PO19 6SE
        • St Richard's Hospital
    • Worcestershire
      • Worcester, Worcestershire, United Kingdom, WR5 1DD
        • Worcestershire Acute Hospital Trust
    • Yorkshire
      • Middlesborough, Yorkshire, United Kingdom, TS43BW
        • James Cook University Hospital South Tees
    • Alabama
      • Dothan, Alabama, United States, 36305
        • SEC Clinical Research
      • Fairhope, Alabama, United States, 36532
        • Eastern Shore Research Institute, LLC | Fairhope, AL
      • Mobile, Alabama, United States, 36617
        • University of South Alabama Medical Center
      • Mobile, Alabama, United States, 36608
        • Mobile Heart Specialists, PC
    • Arkansas
      • Little Rock, Arkansas, United States, 72205
        • Arkansas Cardiology | Little Rock
    • California
      • Covina, California, United States, 91723
        • Valley Clinical Trials, Inc. | Covina, CA
      • Culver City, California, United States, 90230
        • Science 37
      • Irvine, California, United States, 92697
        • University of California, Irvine
      • Long Beach, California, United States, 90822
        • VA Long Beach Healthcare System
      • Los Angeles, California, United States, 90073-1003
        • VA Greater Los Angeles Healthcare System | West Los Angeles VA Medical Center - Cardiology Department
      • Newport Beach, California, United States, 92663
        • Radin Cardiovascular Medical Group
      • Northridge, California, United States, 91324
        • Amicis Research Center | Northridge, CA
      • Santa Barbara, California, United States, 93102
        • Cottage Health | Santa Barbara Cottage Hospital - Cardiology Department
      • Santa Rosa, California, United States, 95405
        • NorthBay Clinical Research, LLC | Santa Rosa, CA
      • Torrance, California, United States, 90502
        • Harbor - UCLA Medical Center
      • Torrance, California, United States, 90502-2004
        • The Lundquist Institute | Cardiology Department
      • Vista, California, United States, 92081
        • Blue Coast Research Center, LLC
      • West Hills, California, United States, 91307
        • Interventional Cardiology Medical Group | West Hills, CA
    • Colorado
      • Aurora, Colorado, United States, 80045
        • University of Colorado Hospital - Cardiology
      • Littleton, Colorado, United States, 80120
        • South Denver Cardiology Associates, PC
    • Connecticut
      • Norwalk, Connecticut, United States, 06851
        • Cardiology Associates of Fairfield County, P.C. | Stamford, CT
    • Florida
      • Boynton Beach, Florida, United States, 33472
        • Integrity Clinical Research | Cardiology Associates of South Florida
      • Boynton Beach, Florida, United States, 33437
        • Integrity Clinical Research | Florida Premier Cardiology
      • Bradenton, Florida, United States, 34209
        • Nova Clinical Research | Brandenton, FL
      • Bradenton, Florida, United States, 34209
        • Cardiovascular & Vein Center of Florida | Bradenton, FL
      • Clearwater, Florida, United States, 33756
        • Clearwater Cardiovascular Associates | Clearwater, FL
      • Daytona Beach, Florida, United States, 32114
        • Cardiology Consultants, PA
      • Daytona Beach, Florida, United States, 32117
        • Cardiology Associates Research Company
      • Delray Beach, Florida, United States, 33446
        • Integrity Clinical Research | Heller Heart Health
      • Gainesville, Florida, United States, 32608
        • North Florida Foundation For Research And Education | Veterans Benefits Administration
      • Hialeah, Florida, United States, 33012
        • Indago Research and Health Center | Hialeah, FL
      • Inverness, Florida, United States, 34452
        • Encore Research Group | Nature Coast Clinical Research - Inverness
      • Jacksonville, Florida, United States, 32209
        • University of Florida - Jacksonville
      • Longwood, Florida, United States, 32779
        • Heart Vein & Vascular | Longwood, FL
      • Miami, Florida, United States, 33130
        • Life Spring Research | Miami, FL
      • Naples, Florida, United States, 34102-8143
        • Southwest Florida Research | Naples, FL
      • Naples, Florida, United States, 34102
        • Advanced Research for Health Improvement, LLC | Naples, FL
      • Palm Beach Gardens, Florida, United States, 33410
        • Cardiology Partners Clinical Research Institute | Palm Beach Gardens Office
