Analysis of Outcomes in Ischemic Vs Nonischemic Cardiomyopathy in Patients with Atrial Fibrillation a Report from the GARFIELD-AF Registry

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JAMA Cardiology | Original Investigation Analysis of Outcomes in Ischemic vs Nonischemic Cardiomyopathy in Patients With Atrial Fibrillation A Report From the GARFIELD-AF Registry

Ramon Corbalan, MD; Jean-Pierre Bassand, MD; Laura Illingworth, MSc; Giuseppe Ambrosio, MD, PhD; A. John Camm, MD; David A. Fitzmaurice, MD; Keith A. A. Fox, MBChB; Samuel Z. Goldhaber, MD, PhD; Shinya Goto, MD, PhD; Sylvia Haas, MD; Gloria Kayani, BSc; Lorenzo G. Mantovani, MSc; Frank Misselwitz, MD, PhD; Karen S. Pieper, MS; Alexander G. G. Turpie, MD; Freek W. A. Verheugt, MD; Ajay K. Kakkar, MBBS, PhD; for the GARFIELD-AF Investigators

Supplemental content IMPORTANCE Congestive heart failure (CHF) is commonly associated with nonvalvular atrial fibrillation (AF), and their combination may affect treatment strategies and outcomes.

OBJECTIVE To assess the treatment strategies and 1-year clinical outcomes of antithrombotic and CHF therapies for patients with newly diagnosed AF with concomitant CHF stratified by etiology (ischemic cardiomyopathy [ICM] vs nonischemic cardiomyopathy [NICM]).

DESIGN, SETTING, AND PARTICIPANTS The GARFIELD-AF registry is a prospective, noninterventional registry. A total of 52 014 patients with AF were enrolled between March 2010 and August 2016. A total of 11 738 patients 18 years and older with newly diagnosed AF (Յ6 weeks’ duration) and at least 1 investigator-determined stroke risk factor were included. Data were analyzed from December 2017 to September 2018.

EXPOSURES One-year follow-up rates of death, stroke/systemic embolism, and major bleeding were assessed.

MAIN OUTCOMES AND MEASURES Event rates per 100 person-years were estimated from the Poisson model and Cox hazard ratios (HRs) and 95% confidence intervals.

RESULTS The median age of the population was 71.0 years, 22 987 of 52 013 were women (44.2%) and 31 958 of 52 014 were white (61.4%). Of 11 738 patients with CHF, 4717 (40.2%) had ICM and 7021 (59.8%) had NICM. Prescription of oral anticoagulant and antiplatelet drugs was not balanced between groups. Oral anticoagulants with or without antiplatelet drugs were used in 2753 patients with ICM (60.1%) and 5082 patients with NICM (73.7%). Antiplatelets were prescribed alone in 1576 patients with ICM (34.4%) and 1071 patients with NICM (15.5%). Compared with patients with NICM, use of angiotensin-converting enzyme inhibitors/angiotensin receptor blockers (72.6% [3439] vs 60.3% [4236]) and of β blockers (63.3% [2988] vs 53.2% [3737]) was higher in patients with ICM. Rates of all-cause and cardiovascular death per 100 patient-years were significantly higher in the ICM group (all-cause death: ICM, 10.2; 95% CI, 9.2-11.1; NICM, 7.0; 95% CI, 6.4-7.6; cardiovascular death: ICM, 5.1; 95% CI, 4.5-5.9; NICM, 2.9; 95% CI, 2.5-3.4). Stroke/systemic embolism rates tended to be higher in ICM groups compared with NICM groups (ICM, 2.0; 95% CI, 1.6-2.5; NICM, 1.5; 95% CI, 1.3-1.9). Major bleeding rates were significantly higher in the ICM group (1.1; 95% CI, 0.8-1.4) compared with the NICM group (0.7; 95% CI, 0.5-0.9).

CONCLUSIONS AND RELEVANCE Patients with ICM received oral anticoagulants with or Author Affiliations: Author affiliations are listed at the end of this without antiplatelet drugs less frequently and antiplatelets alone more frequently than article. patients with NICM, but they received angiotensin-converting enzyme inhibitors/angiotensin Group Information: The receptor blockers more often than patients with NICM. All-cause and cardiovascular death GARFIELD-AF Investigators are listed rates were higher in patients with ICM than patients with NICM. at the end of this article. Corresponding Author: Ramon TRIAL REGISTRATION ClinicalTrials.gov identifier: NCT01090362 Corbalan, MD, Division of Cardiovascular Diseases, Catholic University School of Medicine, JAMA Cardiol. 2019;4(6):526-548. doi:10.1001/jamacardio.2018.4729 Marcoleta 367, Santiago 8330024, Published online May 8, 2019. Chile ([email protected]).

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ongestive heart failure (CHF) is commonly associated with atrial fibrillation (AF), and their combined presen- Key Points tation confers a worse prognosis than either condition C Question What are the management strategies and outcomes of 1 alone. Treatment of both conditions implies use of specific patients with nonvalvular atrial fibrillation and concomitant drugs for CHF plus antithrombotic agents for stroke preven- congestive heart failure (ischemic or nonischemic tion. In addition, management strategies and outcomes may cardiomyopathy)? be affected by the etiology of CHF, namely ischemic cardio- Findings In this cohort study of a registry that included 52 014 myopathy (ICM) or nonischemic cardiomyopathy (NICM) patients, patients with ischemic cardiomyopathy were less likely to because the prescription of antithrombotic therapies might receive oral anticoagulants with or without antiplatelet drugs and be different and could affect prognosis in terms of death, more likely to receive antiplatelet drugs alone than patients with stroke/systemic embolism (SE), and bleeding.2,3 The aim of nonischemic cardiomyopathy and had a worse outcome in terms our study was to assess the treatment strategies in terms of of all-cause and cardiovascular death. antithrombotic and CHF therapies and 1-year clinical out- Meaning There is a need for physicians to opt for improved comes in patients with newly diagnosed AF and concomitant adherence to guidelines-directed treatment of both atrial CHF stratified by etiology (ICM vs NICM) enrolled in the Global fibrillation and concomitant congestive heart failure, particularly Anticoagulant Registry in the Field–Atrial Fibrillation in patients with ischemic cardiomyopathy. (GARFIELD-AF) registry. Collection of follow-up data was performed every 4 months up to 12 months.4,5 Standardized definitions for clinical events 4,5 Methods have been reported previously. In brief, baseline characteristics and treatments and the incidences of death (cardiovas- The design of the GARFIELD-AF registry was reported cular and noncardiovascular), stroke/SE, and bleeding were re- previously.4,5 Briefly, men and women 18 years and older with corded. Submitted data were examined for completeness and AF diagnosed according to standard local procedures within accuracy by the coordinating center (Thrombosis Research In- the previous 6 weeks and with at least 1 nonprespecified risk stitute, London, England), and data queries were sent to study factor for stroke as judged by the local investigator and no val- sites. The GARFIELD-AF data are captured using an elec- vular disease were eligible for inclusion.5 Patients were en- tronic case report form. In accordance with the study proto- rolled prospectively and consecutively in 35 countries. When col, 20% of all electronic case report forms were monitored random site selection did not generate the required number against source documentation.6 Data for the analysis in this of sites in a given country, the national lead investigator was report were extracted from the study database on October 18, asked to recommend sites to make up the numbers (18 of 1317 2017. sites). The sites represent the different care settings in each par- ticipating country (office-based practice; hospital depart- Definitions ments, including neurology, cardiology, geriatrics, internal Heart failure was defined as current/prior history of CHF or left medicine, and emergency; anticoagulation clinics; and gen- ventricular ejection fraction (LVEF) of less than 40%. Conges- eral or family practice).4,5 Except for Egypt and South Africa, tive heart failure was diagnosed according to clinical criteria there were no other participant countries from Africa. at entry and classified according to the New York Heart Asso- Independent ethics committee and hospital-based insti- ciation (NYHA) functional class. Information about LVEF as- tutional review board approvals were obtained. The registry sessed by 2-dimensional echocardiography was available in is being conducted in accordance with the principles of the Dec- 73% of patients with CHF and was stratified as preserved LVEF laration of Helsinki, local regulatory requirements, and the In- when this was 40% or higher and as reduced LVEF when less ternational Conference on Harmonization–Good Pharmaco- than 40%. Ischemic cardiomyopathy was defined as patients epidemiological and Clinical Practice guidelines. Written with a history of coronary artery disease, including known informed consent was obtained from all study participants. chronic angina pectoris, previous myocardial infarction or un- Confidentiality and anonymity of all patients recruited into this stable angina, coronary artery bypass grafting, or previous per- registry are maintained. cutaneous coronary intervention with or without stenting. Nonischemic cardiomyopathy was the default diagnosis. Wors- Procedures and Outcome Measures ening HF was defined as progressive or acute decompensa- Baseline characteristics collected at inclusion in the registry tion of previously stable CHF.Vascular disease included coro- included medical history, care setting, type of AF, date and nary artery disease with a history of acute coronary syndromes method of diagnosis, symptoms, antithrombotic treatment (ie, and/or peripheral artery disease. Chronic kidney disease (CKD) vitamin K antagonists, nonvitamin K antagonist oral antico- was classified according to National Kidney Foundation guide- agulants, and antiplatelets [AP]), and all cardiovascular drugs. lines into moderate-to-severe (stages 3-5), mild (stages 1 and Race/ethnicity was classified by the investigator in agree- 2), or none. 5 ment with the patient. Data on components of the CHA2DS2- VASc and HAS-BLED risk stratification schemes were col- Statistical Analysis lected. The HAS-BLED scores were calculated excluding Continuous variables were expressed as medians and inter- fluctuations in international normalized ratio. quartile ranges (IQR) and categorical variables as frequencies

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and percentages. Because studies with large sample sizes are Prior stroke/transient ischemic attack was present in 5954 of prone to producing statistically significant findings in the pres- 52 007 patients (11.4%), history of bleeding in 1317 (2.5%), dia- ence of clinically irrelevant differences, no formal statistical betes in 11 540 (22.2%), and moderate-to-severe CKD in 5373 tests are performed for the baseline tables. Instead, clinical in- (11.7%). At enrollment, 4717 patients (9.1%) had ICM and 7021 terpretations are applied, and statistical tests are reserved for (13.5%) had NICM (eTable 1 in the Supplement). hypotheses of differences in outcomes. Compared with patients with NICM, patients with ICM All cohorts of patients had been followed up for a mini- were more frequently white (74.5% [3465 of 4651] vs 55.8% mum of 1 year. Thus, events and time to events are censored [3848 of 6897]) and less frequently non-Chinese Asian (12.8% at 365 days. Occurrence of major clinical outcomes was ex- [596] vs 29.5% [2035]), had a higher mean body weight (80.7 pressed as person-time event rates (per 100 person-years) and kg vs 77.2 kg), had a similar mean LVEF (45.9% vs 46.9%), had 95% confidence intervals. Person-year rates for the first oc- a higher rate of depressed LVEF (32.4% [1170 of 3606] vs 37.8% currence of the event of interest were estimated using a Pois- [1892 of 5005]), were less likely to have permanent or persis- son model, with the number of events as the dependent vari- tent AF (30.4% [1434 of 4717] vs 37.3% [2619 of 7021]), and more able and the log of time as an offset, ie, a covariate with a known frequently had NYHA class III/IV CHF (37.0% [1468 of 3964] coefficient of 1. vs 28.8% [1589 of 5533]). In addition, compared with patients Evaluation of 1-year outcomes by patients with ischemic vs with NICM, patients with ICM were more likely to have ca- nonischemic HF were performed both as unadjusted and ad- rotid occlusive disease (4.3% [199 of 4608] vs 2.4% [169 of justed analyses using Cox proportional hazards models. In ad- 6932]), history of stroke/transient ischemic attack (12.6% [596 dition to the unadjusted person-time event rates, the hazard ra- of 4717] vs 9.7% [684 of 7021]), hypertension (84.6% [3985 of tios with 95% confidence intervals are provided for both 4710] vs 73.1% [5121 of 7004]), hypercholesterolemia (55.7% unadjusted and adjusted results. Adjustment factors, as deter- [2530 of 4545] vs 34.0% [2303 of 6782]), type 2 diabetes (28.3% mined in previous models of the key outcomes, were age with [1335 of 4717] vs 20.2% [1415 of 7021]), and moderate-to- spline knots at 48, 65, 79, and 88 years; sex; race/ethnicity; severe CKD (16.2% [764 of 4717] vs 13.7% [960 of 7020]), had

smoking status; diabetes; hypertension; history of bleeding; a higher mean CHA2DS2-VASc score (4.4 vs 3.8), and were moderate-to-severe CKD; use of oral anticoagulation therapy treated more frequently in cardiology (74.5% [3514 of 4717] vs (OAC) at baseline; type of AF; and heavy use of alcohol. 68.5% [4812 of 7021]) (Table 1). The association of type of HF with outcomes in patients who used AP therapy was also of interest. The inclusion of the main Antithrombotic Therapies effect of AP alone vs AP therapy plus OAC and the interaction Oral anticoagulants alone or in combination with AP were pre- of ischemic vs NICM by AP alone vs AP plus OAC was evalu- scribed in fewer patients with ICM than patients with NICM ated in unadjusted and adjusted analyses. The adjustment fac- (alone: ICM, 31.5% [1443 of 4579]; NICM, 61.2% [4225 of 6898]; tors included those listed previously, except OAC use, which ap- combined: ICM, 60.1% [2753 of 4579]; NICM, 73.7% [5082 of pears in the treatment of interest. The test for interaction 6898]). Patients with ICM were more likely to receive AP alone specifies whether the association between patients with ICM and than patients with NICM (34.4% [1576 of 4579] vs 15.5% [1071 NICM varies according to treatment received. Hazard ratios with of 6898]). Dual AP therapy was given in 580 of 4681 patients 95% confidence intervals of the difference outcomes for pa- with ICM (12.4%) and in 103 of 6961 with NICM (1.5%). No an- tients with ICM vs NICM within each of the 2 treatment strate- tithrombotic drugs were prescribed in 250 of 4579 patients with gies are derived from this model. All statistical analyses were ICM (5.5%) and 745 of 6898 with NICM (10.8%) (Table 2). The performed using SAS, version 9.4 (SAS Institute), while forest prescription patterns were remarkably similar across the vari-

plots were created using SigmaPlot, version 12.5 (Microsoft). The ous categories of risk of stroke as defined by CHA2DS2-VASc log-rank test was used to compare the survival distribution rates score (0-1, 2-4, and >4), with OAC with or without AP rates ap- between ICM and NICM groups. A P value of less than .05 was proximately 60% in patients with ICM vs 70% in patients with considered statistically significant. NICM and AP only rates approximately 30% in patients with ICM vs 15% in patients with NICM (Figure 1). The prescription patterns were also mostly similar in cardiology, internal medi- Results cine, and primary care settings; the rates of AC with or without AP were approximately 60% for patients with ICM and 74% Baseline Characteristics for patients with NICM, and rates of AP were approximately The population of this study included all 5 cohorts of the 35% and 15%, respectively. There were too few patients in neu- GARFIELD-AF registry (eFigure 1 in the Supplement), total- rology and geriatrics settings to have a reliable picture of the ing 52 014 patients recruited between March 2010 and Au- prescription patterns (eFigure 2 in the Supplement). Lastly, in gust 2016 and followed up prospectively for a minimum of emergency departments, hospitals, and office settings, rates 1 year. Detailed baseline characteristics of the population are of AC with or without AP were approximately 60% in pa- reported in eTable 1 in the Supplement. The median age of the tients with ICM and 70% in patients with NICM, and rates of population was 71.0 years, and 22 987 of 52 013 (44.2%) were AP were approximately 30% and 15%, respectively. In antico- women. Concomitant CHF was present in 11 738 of 52 007 pa- agulation clinics, most patients received AC with or without tients (22.5%), coronary artery disease in 11 232 of 52 007 AP, primarily in the form of vitamin K antagonists (eFigure 3 (21.6%), and history of hypertension in 38 585 of 51 863 (73.4%). in the Supplement).

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Table 1. Baseline Characteristics of Patients With Ischemic Table 1. Baseline Characteristics of Patients With Ischemic and Nonischemic Cardiomyopathy and Nonischemic Cardiomyopathy (continued)