      • Pensacola, Florida, United States, 32503
        • Baptist Heart and Vascular/Cardiology Consultants
      • Port Charlotte, Florida, United States, 33592
        • Peace River Cardiovascular Center | Port Charlotte, FL
      • Saint Augustine, Florida, United States, 32086
        • East Coast Institute for Research | St. Augustine, FL
      • Saint Augustine, Florida, United States, 32081
        • Encore Research Group | St. Johns Center for Clinical Research
      • Sarasota, Florida, United States, 34239
        • Cardiovascular Center of Sarasota Foundation for Research and Education | Sarasota, FL
      • Wellington, Florida, United States, 33449
        • Cardiology Partners Clinical Research Institute | Wellington Office
      • West Palm Beach, Florida, United States, 33407-2495
        • St. Mary's Medical Center | West Palm Beach - Neurology Department
    • Georgia
      • Atlanta, Georgia, United States, 30303-3031
        • Morehouse School of Medicine | Clinical Research Centre
      • Cumming, Georgia, United States, 30041
        • NSC Cardiology | Johns Creek, GA
      • Peachtree Corners, Georgia, United States, 30092
        • Alta Pharmaceutical Research Center, LLC
      • Tucker, Georgia, United States, 30084
        • Atlanta Heart Specialists, LLC
    • Idaho
      • Meridian, Idaho, United States, 83642
        • St. Luke's Health System | St. Luke's Clinic - Idaho Cardiology Associates
    • Illinois
      • Chicago, Illinois, United States, 60611
        • Northwestern University
      • Glenview, Illinois, United States, 60026
        • Northshore Medical Center
      • Oak Brook, Illinois, United States, 60523
        • Affinity Health Research Institute | Oak Brook, IL
    • Indiana
      • Elkhart, Indiana, United States, 46514
        • Midwest Cardiovascular Research and Education Foundation | Elkhart, IN
      • Hammond, Indiana, United States, 46320
        • Cardiovascular Research of Northwest Indiana, LLC. | Munster, IN
      • Indianapolis, Indiana, United States, 46202
        • IU Health Physicians Cardiology
      • Richmond, Indiana, United States, 47374
        • Reid Physician Associates | Cardiology Department
    • Iowa
      • Ames, Iowa, United States, 50010
        • Accellacare | Ames, IA
      • Iowa City, Iowa, United States, 52242
        • University of Iowa
    • Kansas
      • Wichita, Kansas, United States, 67226
        • Kansas Nephrology Physicians, PA
    • Kentucky
      • Lexington, Kentucky, United States, 40503
        • Baptist Health Lexington
      • Louisville, Kentucky, United States, 40207
        • Baptist Health Medical Group - Louisville Cardiology
      • Owensboro, Kentucky, United States, 42303
        • Research Integrity, LLC
    • Louisiana
      • Alexandria, Louisiana, United States, 71301
        • Cambridge Medical Trials
      • Baton Rouge, Louisiana, United States, 70836
        • Ochsner Clinic Foundation
      • Covington, Louisiana, United States, 70433
        • Cardiovascular Associates Research, LLC
      • New Orleans, Louisiana, United States, 70121
        • Ochsner Medical Center - New Orleans
      • Slidell, Louisiana, United States, 70458
        • Louisiana Heart Center Research - Slidell
    • Maine
      • Bangor, Maine, United States, 04401
        • Northeast Cardiology Associates
      • Scarborough, Maine, United States, 04039
        • MaineHealth Maine Medical Center | Maine Medical Partners Cardiology
    • Maryland
      • Baltimore, Maryland, United States, 21287
        • Johns Hopkins Hospital/Health System
      • Baltimore, Maryland, United States, 21215
        • LifeBridge Health | Sinai Hospital - Platelet and Thrombosis Research Department
      • Baltimore, Maryland, United States, 21229
        • Spectrum Clinical Research | Maryland Cardiovascular Specialists
      • Columbia, Maryland, United States, 21044
        • Johns Hopkins University School of Medicine | CAPRES
      • Fort Washington, Maryland, United States, 20744
        • Anderson Medical Group and Cardiology | Anderson Medical Research, LLC
      • Silver Spring, Maryland, United States, 20904
        • Adventist HealthCare | White Oak Medical Center
    • Michigan
      • Bay City, Michigan, United States, 48708
        • McLaren Health Care | McLaren Bay Region - Research Department
      • Detroit, Michigan, United States, 48202
        • Henry Ford Health System
      • Flint, Michigan, United States, 48504
        • AA Medical Research Center | Flint, MI
      • Lansing, Michigan, United States, 48912
        • Sparrow Clinical Research Institute | Sparrow Hospital - Clinical Research Department
    • Minnesota
      • Maplewood, Minnesota, United States, 55109
        • M Health Fairview
      • Minneapolis, Minnesota, United States, 55417
        • Veterans Benefits Administration | Minneapolis VA Medical Center - Cardiology Department
      • Rochester, Minnesota, United States, 55905
        • Mayo Clinic - Rochester
      • Saint Paul, Minnesota, United States, 55102
        • Minneapolis Heart Institute
    • Mississippi
      • Jackson, Mississippi, United States, 39216
        • Jackson Heart Clinic | Jackson, MS
      • Tupelo, Mississippi, United States, 38801
        • Cardiology Associates Research, LLC
    • Missouri
      • Saint Louis, Missouri, United States, 63136
        • St. Louis Heart & Vascular, PC
    • Nebraska
      • Grand Island, Nebraska, United States, 68803
        • CHI Health Clinic Heart Institute - Grand Island
    • New Jersey
      • Bridgewater, New Jersey, United States, 08807
        • Advanced Heart Care, LLC | Bridgewater, NJ
      • Linden, New Jersey, United States, 07036
        • NJ Heart | Linden, NJ
      • Manalapan, New Jersey, United States, 07726
        • Garden State Heart Care
      • Mullica Hill, New Jersey, United States, 08062
        • Inspira Medical Centers | Clinical Research Office
      • Ridgewood, New Jersey, United States, 07450
        • The Valley Hospital, Inc.
      • Voorhees, New Jersey, United States, 08043
        • Cooper Specialty Care at Voorhees
      • Warren, New Jersey, United States, 07059
        • IMA Clinical Research | Warren, NJ
    • New York
      • Middletown, New York, United States, 10941
        • Circuit Clinical/Crystal Run
      • New York, New York, United States, 10001
        • NYU Langone Health | NYU Langone Medical Associates Chelsea - Cardiovascular Research
      • Riverhead, New York, United States, 11901
        • Division of Cardiovascular Research at Peconic Bay Med Ctr
      • Westfield, New York, United States, 14787
        • Great Lakes Medical Research | Westfield, NY
    • North Carolina
      • Chapel Hill, North Carolina, United States, 27514
        • University of North Carolina at Chapel Hill | Cardiology Department
      • Durham, North Carolina, United States, 27710
        • Duke Univ. Medical Center
      • Durham, North Carolina, United States, 27710-4000
        • Duke University | Duke Clinical Research Institute - Participant Research Operations
      • Greensboro, North Carolina, United States, 27408
        • Medication Management | Greensboro - Cardiology
      • Mount Airy, North Carolina, United States, 27030
        • Clinical Trials of America, Inc.
    • North Dakota
      • Fargo, North Dakota, United States, 58104
        • Lillestol Research LLC | Fargo, ND
    • Ohio
      • Canton, Ohio, United States, 44710
        • Aultman | Aultman Hospital Main Campus - Clinical Trials
      • Kettering, Ohio, United States, 45429
        • Kettering Health Network | Research Institute
      • Marion, Ohio, United States, 43302-6774
        • Rama Research LLC | Marion, OH
      • Toledo, Ohio, United States, 43615
        • ProMedica Toledo Hospital
    • Oklahoma
      • Oklahoma City, Oklahoma, United States, 73135
        • South Oklahoma Heart Research, LLC
    • Oregon
      • Portland, Oregon, United States, 97239
        • Oregon Health and Science University
    • Pennsylvania
      • Camp Hill, Pennsylvania, United States, 17011
        • Capital Area Research | Camp Hill, PA
      • Doylestown, Pennsylvania, United States, 18901
        • Doylestown Hospital
      • Erie, Pennsylvania, United States, 16507
        • University of Pittsburgh Medical Center, Hamot | Clinical Trials and Research
      • Hershey, Pennsylvania, United States, 17033
        • Pennsylvania State University College of Medicine
      • Philadelphia, Pennsylvania, United States, 19107
        • Thomas Jefferson University Hospital
      • Philadelphia, Pennsylvania, United States, 19141
        • Einstein Healthcare Network
      • Pittsburgh, Pennsylvania, United States, 15219
        • University of Pittsburgh Medical Center Health System
      • Scranton, Pennsylvania, United States, 18510
        • Geisinger Community Medical Center