No. (%) No. (%) Ischemic Nonischemic Ischemic Nonischemic Cardiomyopathy Cardiomyopathy Cardiomyopathy Cardiomyopathy Characteristic (n = 4717) (n = 7021) Characteristic (n = 4717) (n = 7021) Sex Congestive heart failure NYHA class Male 2814 (59.7) 3892 (55.4) I 544 (13.7) 1281 (23.2) Female 1903 (40.3) 3128 (44.6) II 1952 (49.2) 2663 (48.1) Age at diagnosis, y III 1285 (32.4) 1348 (24.4) Mean (SD) 70.2 (10.6) 70.0 (12.3) IV 183 (4.6) 241 (4.4) Median (IQR) 71.0 (63.0-78.0) 71.0 (62.0-79.0) Unknown, No. 294 606 Race/ethnicity Coronary artery disease 4365 (92.5) NA White 3465 (74.5) 3848 (55.8) Acute coronary 1695 (36.7) NA Hispanic/Latino 150 (3.2) 557 (8.1) syndrome Afro-Caribbean 11 (0.2) 46 (0.7) Vascular disease 2200 (47.3) 327 (4.7) Asian (not Chinese) 596 (12.8) 2035 (29.5) Coronary artery bypass 490 (10.8) NA Chinese 337 (7.2) 267 (3.9) graft PCI with stenting 1041 (22.1) NA Mixed/other 92 (2.0) 144 (2.1) Carotid occlusive disease 199 (4.2) 169 (2.4) Height, cm Stroke/TIA 596 (12.6) 684 (9.7) Mean (SD) 167.7 (9.6) 165.5 (11.0) Systemic embolization 26 (0.6) 45 (0.6) Median (IQR) 168.0 (160.0-175.0) 165.0 (158.0-173.0) History of bleeding 160 (3.4) 193 (2.8) Weight, kg History of hypertension 3985 (84.6) 5121 (73.1) Mean (SD) 80.7 (18.7) 77.2 (21.4) Hypercholesterolaemia 2530 (55.7) 2303 (34.0) Median (IQR) 80.0 (68.0-92.0) 75.0 (62.0-90.0) Diabetes BMI Type 1 52 (1.1) 62 (0.9) Mean (SD) 28.6 (5.8) 28.0 (6.4) Type 2 1335 (28.3) 1415 (20.2) Median (IQR) 28.0 (25.0-32.0) 27.0 (24.0-31.0) Alcohol consumption Pulse, bpm Abstinent 2284 (55.3) 3411 (55.8) Mean (SD) 88.6 (25.1) 95.2 (27.6) Light 1456 (35.3) 1822 (29.8) Median (IQR) 82.0 (70.0-100.0) 90.0 (75.0-112.0) Moderate 317 (7.7) 667 (10.9) Systolic BP, mm Hg Heavy 70 (1.7) 216 (3.5) Mean (SD) 132.0 (19.7) 132.0 (20.9) Unknown, No. 590 905 Median (IQR) 130.0 (120.0-142.0) 130.0 (120.0-144.0) Smoker Diastolic BP, mm Hg No 2727 (62.0) 4229 (65.4) Mean (SD) 79.8 (12.7) 80.2 (14.1) Former smoker 1155 (26.3) 1473 (22.8) Median (IQR) 80.0 (70.0-90.0) 80.0 (70.0-90.0) Current smoker 518 (11.8) 769 (11.9) LVEF, % Chronic renal disease Mean (SD) 46.9 (14.1) 45.9 (15.3) I 816 (20.0) 1545 (24.9) Median (IQR) 48.0 (35.0-58.0) 45.0 (34.0-59.0) II 639 (15.6) 882 (14.2) LVEF category III 635 (15.5) 793 (12.8) <40% 1170 (32.4) 1892 (37.8) IV 95 (2.3) 129 (2.1) ≥40% 2436 (67.6) 3113 (62.2) V 34 (0.8) 38 (0.6) Care setting specialty at diagnosis None 1868 (45.7) 2821 (45.4) Internal medicine 794 (16.8) 1363(19.4) Moderate-to-severe CKD 764 (16.2) 930 (13.7) Cardiology 3514 (74.5) 4812 (68.5) CHA2DS2-VASc score Neurology 27 (0.6) 60 (0.9) Mean (SD) 4.4 (1.6) 3.8 (1.5) Geriatrics 9 (0.2) 43 (0.6) Median (IQR) 4.0 (3.0-5.0) 4.0 (3.0-5.0) Primary care/general 373 (7.9) 743 (10.6) HAS-BLED score practice Mean (SD) 1.8 (0.9) 1.4 (0.9) Type of AF diagnosed Median (IQR) 2.0 (1.0-2.0) 1.0 (1.0-2.0) Permanent 710 (15.1) 1126 (16.0) Persistent 724 (15.3) 1493 (21.3) Abbreviations: AF, atrial fibrillation; BMI, body mass index (calculated as weight in kilograms divided by height in meters squared); BP, blood pressure; Paroxysmal 1025 (21.7) 1395 (19.9) CKD, chronic kidney disease; IQR, interquartile range; LVEF, left ventricular New onset 2258 (47.9) 3007 (42.8) ejection fraction; NA, not applicable; NYHA, New York Heart Association; (unclassified) PCI, percutaneous coronary intervention; TIA, transient ischemic attack. (continued)

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Table 2. Baseline Treatments (GARFIELD-AF Cohorts 1 to 5) and AF Treatment of AF Management at Diagnosis (GARFIELD-AF Cohorts 3 to 5) Complete information about treatment and drug therapies of AF were available for the last 3 cohorts of 34 854 patients No. (%) (Table 2), of whom 3332 had ICM and 4459 had NICM. Rate con- Ischemic Nonischemic Treatment Cardiomyopathy Cardiomyopathy trol was attempted more frequently than rhythm control in Cohorts 1 to 5 both groups. The uptake of antiarrhythmic drugs was mostly No. 4717 7021 similar in both groups, except that class 3 drugs were more fre- Antithrombotic drugs quently used in patients with ICM. Cardioversion was at- AC 1443 (31.5) 4225 (61.2) tempted in a minority of patients, at a similar rate in both AC with or without AP 2753 (60.1) 5082 (73.7) groups. Patients with NICM were more likely to receive elec- VKA 880 (19.2) 2440 (35.4) tric cardioversion than patients with ICM. VKA+AP 887 (19.4) 627 (9.1) FXA 391 (8.5) 1342 (19.5) HF Drugs FXA+AP 318 (6.9) 173 (2.5) The use of angiotensin-converting enzyme inhibitors or angio- DTI 172 (3.8) 443 (6.4) tensin receptor blockers was higher in patients with ICM vs pa- DTI+AP 105 (2.3) 57 (0.8) tients with NICM (72.9% [3439 of 4717] vs 60.3% [4236 of 7021]). AP only 1576 (34.4) 1071 (15.5) The same was observed for β-blocker use (63.3% [2988 of 4717] None 250 (5.5) 745 (10.8) vs 53.2% [3737 of 7021], respectively). The use of mineralocor- Unknown, No. 138 123 ticoid receptor antagonists, loop diuretics, and digoxin and other Heart failure/hypertension digitalis was similar between the 2 groups (Table 2). drugs ACEi/ARBs 3439 (72.9) 4236 (60.3) Clinical Outcomes at 1-Year Follow-up β-Blockers 2988 (63.3) 3737 (53.2) Incidence rates per 100 person-years of all-cause and cardio- Loop and other diuretics 2753 (58.4) 3897 (55.5) vascular death were significantly higher in patients with ICM MRA 979 (20.8) 1225 (17.4) compared with NICM (all-cause death: ICM, 10.2; 95% CI, 9.2- Digoxin and other digitalis 471 (10.0) 662 (9.4) 11.1; NICM, 7.0; 95% CI, 6.4-7.6; P <.001; cardiovascular death: Other drugs of interest ICM, 5.1; 95% CI, 4.5-5.9; NICM, 2.9; 95% CI, 2.5-3.4; P <.001) Oral antidiabetics 461 (13.8) 416 (9.3) (Table 3 and Figure 2A). Rates of noncardiovascular death were Insulin 241 (7.2) 153 (3.4) similar in both cardiomyopathy groups. α-Blockers 98 (2.9) 131 (2.9) Incidence rates of stroke/SE tended to be higher in the ICM Cohorts 3 to 5 group (2.0; 95% CI, 1.6-2.5) compared with the NICM group (1.5; No. 3332 4459 95% CI, 1.3-1.9). Incidence rates of major bleeding were sig- AF treatment/strategy initiated nificantly higher in the ICM group than in the NICM group. New None declared 194 (6.0) 398 (9.2) acute coronary syndromes occurred at a significantly higher Rhythm control 1111 (34.5) 939 (21.7) rate in the ICM group (1.9; 95% CI, 1.5-2.3) compared with the Rate control 1262 (39.2) 2197 (51.0) NICM group (0.7; 95% CI, 0.6-1.0). Worsening CHF occurred Both 651 (20.2) 777 (18.0) at similar rates in both ICM and NICM groups. Unknown, No. 114 148 The most frequent classified causes of cardiovascular death Cardioversion were CHF, unwitnessed/sudden death, and myocardial infarc- No 2815 (86.5) 3787 (88.4) tion, which tended to be balanced in the 2 CHF groups. The Yes 440 (13.5) 498 (11.6) causes of deaths classified as noncardiovascular were also bal- Currenta 124 (33.8) 234 (62.4) anced between the ICM and NICM groups and were mostly Pharmacologicala 242 (66.1) 141 (37.6) linked to malignancy, respiratory failure, and infection/sepsis. Antiarrhythmic drugs Nevertheless, there was some imbalance in the rates of other Class Ia 22 (0.7) 22 (0.5) and undetermined causes of death between the 2 groups; in par- Class Ic 59 (1.8) 113 (2.5) ticular, the rate of undetermined cause of death was substan- Class II (β-blockers) 1492 (44.8) 1842 (41.3) tially higher in ICM group (eTable 2 in the Supplement). Class III 568 (17.1) 358 (8.0) Class IV (calcium-channel 395 (11.9) 608 (13.6) AP Therapy and 1-Year Clinical Outcomes blocker) The adjusted hazard ratios for ICM vs NICM in patients who Class V (digoxin and other 624 (18.7) 939 (21.1) digitalis) received AP therapy and in patients who did not receive AP therapy at enrollment are presented for mortality, stroke/SE, Abbreviations: AC, anticoagulants; ACEi/ARB, angiotensin-converting enzyme inhibitor/angiotensin receptor blocker; AF, atrial fibrillation; AP, antiplatelets; and major bleeding in Figure 2B. Ischemic cardiomyopathy was DTI, direct thrombin inhibitor; FXaI, factor Xa inhibitor; MRA, mineralocorticoid significantly associated with higher rates of all-cause death, receptor antagonist; VKA, vitamin K antagonist. cardiovascular death, and major bleeding in patients who did a Patients submitted to cardioversion during the first month after inclusion in not receive AP therapy at enrollment. No such excess of risk GARFIELD-AF. Patients who underwent both current and pharmacologic cardioversion are not reported here. in ICM vs NICM was observed among patients who received AP therapy.