      • Wilkes-Barre, Pennsylvania, United States, 18711
        • Geisinger Wyoming Valley Medical Center
      • Wynnewood, Pennsylvania, United States, 19096
        • Main Line Health
      • Yardley, Pennsylvania, United States, 19067
        • Cardiology Consultants of Philadelphia | Yardley
    • Rhode Island
      • Providence, Rhode Island, United States, 02906
        • Lifespan | The Miriam Hospital - Cardiovascular Research
    • South Carolina
      • Anderson, South Carolina, United States, 29621
        • AnMed Clinical Research
      • Charleston, South Carolina, United States, 29425
        • Medical University of South Carolina - Cardiology
      • Fort Mill, South Carolina, United States, 29707
        • Piedmont Research Partners LLC
      • Ladson, South Carolina, United States, 29456
        • Accellacare | Mt. Pleasant, SC
      • Lancaster, South Carolina, United States, 29720
        • Carolina Heart Specialists | Lancaster, SC
    • South Dakota
      • Rapid City, South Dakota, United States, 57701
        • Rapid City Regional Hospital
      • Sioux Falls, South Dakota, United States, 57117
        • Sanford USD Medical Center
    • Tennessee
      • Bristol, Tennessee, United States, 37620
        • Holston Medical Group - Bristol
      • Chattanooga, Tennessee, United States, 37403
        • Erlanger Health, Inc.
      • Germantown, Tennessee, United States, 38138
        • Stern Cardiovascular Center
      • Jackson, Tennessee, United States, 38301
        • Apex Research Foundation, LLC. | Jackson, TN
      • Nashville, Tennessee, United States, 37232
        • Vanderbilt University Medical Center
      • Powell, Tennessee, United States, 37849
        • Cardiovascular Research of Knoxville
    • Texas
      • Amarillo, Texas, United States, 79109
        • PharmaTex Research, LLC
      • Dallas, Texas, United States, 75235
        • Southwest Family Medicine Associates | Dallas, TX
      • Denton, Texas, United States, 76201
        • Prime Revival Reserach Institute, LLC | Denton, TX
      • El Paso, Texas, United States, 79905
        • David Turbay MD PLLC
      • Fort Worth, Texas, United States, 76104
        • Texas Health Research & Education Institute
      • Fort Worth, Texas, United States, 76107
        • Texas Health Physicians Group - Fort Worth
      • Galveston, Texas, United States, 77555-0587
        • University of Texas Medical Branch at Galveston
      • Houston, Texas, United States, 77030
        • Houston Methodist Hospital
      • Kingwood, Texas, United States, 77339
        • TCR Institute
      • McKinney, Texas, United States, 75071
        • North Texas Research Associates
      • McKinney, Texas, United States, 75069-1780
        • North Dallas Research Associate | McKinney, TX
      • Plano, Texas, United States, 75093
        • Styde Research LLC | Plano, TX
      • San Antonio, Texas, United States, 78212-4740
        • Clinical Advancement Center, PLLC
      • San Antonio, Texas, United States, 78201
        • South Texas Cardiovascular Consultants, PLLC
      • Sugar Land, Texas, United States, 77479
        • Mt. Olympus Medical Research
      • Tomball, Texas, United States, 77375
        • Northwest Houston Clinical Research, PLLC - Houston Heart Center | Tomball, TX
      • Tyler, Texas, United States, 75701
        • Tyler Cardiovascular Consultants | Tyler, TX
      • Tyler, Texas, United States, 75702
        • CHRISTUS Trinity | Mother Frances Louis and Peaches Owen Heart Hospital - Electrophysiology Clinic
    • Utah
      • Murray, Utah, United States, 84107
        • Intermountain Healthcare | Cardiovascular Research Department
    • Virginia
      • Fairfax, Virginia, United States, 22031
        • Inova Fairfax Hospital - Fairfax
      • Falls Church, Virginia, United States, 22042
        • Virginia Heart
      • Manassas, Virginia, United States, 20109
        • Carient Heart and Vascular
      • Norfolk, Virginia, United States, 23504
        • York Clinical Research, LLC | Norfolk, VA
      • Richmond, Virginia, United States, 23284
        • Virginia Commonwealth University
      • Richmond, Virginia, United States, 23249-0001
        • Hunter Holmes McGuire Veterans Affairs Medical Center
    • Washington
      • Port Orchard, Washington, United States, 98366
        • Sound Medical Research | Sound Medical Research of Port Orchard
      • Wenatchee, Washington, United States, 98801
        • Confluence Health