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Figure 1. Percentage of Prescription of Anticoagulants and Antiplatelets (AP) and Their Combination in

Ischemic Cardiomyopathy (ICM) and Nonischemic Cardiomyopathy (NICM) According to CHA2DS2-VASc Score

100

VKA 80 FXa/DTI VKA + AP FXa/DTI + AP 60 AP None

Patients, % 40

0 NICM ICM NICM ICM NICM ICM CHA2DS2-VASc CHA2DS2-VASc CHA2DS2-VASc CHA2DS2-VASc CHA2DS2-VASc CHA2DS2-VASc Score Score Score Score Score Score DTI indicates direct thrombin 0 (n = 360) 0-1 (n = 82) 2-4 (n = 4200) 2-4 (n = 2345) >4 (n = 2235) >4 (n = 2044) inhibitor; FXA, factor Xa inhibitor; VKA, vitamin K anticoagulation.

Table 3. Incidence Rates per 100 Person-Years of Clinical Outcomes at 1-Year Follow-up

Ischemic Cardiomyopathy Nonischemic Cardiomyopathy Variable (n = 4717) (n = 7021) P Valuea All-cause mortality No. (%) 443 (9.4) 456 (6.5) NA Incidence rate (95% CI) 10.2 (9.2-11.1) 7.0 (6.4-7.6) <.001 Cardiovascular mortality No. (%) 224 (4.7) 191 (2.7) NA Incidence rate (95% CI) 5.1 (4.5-5.9) 2.9 (2.5-3.4) <.001 Noncardiovascular mortality No. (%) 102 (2.2) 157 (2.2) NA Incidence rate (95% CI) 2.3 (1.9-2.9) 2.4 (2.1-2.8) .84 Undetermined cause of mortality No. (%) 117 (2.5) 108 (1.5) NA Incidence rate (95% CI) 2.7 (2.2-3.2) 1.7 (1.4-2.0) <.001 Stroke/SE No. (%) 87 (1.8) 99 (1.4) NA Incidence rate (95% CI) 2.0 (1.6-2.5) 1.5 (1.3-1.9) .06 Major bleeding No. (%) 46 (1.0) 44 (0.6) NA Incidence rate (95% CI) 1.1 (0.8-1.4) 0.7 (0.5-0.9) .03 New ACS No. (%) 81 (1.7) 48 (0.7) NA

Incidence rate (95% CI) 1.9 (1.5-2.3) 0.7 (0.6-1.0) <.001 Abbreviations: ACS, acute coronary Worsening CHF syndrome; CHF, chronic heart failure; NA, not applicable; SE, systemic No. (%) 265 (5.6) 444 (6.3) NA embolism. Incidence rate (95% CI) 6.3 (5.6-7.1) 7.1 (6.5-7.8) .79 a P value is log-rank test.

fer in terms of outcome, with higher rates of death, major bleed- Discussion ing, and new acute coronary syndromes. The known causes of cardiovascular death were proportionally mostly similar in The main findings of this study are that patients with ICM and both groups, including death from ischemic stroke (eTable 2 patients with NICM and concomitant AF substantially differ in the Supplement). in terms of baseline characteristics, functional impairment, LV In patients without AF, a higher risk of death in patients function impairment, and treatments that may be signifi- with ICM compared with patients with NICM was inconsis- cantly associated with outcomes. They also significantly dif- tently reported in observational studies, in retrospective analy-

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Figure 2. Unadjusted and Adjusted Hazard Ratios (HRs) for 1-Year Outcomes

A 1-y Clinical outcomes B ICM vs NICM by receipt of AP therapy Increased Increased Increased Increased Risk With Risk With Risk With Risk With Factor HR (95% CI) NICM ICM Factor HR (95% CI) NICM ICM Stroke/SE Stroke Unadjusted 1.32 (0.99-1.76) Treated with AP 0.74 (0.43-1.27) Adjusted 1.23 (0.91-1.65) Not treated with AP 1.40 (0.95-2.06) Major bleeding Major bleeding Unadjusted 1.57 (1.04-2.37) Treated with AP 1.69 (0.33-8.76) Adjusted 1.63 (1.06-2.50) Not treated with AP 1.61 (1.02-2.53) All-cause death All-cause death Unadjusted 1.46 (1.28-1.66) Treated with AP 1.14 (0.87-1.49) Adjusted 1.35 (1.18-1.54) Not treated with AP 1.72 (1.45-2.04) Cardiovascular death Cardiovascular death Unadjusted 1.76 (1.45-2.13) Treated with AP 1.17 (0.78-1.74) Adjusted 1.61 (1.32-1.97) Not treated with AP 2.15 (1.67-2.77) Noncardiovascular death Noncardiovascular death Unadjusted 0.98 (0.76-1.25) Treated with AP 0.88 (0.55-1.41) Adjusted 0.83 (0.65-1.08) Not treated with AP 1.01 (0.72-1.41) New ACS Undetermined cause of mortality Unadjusted 2.54 (1.78-3.63) Treated with AP 1.58 (0.89-2.82) Adjusted 2.12 (1.47-3.06) Not treated with AP 1.94 (1.39-2.70) New or worsening CHF Unadjusted 0.97 (0.78-1.21) Adjusted 0.86 (0.69-1.08)

0.1 1 10 0.1 1 10 HR (95% CI) HR (95% CI)

A, Unadjusted and adjusted HRs for clinical outcomes at 1 year. Rates were according to antiplatelet (AP) treatment. Rates were adjusted for age, sex, adjusted for age, sex, race/ethnicity, smoking, diabetes, hypertension, history of race/ethnicity, smoking, diabetes, hypertension, history of bleeding, bleeding, moderate-to-severe kidney disease, type of medication, type of atrial moderate-to-severe kidney disease, type of atrial fibrillation, and heavy alcohol fibrillation, and heavy alcohol use. B, Adjusted HRs for patients with ischemic use. ACS indicates acute coronary syndrome; CHF, congestive heart failure; cardiomyopathy (ICM) vs patients with nonischemic cardiomyopathy (NICM) SE, systemic embolism.

ses of hospital records, and in reviews of randomized clinical tion (about two-thirds of patients with CHF had preserved trials.7-13 The discrepancies between reports were thought to LVEF,but patients with ICM had higher rates of reduced LVEF), be associated with inconsistency in diagnosing ischemic CHF and higher rates of comorbidities, particularly coronary ar- in the absence of rigorous discriminant definitions of ische- tery disease and CKD, which might have contributed to a worse mic and nonischemic CHF, with patient selection, or with im- prognosis. Treatment strategy of AF and use of antiarrhyth- balance in baseline characteristics, with more severe comor- mic drugs were mostly similar in both groups, but there was bidities in ischemic vs nonischemic CHF.10 The poorer some imbalance between the 2 groups regarding rate or rhythm prognosis of ICM was attributed to differences in structural al- control and use of class 3 antiarrhythmic drugs. Antithrom- terations between the 2 entities, with more regional wall mo- botic therapy was suboptimal in the ICM group compared with tion abnormalities, asynchrony of LV contraction, extensive the NICM group, as shown by a much lower rate of anticoagu- scar tissue, and poorer LV compliance in addition to a greater lation with or without AP therapy and, consequently, a high extent of coronary artery disease and residual ischemia in ICM rate of AP alone prescription even in patients without indica- vs NICM.14 tion for AP therapy, as already reported17 (Table 2). This may A limited number of reports addressed the outcome of pa- have had a detrimental effect on the risk of death because an- tients with CHF and concomitant AF. They showed that con- ticoagulation was shown to be associated with a substantial comitant AF was associated with a higher risk of death in ICM reduction of the risk of death in previous reports.18,19 In the only.2,3 Atrial fibrillation in patients with ischemic heart dis- Reduction of Atherothrombosis for Continued Health Regis- ease may contribute to impaired myocardial perfusion, coro- try (REACH) trial,20 where the incidence of AF in patients with nary vasoconstriction, and further deterioration of diastolic coronary artery disease was 12.5%, it was shown that only 53% function. In addition, impaired myocardial perfusion is asso- of these patients were given anticoagulation therapy whereas ciated with electrical instability and a higher risk of sudden 40% were receiving AP agents alone. Additionally, there were death.15,16 higher rates of heart failure and cardiovascular death in the AF In this report, patients with ICM had more advanced de- population than in the non-AF population. terioration of their cardiac condition, as shown by a higher The reasons for inadequate antithrombotic treatment in the NYHA functional class, a higher rate of depressed LV func- ICM group remain to be determined. These patients, often el-

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derly, need treatments for stroke prevention, heart failure, and may explain the higher risk of major bleeding in patients with coronary disease, resulting in an extensive list of drugs, which ICM in this study. may deter the physician from prescribing them all and deter the Finally, to our knowledge, this study is the first to assess the patient from complying with the prescription.21 Physicians’ ad- outcomes of ICM and NICM in patients with AF from an unse- herence to guideline recommendations remains a matter of lected prospective registry population representative of real life. debate.22,23 In a previous report of the GARFIELD registry,19 phy- Ischemic cardiomyopathy carried a poorer prognosis than NICM sicians’ decision was the most common reason for not prescrib- in terms of all-cause and cardiovascular death. It was also as- ingOACsinpatientswithAF.Lackofadherencemayhaveplayed sociated with a substantial but not significant excess of stroke/SE a role because the implementation of guidelines was shown to and significantly higher risk of bleeding. In addition, patients have a favorable association with outcomes in other settings.24,25 with ICM were suboptimally treated with regards to stroke pro- In this context, an intriguing fact needs to be mentioned. In pa- phylaxis, which may have affected outcomes. Polypharmacy tients who did not receive AP therapy, the risks of all-cause and and/or poor adherence to guideline-recommended therapies cardiovascular death as well as the risk of major bleeding were may explain the inadequacy of treatment in ischemic CHF. significantly higher in those with ICM than in those with NICM; in contrast, in patients who did receive AP therapy, there was Limitations no excess of events in those with ICM (Figure 2B). This tends Our study had limitations. Ischemic cardiomyopathy was not to confirm that AP therapy is associated with a more positive defined by the investigator but retrospectively based on the outcome in patients with ischemic heart disease. However, these history of coronary artery disease (ie, known chronic angina data were generated from a nonprespecified subgroup analy- pectoris, previous myocardial infarction or unstable angina, sis. As such, no firm conclusions can be derived, and these data coronary artery bypass grafting, or previous percutaneous coro- are only hypothesis generating. nary intervention with or without stenting), low LVEF, and There was a substantial but not significant excess of signs/symptoms of CHF.Nevertheless, we cannot rule out that stroke/SE and a significant excess of major bleeding risks in pa- some patients in the NICM group had ischemic heart disease. tients with ICM compared with patients with NICM (Table 3 The population included in this analysis is mostly made of and Figure 2A). Congestive heart failure without AF is associ- white and Asian individuals, so the results may not be rel- ated with a higher risk of stroke, and the combination of evant for other racial/ethnic groups. CHF and AF further increases this risk irrespective of LV function (preserved or depressed) or of etiology (ischemic or nonischemic).26-28 A higher mean CHA DS -VASc score and a 2 2 Conclusions higher incidence of carotid artery disease in the ICM group may also explain the excess of stroke/SE. Furthermore, as already More than 22% of the population of patients with newly diag- mentioned, stroke prophylaxis was suboptimal in the ICM nosed AF included in the GARFIELD-AF registry had concomi- group, where twice as many patients received AP therapy alone tant CHF, of whom around 40% had ICM. They were subop- compared with the NICM group. In addition, prescribing rates timally given anticoagulation therapy and more often received of OAC alone or in combination with AP therapy were substan- AP therapy alone or in combination with anticoagulants. These tially lower in patients with ICM than in those with NICM patients had worse outcomes than patients with NICM in terms (Table 2). These prescription patterns were observed irrespec- of all-cause and cardiovascular death despite the fact that they

tive of CHA2DS2-VASc score, medical specialty, and care set- were more likely to receive angiotensin-converting enzyme in- ting. Combination therapy is known to increase the risk of hibitors/angiotensin receptor blockers than patients with NICM. bleeding,29,30 and AP therapy alone does not confer any pro- These findings should prompt physicians to opt for active treat- tection against stroke/SE but increases bleeding risk.31,32 This ment of both AF and CHF, particularly in patients with ICM.

ARTICLE INFORMATION (Goto); Formerly at Klinikum rechts der Isar, Acquisition, analysis, or interpretation of data: Accepted for Publication: December 7, 2018. Technical University of Munich, Munich, Germany Illingworth, Ambrosio, Camm, Fitzmaurice, Goto, (Haas); Center for Public Health Research, Kayani, Mantovani, Pieper, Turpie. Published Online: May8,2019. University of Milan Bicocca, Monza, Italy Drafting of the manuscript: Corbalan, Bassand, doi:10.1001/jamacardio.2018.4729 (Mantovani); Bayer AG Pharmaceuticals, Berlin, Goldhaber, Verheugt. Author Affiliations: Division of Cardiovascular Germany (Misselwitz); Duke Clinical Research Critical revision of the manuscript for important Diseases, Catholic University School of Medicine, Institute, Durham, North Carolina (Pieper); intellectual content: Illingworth, Ambrosio, Camm, Santiago, Chile (Corbalan); University of Besançon, McMaster University, Hamilton, Ontario, Canada Fitzmaurice, Fox, Goldhaber, Goto, Haas, Kayani, Besançon, France (Bassand); Thrombosis Research (Turpie); Onze Lieve Vrouwe Gasthuis, Amsterdam, Mantovani, Misselwitz, Pieper, Turpie, Kakkar. Institute, London, England (Bassand, Illingworth, the Netherlands (Verheugt); University College Statistical analysis: Illingworth, Goldhaber, Kayani, Pieper); University of Perugia School of London, London, United Kingdom (Kakkar). Mantovani, Pieper. Medicine, Perugia, Italy (Ambrosio); St George’s Author Contributions: Dr Pieper had full access to Obtained funding: Goto, Misselwitz, Kakkar. University of London, London, England (Camm); all of the data in the study and takes responsibility Administrative, technical, or material support: Warwick Medical School, University of Warwick, for the integrity of the data and the accuracy of the Fitzmaurice, Goldhaber, Goto, Turpie, Kakkar. Coventry, England (Fitzmaurice); Edinburgh data analysis. Study supervision: Corbalan, Bassand, Camm, University, Edinburgh, Scotland (Fox); Brigham and Study concept and design: Corbalan, Bassand, Fitzmaurice, Goldhaber, Haas, Kayani, Mantovani, Women’s Hospital and Harvard Medical School, Ambrosio, Camm, Fox, Goldhaber, Haas, Misselwitz, Verheugt, Kakkar. Boston, Massachusetts (Goldhaber); Tokai Mantovani, Misselwitz, Turpie, Verheugt, Kakkar. Conflict of Interest Disclosures: Dr Camm has University School of Medicine, Kanagawa, Japan received grants and personal fees from Bayer and