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

18 years and older (Adult, Older Adult)

Accepts Healthy Volunteers

No

Description

Inclusion Criteria:

  • 18 years of age or older
  • The patient willing and able to understand the Patient information Sheet and provide written informed consent
  • Atrial fibrillation with an indication for indefinite treatment with an oral anticoagulant
  • CHA2DS2-VASc score ≥ 3 if male or ≥ 4 if female, OR CHA2DS2-VASc score of 2 if male or 3 if female and at least one of the following enrichment criteria:

    • age ≥ 70
    • previous stroke, transient ischemic attack, or systemic embolism
    • renal dysfunction with eGFR < 50 ml/min within 14 days prior to randomization
    • prior episode of non-traumatic major bleeding
    • current single agent antiplatelet therapy planned to continue for at least 6 months after randomization
    • ≤ 6 consecutive weeks of treatment with oral anticoagulant prior to randomization.

Exclusion Criteria:

  • Mechanical heart valve prosthesis
  • Moderate-to-severe mitral stenosis at the time of study inclusion.
  • Atrial fibrillation only due to reversible cause.
  • Participants after successful ablation therapy without documented recurrent AF or participants after left atrial appendage occlusion / exclusion or plan for ablation or Left atrial appendage (LAA) occlusion / exclusion within the next 6 months.
  • Recent ischemic stroke (within 7 days prior to randomization).
  • Active non-trivial bleeding; known chronic bleeding disorder ; history of non-traumatic intracranial hemorrhage.
  • Known significant liver disease or known hepatic insufficiency classified as Child-Pugh B or C at randomization.
  • Estimated glomerular filtration rate (eGFR) < 25 mL/min/1.73 m2 within 14 days prior to randomization or on dialysis or expected to be started on dialysis within the next 12 months starting from randomization.
  • Major surgery during the last 30 days prior to randomization.
  • Known allergy, intolerance or hypersensitivity to either of the study interventions.
  • Any contraindication for the use of an anticoagulant or listed in the local labelling for apixaban.
  • Requirement for chronic anticoagulation for a different indication than AF, e.g. mechanical heart valve or left ventricular cardiac thrombus (atrial thrombus is allowed), or dual antiplatelet therapy (single agent therapy is allowed).
  • Treatment with Vitamin K antagonist (VKA) in the 10 days prior to randomization.
  • Concomitant use of or anticipated need for:

    • daily or near daily (> 5 days per week) therapy with nonsteroidal anti-inflammatory drugs (NSAIDs) for more than 4 weeks during the study
    • herbal or traditional medicine, and / or supplements with known anticoagulant and / or antiplatelet effect
    • combined P-glycoprotein (P-gp) and strong cytochrome P450 isoenzyme 3A4 (CYP3A4) inhibitors
    • combined P-gp and strong / moderate CYP3A4 inducers Respective substances (apart from NSAIDs) must be stopped - in case of combined inhibitors / inducers of CYP3A4 and P-gp for at least 14 days before randomization.
  • Previous (within 30 days or 5 half-lives of the investigational drug, whichever is longer) or concomitant participation in another clinical study with investigational medicinal product(s) or device(s). Registries and observational studies are allowed.
  • Known current alcohol and / or illicit drug abuse.
  • Close affiliation with the investigational site.
  • Any other history, condition or therapy, or uncontrolled intercurrent illness which would make the participant unsuitable for the study vulnerable or life expectancy < 12 months.

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Treatment
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: Quadruple

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: Asundexian
Participants will receive asundexian and apixaban matching placebo.
Once a day
Placebo to apixaban, twice a day
Active Comparator: Apixaban
Participants will receive apixaban and asundexian matching placebo.
5 mg or 2.5 mg, twice a day, according to product label.
Placebo to asundexian, once a day

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Number of Participants With Composite of Stroke or Systemic Embolism
Time Frame: Approximately 12 months

The assessment was based on the cause-specific hazard ratio (csHR), comparing asundexian with apixaban which is based on time to first event.

Stroke was defined as an acute episode of focal or global neurological dysfunction caused by an injury of the brain, spinal cord, or retina as a result of hemorrhage or infarction.