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Boehringer Ingelheim as well as personal fees from A. John Camm, Chair; University of Besançon, United Kingdom: David Fitzmaurice; Daiichi Sankyo and Pfizer/Bristol-Myers Squibb. Besançon, France: Jean-Pierre Bassand; Harvard Harvard Medical School, Brigham and Dr Fox has received grants and personal fees from Medical School, Brigham and Women’s Hospital, Women’s Hospital, Boston, Massachusetts, Bayer/Janssen Pharmaceutica, grants from Boston, Massachusetts, US; Samuel Z. Goldhaber; US: Samuel Z. Goldhaber. AstraZeneca, and personal fees from Sanofi/ Formerly Haemostasis and Thrombosis Research GARFIELD-AF National Investigators: Regeneron and Verseon. Dr Goldhaber has received Group, Institute for Experimental Oncology and China research support from BiO2 Medical, Boehringer Therapy Research, Technical University of Munich, Ingelheim, Bristol-Myers Squibb, BTG EKOS Munich, Germany: Sylvia Haas; Thrombosis Peking University People’s Hospital, Beijing: Yihong Corporation, Daiichi Sankyo, Janssen Research Institute, United Kingdom: Gloria Kayani; Sun, Dayi Hu, Lei Li, and Wenling Liu; Southwest Pharmaceutica, the National Heart, Lung, and University of Milano-Bicocca, Milan, Italy: Lorenzo Hospital, Third Military Medical University, Blood Institute, and the Thrombosis Research G. Mantovani. Audit Committee: University of Chongqing, China: Kangning Chen and Hong Zhai; Institute and has consulted for Agile Medical, Bayer, Edinburgh, Edinburgh, United Kingdom: Keith A. A. Beijing 301 Hospital, Beijing, China: Yusheng Zhao Boehringer Ingelheim, Bristol-Myers Squibb, Daiichi Fox; (Mayo Clinic, Rochester, Minnesota, US: and Ran Zhang; The First Affiliated Hospital of Sankyo, Janssen Pharmaceutica, Portola Bernard J. Gersh. GARFIELD-AF National Wenzhou Medical College, Wenzhou, China: Huaiqin Pharmaceuticals, and Soleno Therapeutics. Dr Goto Coordinators: Universidad Nacional de Tucumán, Zhang and Xiao Chen; The First Affiliated Hospital, has received grants from Bristol-Myers Squibb, the San Miguel de Tucuman, Tucuman, Argentina: School of Medicine, Zhejiang University, Hangzhou, Japanese Ministry of Education, Culture, Sports, Hector Lucas Luciardi; The Alfred Hospital, China: Tingting Liu, Jiyan Chen, Wang, and Science and Technology/Japan Society for the Melbourne, Victoria, Australia: Harry Gibbs; Xiaosheng Hu; Nanfang Hospital of Southern Medical Promotion of Science, Ono Pharmaceutical, Sanofi, Medizinische Universität Graz Klinische Abteilung University, Guangzhou, China: Qiong Zhan, Shiping and Pfizer. Dr Haas has received personal fees from für Angiologie, Graz, Austria: Marianne Brodmann; Cao, Jingshan Yang, and Xingfu Huang; Union Aspen Medical Products, Bayer, Bristol-Myers AZ KLINA, Cardiology, Brasschaat, Belgium: Frank Hospital of Tongji Medical College of Huazhong Squibb, Daiichi Sankyo, Portola Pharmaceuticals, Cools; Hospital das Clínicas da Faculdade de Science and Technology University, Wuhan, China: and Sanofi. Dr Kayani has received grants from Medicina da USP, Sao Paulo, Sao Paulo, Brazil: Ting Yu and Daowen Wang; Fuwai Hospital, Beijing, Bayer. Dr Mantovani has received grants and Antonio Carlos Pereira Barretto; McMaster China: Qian Zhang, Yuejin Yang, Zhicheng Jing, personal fees from Bayer and Boehringer University, Hamilton, Ontario, Canada: Stuart J. Xiaoliang Luo, and Xiaojin Gao; The First Affiliated Ingelheim, grants from Daiichi Sankyo, and personal Connolly; McMaster University, Hamilton, Ontario, Hospital of Xiamen University, Xiamen, China: fees from Pfizer. Dr Misselwitz is employed by and Canada: John Eikelboom; Pontificia, Universidad Weihua Li and Wuyang Zheng; Daqing Oilfield owns stock in Bayer. Dr Turpie has received Catolica, Santiago, Chile: Ramon Corbalan; National General Hospital, Daqing, China: Yanhong Li, Hui Li, personal fees from Bayer and the Thrombosis Center for Cardiovascular Disease, Chinese and Hongying Yu; The Second Affiliated Hospital of Research Institute. Dr Kakkar has received grants Academy of Medical Sciences and Peking Union Chongqing Medical University, Chongqing, China: and personal fees from Bayer as well as personal Medical College, Beijing, China: Zhi-Cheng Jing; Yuehui Yin, Xianbin Lan, and Bei Zhou; The First fees from Boehringer Ingelheim, Daiichi Sankyo, University Hospital Motol, Prague, Czech Republic: Affiliated Hospital of Liaoning Medical University, Janssen Pharmaceutica, Sanofi, and Verseon. No Petr Jansky; Bispebjerg and Frederiksberg Hospital, Jinzhou, China: Ge Tian, Guizhou Tao, and Xiaojing other disclosures were reported. Denmark: Jørn Dalsgaard Nielsen; National Heart Shi; China-Japan Union Hospital of Jilin University, Changchun, China: Ping Yang and Bing Li; Renji Funding/Support: This work was supported by an Institute, Cairo, Egypt: Hany Ragy; Tampere University Hospital, Tampere, Finland: Pekka Hospital Shanghai Jiaotong University School of unrestricted research grant from Bayer AG, Berlin, Medicine, Shanghai, China: Yingmin Chen; Northern Germany, to Thrombosis Research Institute, Raatikainen; Georges Pompidou Hospital, Paris, France: Jean-Yves Le Heuzey; Vivantes Neukoelln Jiangsu People’s Hospital, Yangzhou, China: Shenghu London, United Kingdom, which sponsors the He and Yi Zhang; China-Japan Friendship Hospital, GARFIELD-AF registry. Medical Center, Berlin, Germany: Harald Darius; Hungarian Institute of Cardiology, Budapest, Beijing, China: Yong Wang and Jing Li; Sir Run Run Role of the Funder/Sponsor: The funding source Hungary: Matyas Keltai; Sir Ganga Ram Hospital, Shaw Hospital, Hangzhou, China: Yang Ye, Guosheng had no role in the design and conduct of the study; Delhi, India: Jitendra Pal Singh Sawhney; University Fu, and Xia Sheng; Jinzhou Central Hospital, Jinzhou, collection, management, analysis, and of Perugia School of Medicine, Perugia, Italy: China: Xin Li; Guangzhou Red Cross Hospital, interpretation of the data; preparation, review, or Giancarlo Agnelli; University of Perugia School of Guangzhou, China: Jin Chen and Tongguo Wu; The approval of the manuscript; and decision to submit Medicine, Perugia, Italy: Giuseppe Ambrosio; Osaka Second Affiliated Hospital of Nanchang University, the manuscript for publication. National Hospital, Osaka, Japan: Yukihiro Nanchang, China: Xiaoshu Cheng, Juxiang Li, and Group Information: The GARFIELD-AF Koretsune; Instituto de Cardiologia y Medicina Jianhua Yu; Peking Union Medical College Hospital, Investigators are: Global Steering Committee: Vascular, TecSalud, Tecnológico de Monterrey, Beijing, China: Ruiyi Xu and Xiaowei Yan; Baotou University College London, London, United Monterrey, Mexico: Carlos Jerjes Sánchez Díaz; Central Hospital, Baotou, China: Ruiping Zhao, Kingdom: Ajay K. Kakkar; Chair; University of Institute Maastricht, Maastricht University Medical Yangyang Liu, and Rina Wu; Haikou City People’s Besançon, Besançon, France: Jean-Pierre Bassand; Center, Maastricht, the Netherlands: Hugo Ten Hospital, Haikou, China: Tianyi Ma, Yixue Zhang, St George’s University of London, London, United Cate; Oslo University Hospital, Oslo, Norway: Dan Moshui Chen, Zhihong Zhou, and Xiaoai He; The Kingdom: A. John Camm; University of Warwick, Atar; Institute of Cardiology, Warsaw, Poland: Second Xiangya Hospital of Central South University, Coventry, United Kingdom: David A. Fitzmaurice; Janina Stepinska; Atherothrombosis Clinical Changsha, China: Li Wang, Chuanfang Cheng, Harvard Medical School, Brigham and Women’s Problems Laboratory, Cardiology Research and Longgen Xiong, and Zhicheng Lu; Shantou Central Hospital, Boston, Massachusetts: Samuel Z. Production Center, Moscow, Russia: Elizaveta Hospital, Shantou, China: Ping Chen and Ying Wang; Goldhaber; Tokai University School of Medicine, Panchenko; National University Heart Centre, The Second Affiliated Hospital of Soochow Kanagawa, Japan: Shinya Goto; Formerly Singapore: Toon Wei Lim; University of the University, Suzhou, China: Yang Jiao and Xinyi Zhu; Haemostasis and Thrombosis Research Group, Witwatersrand, Johannesburg, South Africa: Hunan Province People’s Hospital, Changsha, China: Institute for Experimental Oncology and Therapy Barry Jacobson; University College of Medicine, Qinghua Fu, Qin Yang, Na Li, Ying Guo, Jianqiang Research, Technical University of Munich, Munich, Seoul, South Korea: Seil Oh; Hospital de la Santa Peng, and Qiong Xie; General Hospital of Ningxia Germany: Sylvia Haas; University Hospital of Creu i Sant Pau, Barcelona, Spain: Xavier Viñolas; Medical University, Yinchuan, China: Weina Guo, Heidelberg, Heidelberg, Germany: Werner Hacke; Karolinska Institutet, Stockholm, Sweden: Marten Ruhua He, Li Xue, and Guoshan Zhang; and Second University of Milano-Bicocca, Milan, Italy: Lorenzo Rosenqvist; University Hospital Zurich, Zurich, Affiliated Hospital of Shanxi University, Taiyuan, G. Mantovani; Bayer AG, Berlin, Germany: Frank Switzerland: Jan Steffel; Ramathibodi Hospital, China: Shuai Feng, Lingli Yang, Zhiming Yang, and Misselwitz; Duke Clinical Research Institute, Mahidol University, Bangkok, Thailand: Pantep Chunlin Bai. Durham, North Carolina, US: Karen S. Pieper; Angchaisuksiri; Hacettepe University Faculty of India McMaster University, Hamilton, Ontario, Canada: Medicine, Ankara, Turkey: Ali Oto; National Sujata Birla Hospital & Medical Research Centre, Alexander G. G. Turpie; Bayer AG, Berlin, Germany: Scientific Center, MD Strazhesko Institute of Nashik, India: Priyanka Dhakrao and Praveen Jadhav; Martin van Eickels; Onze Lieve Vrouwe Gasthuis, Cardiology, Kiev, Ukraine: Alex Parkhomenko; Lalitha Super Speciality Hospital, Guntur, India: Amsterdam, the Netherlands: Freek W. A. Heart and Vascular Institute, Cleveland Clinic, Raghava Sarma and Naga Malleswara Rao; Shree Verheugt. 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Society's Dr Prabhakar Kore Hospital and Hakusan-shi, Japan: Hiroyuki Oda; Shuwakai Shuwa Kagoshima-shi, Japan: Yoshihiko Atsuchi; Nagoshi Medical Research Centre, Belgaum, India: James Kot General Hospital, Kasukabe-shi, Japan: Susumu Naika, Miyazaki-shi, Japan: Toshiro Nagoshi; Ojukai and Veerappa Annasaheb Kothiwale and Kinjal Shah Adachi; Hoyukai Chitose Hoyukai Hospital, Sanno Naika, Aira-shi, Japan: Kazuhisa Sanno; and Vineeta Dhyani; Chinmaya Narayana Institute of Chitose-shi, Japan: Kei Chiba; Yuaikai Oda Regional Karinkai Murakamikarindoh Hospital, Fukuoka-shi, Neuroscience, Bangalore, India: Sudheer Garapati Medical Center, Kashima-shi, Japan: Hiroaki Norita; Japan: Fumihiro Hoshino; Yokota Naika, and Bagirath Raghuraman and Ayyappa N and Tsuruta Naika Junkankika Clinic, Saga-shi, Japan: Miyazaki-shi, Japan: Naoto Yokota; Kanoya Medical Subramani Krishnappa; Vijan Cardiac and Critical Makoto Tsuruta; Koyanagi Naika Junkankika Clinic, Center Citizens' Health Plaza, Kanoya-shi, Japan: Care, Nashik, India: Vinod Madan Vijan and Mahesh Tosu-shi, Japan: Takeshi Koyanagi; Yamamoto Heart Masahiro Kameko; Tabuchi Naika Junkankika, Dargude; Sir Gangaram Hospital, New Delhi, India: Clinic, Kurume-shi, Japan: Kunihiko Yamamoto; Ando Kikuchi-gun, Japan: Toshifumi Tabuchi; Ishizawa Jitendra Sawhney and Somya Duhan; St John's Naika Junkankika Clinic, Fukuoka-shi, Japan: Hiroshi Junkankinaika, Ebino-shi, Japan: Munesumi Medical College Hospital, Bangalore, India: Ando; Ryubokai Higashi Diabetes and Cardiovascular Ishizawa; Hojunkai Fujiura Junkankinaika Clinic, Ganapathi Bantwal and Sudha Suresh; Crescent Clinic, Tamana-shi, Japan: Takayuki Higashi; Seikeikai Nichinan-shi, Japan: Yoshitake Fujiura; Seijinkai Ikeda Hospital & Heart Centre, Nagpur, India: Puja sherke Okada Hospital, Nagato-shi, Japan: Megumi Okada; Hospital, Kanoya-shi, Japan: Daisuke Ikeda; Seto and Satish Giradkar and Aziz Khan and Kajal Gaikwad Kenshinkai Azakami Naika Junkankika Clinic, Junkankinaika Clinic, Fukuoka-shi, Japan: Taku Seto; and Reshma Kohade and Alka Gedam; S. R. Kalla Nogata-shi, Japan: Shiro Azakami; Kokoronohi Oita Red Cross Hospital, Oita-shi, Japan: Tetsu Iwao; Memorial Gastro & General Hospital, Jaipur, India: Komaki Clinic, Aira-shi, Japan: Shinichiro Komaki; Kieikai Fukuoka Kieikai Hospital, Fukuoka-shi, Japan: Ramdhan Meena and Jugal Gupta and Vipin Jain; Eikokai Kumeda Naika Junkankinaika Clinic, Norio Ishioka; Omotokai Ohama Daiichi Hospital, Chopda Medicare & Research Centre, Nashik, India: Kagoshima-shi, Japan: Kenshi Kumeda; Murayama Naha-shi, Japan: Koichi Oshiro; Tsuchida Clinic of Bhushan Suryawanshi and Priyanka More and Manoj Naika Junkankika Clinic, Kagoshima-shi, Japan: Internal and Cardiovascular Medicine, Nagaoka-shi, Chopada and Anand Rokade; Chinmaya Narayana Takashi Murayama; Shunseikai Higuchi Hospital, Japan: Keizo Tsuchida; Hatori Clinic, Kawasaki-shi, super speciality hospital, Bangalore, India: Rajendran Kasuga-shi, Japan: Jun Matsumura; KKR Chihaya Japan: Yutaka Hatori; Takeuchi Clinic, Kobe-shi, Karthikeyan and Anusha Kotha and Sunitha Hospital, Fukuoka-shi, Japan: Yurika Oba; Chishinkai Japan: Motoshi Takeuchi; Takezawa Clinic (Nagoya), Abraham; Bisne’s Heart Institute, Nagpur, India: Nishimura Naika Noshinkeigeka Hospital, Nagoya-shi, Japan: Hiroto Takezawa; Jiaikai Imamura Bhowari Jamunkar and Neha Madarkar and Vikas Kumamoto-shi, Japan: Ryuji Sonoda; Hibikikai Goto General Hospital, Kagoshima-shi, Japan: Shinjiro Bisne and Darshana Nandekar and Ruchieta Kishty; Naika Clinic, Kumamoto-shi, Japan: Kazuo Goto; Nagano; Matsushirokai Hayato Spa Hospital, Kerala Institute of Medical Sciences, Trivandrum, Minoda Naika Junkankika, Hitoyoshi-shi, Japan: Kirishima-shi, Japan: Masaaki Iwaki; Nakamura India: Govindan Vijayaraghavan and Kavitha VC; Kotaro Minoda; Haraguchikai Haraguchi Junkankika Cardiovascular Clinic, Itoshima-shi, Japan: Yuichiro Rabindranath Tagore International Institute of Naika Clinic, Kumamoto-shi, Japan: Yoshikuni Nakamura; Sanyukai Saino Clinic, Tokorozawa-shi, Cardiac Sciences (RTIICS), Vishakhapatnam, India: Haraguchi; Toeikai Suefuji Naika Junkankika, Japan: Naomasa Miyamoto; Taguchi Partha Bhattacharjee and Debabrata Roy and Anjuli Kumamoto-shi, Japan: Hisakazu Suefuji; Miyagi Junkankikanaika Clinic, Miyakonojo-shi, Japan: Barai; Sri Venkateswara Institute of Medical Sciences, Junkanki Naika, Yatsushiro-shi, Japan: Hiroo Miyagi; Toshifumi Taguchi; Ashida Medical Clinic, Tamba-shi, Tirupati, India: Latheef Kasala and Vanaja Jinseikai Kato Clinic, Osaka-shi, Japan: Hitoshi Kato; Japan: Ko Ashida; Yoshizawa Heart Clinic, Vanajakshamma and Rajashekhar Durgaprasad; Nakamura Medical and Circuratory Clinic, Setagaya-ku, Japan: Naoto Yoshizawa; Agata Clinic, Mysore Medical College and Research Institute, Kitakyushu-shi, Japan: Tsugihiro Nakamura; Obihiro-shi, Japan: Jun Agata; Matsukawa Heart Mysore, India: Rahul ER and Kanuri Prashanth and Nakamura Tadashi Naika Junkankika Clinic, Clinic, Edogawa-ku, Japan: Seishiro Matsukawa; Prasad Shiva and A.G. Ravi Shankar and Dilip Teja Kitakyushu-shi, Japan: Tadashi Nakamura; Nandate Yuaikai Tomishiro Chuo Hospital, Tomigusuku-shi, Naidu; Apollo BGS Hospital, Mysore, India: Dilipa Naika Junkankika, Kitakyushu-shi, Japan: Hidekazu Japan: Osamu Arasaki and Tetsuji Shinjo; Fukuoka Naik and Manasa Rao and Sunil Kumar; Dayanand Nandate; Zaitsu Cardiovascular Clinic, Fukuoka-shi, Clinic, Nichinan-shi, Japan: Shuji Fukuoka; South Medical College and Hospital, Ludhiana, India: Japan: Ryuji Zaitsu; Fukuoka Teishin Hospital, Tokyo Heart Clinic, Machida-shi, Japan: Hirofumi Sukhjeet Kaur and Dinesh Jain; Medanta The Fukuoka-shi, Japan: Yoshihisa Fujiura; Hyodokai Murakami; Mishima Naika Clinic, Kitamorokata-gun, Medicity, Gurgaon, India: Dhriti Adak and Krishan Yoshimura Naika, Nagato-shi, Japan: Akira Japan: Kazuya Mishima; Naha City Hospital, Sharma and Kartikeya Bhargava and Kuldeep Yoshimura; Numata Naika Kokyukika, Fujisawa-shi, Naha-shi, Japan: Mamoru Manita; Kenshinkai Chauhan; Vikram Hospital & Heart Care, Mysore, Japan: Hiroyuki Numata; Handa Naika Clinic, Minamino Cardiovascular Hospital, Hachioji-shi, India: Devina Igoor and Manjappa M and Vinushree K Kanazawa-shi, Japan: Jun Ogawa; Tatematsu Clinic, Japan: Yoshiki Hata; Caress Sapporo Hokko and Rathna RL and Vinay Kumar and Haseena Nagoya-shi, Japan: Hiroshi Tatematsu; Taikai Clinic, Memorial Clinic, Sapporo-shi, Japan: Ichiro Sakuma; Begum and Vaibhavi PS and Bharath Kumar; M. S. Satsumasendai-shi, Japan: Yasuyuki Kamogawa; Tokyobay Urayasu Ichikawa Medical Center, Ramaiah Medical College and Hospital, Bangalore, Murakami Kinshiro Cardiovascular Internal Clinic, Urayasu-shi, Japan: Kotaro Obunai; Takamura Naika India: Dayakar P and Sanjana Xavier and Swathi Sasebo-shi, Japan: Kinshiro Murakami; Wakasa Iin, Otaru-shi, Japan: Ichiro Takamura; Akutsu Naika Balaraju and VIJAY Kumar and Udigala Madappa Medical Clinic, Kanazawa-shi, Japan: Yutaka Wakasa; Iin, Otaru-shi, Japan: Mitsuyuki Akutsu; Unoki Nagamalesh and Beena Lokesh; Indraprastha Apollo Yamasawa Naika, Koriyama-shi, Japan: Masanori Junkankinaika Iin, Miyakonojo-shi, Japan: Toshihide Hospitals, Delhi, India: Swati Sharma and Rajeeve Yamasawa; Maekawa Medical Clinic, Yokohama-shi, Unoki; Kochikukai Go Neurosurgical Clinic, Kumar Rajput and Huma Yusuf and Swati Singhal. Japan: Hiromitsu Maekawa; Kokankai Kokan Clinic, Chikushi-gun, Japan: Yoshinori Go; Shinseikai Japan Kawasaki-shi, Japan: Sumihisa Abe; Kikokai Kihara Ikemura Internal Medicine Clinic, Miyakojima-shi, Cardiovascular Internal Medicine Clinic, Japan: Makoto Ikemura; Miike Junkankika Naika Iin, NHO Osaka National Hospital, Osaka-shi, Japan: Asahikawa-shi, Japan: Hajime Kihara; Close To You Kusu-gun, Japan: Shoji Morii; Tokachi Heart Clinic, Yukihiro Koretsune; Kanamorikai Kanamori Clinic, Est Clinic, Hirosaki-shi, Japan: Satoru Tsunoda; Kato-gun, Japan: Shigeru Marusaki; Doi Naika Uto-shi, Japan: Seishu Kanamori; Keiaikai Saga Seiwakai Nishiarai Heart Center Hospital, Adachi-ku, Junkankika, Miyazaki-shi, Japan: Hideo, Doi; Tanaka Memorial Hospital, Saga-shi, Japan: Kenichi Japan: Katsumi Saito; Tachibana-Iiyama Hospital, Junkankinaika Clinic, Kobayashi-shi, Japan: Mitsuru Yamamoto; Kohokai Fukuoka Sanno Hospital, Kagoshima-shi, Japan: Hiroki Tachibana; Showakai Tanaka; Kotokukai Kusumoto Naika Iin, Izumi-shi, Fukuoka-shi, Japan: Koichiro Kumagai; Fukuoka City Imakiire General Hospital, Kagoshima-shi, Japan: Japan: Takaaki Kusumoto; Otaru Kyokai Hospital, Medical Association Hospital, Kitakyushu-shi, Japan: Ichiro Oba; Yushikai Kuwahata Clinic, Kagoshima-shi, Otaru-shi, Japan: Shigeo Kakinoki; Ogurusu Heart Yosuke Katsuda; Sagaken Medical Center Koseikan, Japan: Takashi Kuwahata; Hakuaikai Makiminato Clinic, Kasaoka-shi, Japan: Chiga Ogurusu; Wayokai Saga-shi, Japan: Keiki Yoshida; Fukuokairyodan