Systemic embolism is defined as abrupt vascular insufficiency associated with clinical or radiological evidence of arterial occlusion in the absence of other likely mechanisms (this does not include myocardial infarction, thromboembolism of the pulmonary vasculature or venous thrombosis, e.g. pulmonary embolism or deep venous thrombosis).

Approximately 12 months
Number of Participants With International Society on Thrombosis and Hemostasis (ISTH) Major Bleeding
Time Frame: Approximately 12 months

Assessment based on the (csHR), comparing asundexian with apixaban which is based on time to first event.

ISTH Major Bleeding was defined as an event that meets at least one of the below criteria, based on the definition given by the ISTH (Schulman and Kearon 2005):

  • Fatal bleeding, and/or
  • Symptomatic bleeding in a critical area or organ (intracranial, intraspinal, intraocular with compromised vision, pericardial, retroperitoneal, intra-articular, or intramuscular with compartment syndrome), and/or
  • Clinically overt* bleeding associated with a recent (within 48 hours) decrease in the hemoglobin level of ≥ 2 g/dL (20 g/L; 1.24 mmol/L) compared with the most recent hemoglobin value available before the event, and/or
  • Clinically overt* bleeding leading to transfusion of 2 or more units of packed red blood cells or whole blood.

    • Overt bleeding required the identification of the bleeding location and the hemoglobin drop and/or transfusion needed to be related to the bleeding.
Approximately 12 months
Number of Participants With Composite of Stroke, Systemic Embolism, or ISTH Major Bleeding
Time Frame: Approximately 12 months
The assessment was based on the cause-specific hazard ratio (csHR), comparing asundexian with apixaban which is based on time to first event.
Approximately 12 months

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Number of Participants With Composite of Ischemic Stroke or Systemic Embolism
Time Frame: Approximately 12 months

The assessment was based on the cause-specific hazard ratio (csHR), comparing asundexian with apixaban which is based on time to first event.

An ischemic stroke was defined as the rapid onset (or present on awakening) of a new focal neurological deficit with clinical (> 24 hours symptoms / signs) or imaging evidence of infarction that is not attributable to a non-ischemic cause (i.e. not associated with infection, tumor, seizure, severe metabolic disease).

Approximately 12 months
Number of Participants With All-cause Mortality
Time Frame: Approximately 12 months
The assessment was based on the cause-specific hazard ratio (csHR), comparing asundexian with apixaban which is based on time to first event.
Approximately 12 months
Number of Participants With Ischemic Stroke
Time Frame: Approximately 12 months

The assessment was based on the cause-specific hazard ratio (csHR), comparing asundexian with apixaban which is based on time to first event.

An ischemic stroke was defined as the rapid onset (or present on awakening) of a new focal neurological deficit with clinical (> 24 hours symptoms / signs) or imaging evidence of infarction that is not attributable to a non-ischemic cause (i.e. not associated with infection, tumor, seizure, severe metabolic disease).

Approximately 12 months
Number of Participants With Cardiovascular (CV) Death
Time Frame: Approximately 12 months

The assessment was based on the cause-specific hazard ratio (csHR), comparing asundexian with apixaban which is based on time to first event.

CV death included death due to stroke, myocardial infarction, heart failure or cardiogenic shock, sudden death or any other death due to other cardiovascular causes or CV procedures. In addition, death due to non-traumatic cardiovascular hemorrhage will be included, e.g. non-stroke intracranial hemorrhage, non-procedural or non-traumatic vascular rupture (e.g. aortic aneurysm), or hemorrhage causing cardiac tamponade

Approximately 12 months
Number of Participants With Composite of CV Death, Stroke, or Myocardial Infarction (MI)
Time Frame: Approximately 12 months

The assessment was based on the cause-specific hazard ratio (csHR), comparing asundexian with apixaban which is based on time to first event.

The diagnosis of MI requires the combination of:

  • Presence of acute myocardial injury (changes in cardiac biomarkers) and
  • Evidence of acute myocardial ischemia derived from the clinical presentation, electrocardiographic changes, or the results of myocardial or coronary artery imaging, or in case of post mortem pathological findings irrespective of biomarker values.
Approximately 12 months
Number of Participants With Composite of ISTH Major or Clinically Relevant Non-major Bleeding
Time Frame: Approximately 12 months

The assessment was based on the cause-specific hazard ratio (csHR), comparing asundexian with apixaban which is based on time to first event.

Clinically relevant non-major bleeding was considered any sign or symptom of acute or sub-acute clinically overt bleeding that does not fit the criteria for the ISTH definition of major bleeding, but does meet at least one of the following criteria (based on criteria published by the EMA) (EMA 2014):

  • requiring medical or surgical treatment by a healthcare professional for bleeding
  • leading to hospitalization or increased level of care for bleeding
  • a change in antithrombotic therapy (including study intervention) for bleeding *Overt bleeding required the identification of the bleeding location.
Approximately 12 months
Number of Participants With Clinically Relevant Non-major Bleeding
Time Frame: Approximately 12 months
The assessment was based on the cause-specific hazard ratio (csHR), comparing asundexian with apixaban which is based on time to first event.
Approximately 12 months
Number of Participants With Hemorrhagic Stroke
Time Frame: Approximately 12 months

The assessment was based on the cause-specific hazard ratio (csHR), comparing asundexian with apixaban which is based on time to first event.

Hemorrhagic stroke was defined as an acute, atraumatic extravasation of blood into the brain parenchyma, intraventricular or subarachnoid space with associated neurological symptoms. This does not include microbleeds or hemorrhagic transformation of an ischemic stroke.

Approximately 12 months
Number of Participants With Intracranial Hemorrhage
Time Frame: Approximately 12 months
The assessment was based on the cause-specific hazard ratio (csHR), comparing asundexian with apixaban which is based on time to first event.
Approximately 12 months
Number of Participants With Fatal Bleeding
Time Frame: Approximately 12 months
The assessment was based on the cause-specific hazard ratio (csHR), comparing asundexian with apixaban which is based on time to first event.
Approximately 12 months
Number of Participants With Minor Bleeding
Time Frame: Approximately 12 months

The assessment was based on the cause-specific hazard ratio (csHR), comparing asundexian with apixaban which is based on time to first event.

All other overt bleeding episodes not meeting the criteria for ISTH major or clinically relevant non-major bleeding were classified as minor bleeding (for example, bleeding from a minor wound that does not prompt a treatment for the bleeding, for instance with surgical hemostasis, or epistaxis that does not require a medical treatment for bleeding or a change in antithrombotic therapy).

Approximately 12 months
Number of Participants With Composite of Stroke, Systemic Embolism, ISTH Major Bleeding, or All-cause Mortality
Time Frame: Approximately 12 months
The assessment was based on the cause-specific hazard ratio (csHR), comparing asundexian with apixaban which is based on time to first event.
Approximately 12 months
Number of Participants With Composite of Disabling Stroke (mRS ≥ 3), Critical Bleeding, or All-cause Mortality
Time Frame: Approximately 12 months

The assessment was based on the cause-specific hazard ratio (csHR), comparing asundexian with apixaban which is based on time to first event.

Critical bleeding was defined as symptomatic bleeding in either of the following critical locations (intracranial, intraspinal, pericardial, intra-articular, or retroperitoneal) or as intraocular bleeding with compromised vision or intramuscular bleeding with compartment syndrome.

Approximately 12 months

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

December 5, 2022

Primary Completion (Actual)

January 31, 2024

Study Completion (Actual)

January 31, 2024

Study Registration Dates

First Submitted

November 30, 2022

First Submitted That Met QC Criteria

November 30, 2022

First Posted (Actual)

December 8, 2022

Study Record Updates

Last Update Posted (Estimated)

December 9, 2024

Last Update Submitted That Met QC Criteria

December 4, 2024

Last Verified

December 1, 2024

More Information

Terms related to this study

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

IPD Plan Description

Availability of this study's data will later be determined according to Bayer's commitment to the EFPIA/PhRMA "Principles for responsible clinical trial data sharing". This pertains to scope, timepoint and process of data access. As such, Bayer commits to sharing upon request from qualified researchers patient-level clinical trial data, study-level clinical trial data, and protocols from clinical trials in patients for medicines and indications approved in the US and EU as necessary for conducting legitimate research. This applies to data on new medicines and indications that have been approved by the EU and US regulatory agencies on or after January 01, 2014.

Interested researchers can use www.vivli.org to request access to anonymized patient-level data and supporting documents from clinical studies to conduct research. Information on the Bayer criteria for listing studies and other relevant information is provided in the member section of the portal.

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

Yes

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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