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Murata Clinic, Sanyoonoda-shi, Japan: Kazuya Kanda, Okazaki-shi, Japan: Hirofumi Kanda; Kaneko Teragawa and Yuichi Fujii and Shuichi Nomura and Murata; Shimoyama Clinic, Yonago-shi, Japan: Naika Junkankika Clinic, Hamamatsu-shi, Japan: Tomohiro Ueda; Kosekai Iwatsuki-minami Hospital, Masaki Shimoyama; Jisshokai Nakatsuka Naika, Masanori Kaneko; Nagasaka Heart Clinic, Saitama-shi, Japan: Yasuyuki Maruyama; Takei Hofu-shi, Japan: Masami Nakatsuka; Hamamatsu-shi, Japan: Shiro Nagasaka; Taguchi Medical Clinic, Odawara-shi, Japan: Kazuo Takei; Asakurashinryojo Asakura Clinic, Imabari-shi, Japan: Naika Junkankika Iin, Hamamatsu-shi, Japan: Atsushi Horie Clinic, Omihachiman-shi, Japan: Hajime Horie; Yutaka Kitami; Soyokaze Cardiovascular Medicine Taguchi; Nitobe Memorial Nakano General Hospital, Clinic Kakehashi, Nagoya-shi, Japan: Tetsutaro Kito; and Diabetes Care, Matsuyama-shi, Japan: Yoichi Nakano-ku, Japan: Shuta Toru and Kazuyuki Saito Asuka Clinic, Nakano-ku, Japan: Hiroshi Asano; Nakamura; Shogen Naika Clinic, Sendai-shi, Japan: and Akiko Miyashita and Hiroki Sasaguri; Osaka Matsushita Medical Clinic, Toyonaka-shi, Japan: Koji Hiroshi Oda; Tojukai Ito Naika Iin, Shimonoseki-shi, General Hospital of West Japan Railway Company, Matsushita; Nakamura Medical Clinic, Suita-shi, Japan: Rikimaru Oyama; Ageta Naika Clinic, Osaka-shi, Japan: Jin Nariyama and Hiroyuki Japan: Masaichi Nakamura; Washizuka Clinic, Nichinan-shi, Japan: Masato Ageta; Mita Miyamoto and Yusuke Nishida and Tatsuya Suga and Kamo-shi, Japan: Takashi Washizuka; Yoshida Heart Medical-Cardiovascular Clinic, Sapporo-shi, Japan: Hiroki Nagata; Hatsuno Clinic, Iruma-gun, Japan: Clinic, Hiroshima-shi, Japan: Tomoki Yoshida; Teruaki Mita; Nagao Naika Junkanki Clinic, Taketo Hatsuno; Iwase Internal Medicine Cardiology Sawano Clinic, Yokohama-shi, Japan: Masato Sawano Sapporo-shi, Japan: Kazuhiko Nagao; Mito Naika Clinic, Shibuya-ku, Japan: Takash Iwase; Itsukikai and Koji Matsushita; Arima Shinichi Clinic, Junkanki Clinic, Sapporo-shi, Japan: Takafumi Mito; Heart Clinic, Katsushika-ku, Japan: Kazuki Sato; Kagoshima-shi, Japan: Shinichi Arima; Kanoya Heart Saito Naika Clinic, Hakodate-shi, Japan: Tsutomu Chikamorikai Chikamori Hospital, Kochi-shi, Japan: Center, Kanoya-shi, Japan: Hidekazu Arai; Iwamoto Saito; Juntenkai Teshima Clinic, Kure-shi, Japan: Kazuya Kawai; Jinikai Makita General Hospital, Medical Clinic, Zentsuji-shi, Japan: Hisanori Junichi Minami; Yotsuba Circulation Clinic, Ota-ku, Japan: Tomobumi Kotani; Tsuji Clinic, Shinohara; Takai Clinic, Kawachinagano-shi, Japan: Matsuyama-shi, Japan: Mitsunori Abe; Fujii Heart Toyonaka-shi, Japan: Tsuyoshi Tsuji; Sakai Medical Hiroyuki Takai; Furukawa Medical Clinic, Nakatsu-shi, Clinic, Kurashiki-shi, Japan: Masako Fujii; Okawa Clinic, Higashiosaka-shi, Japan: Hirosumi Sakai; Japan: Nobufusa Furukawa; Ota Shinryojo, Awa-shi, Naika, Kochi-shi, Japan: Makoto Okawa; Kawaguchi Nishino Clinic, Kochi-shi, Japan: Kiyoshi Nishino; Japan: Akira Ota; Yamamoto Naika, Sakai-shi, Japan: Heart Clinic, Kawaguchi-shi, Japan: Tsuneo Fujito; Tachikawa IM Clinic, Tachikawa-shi, Japan: Kenichi Kentaro Yamamoto; Ebetsu City Hospital, Aishin Clinic, Yachiyo-shi, Japan: Toshiya Taniguchi; Ikeda; Maeda Naika Iin, Niigata-shi, Japan: Kazuo Ebetsu-shi, Japan: Kenji Aoki and Masahiko Abe and Gyokushinkai Kashima Heart Clinic, Kamisu-shi, Maeda; Murao Shinryojo, Neyagawa-shi, Japan: Rikiya Shinohe; Yamamoto Clinic (Shiga), Japan: Tenei Ko; Hakushinkai Hiro Clinic, Tomohiro Shinozuka; Inoue Cardiovascular Clinic, Moriyama-shi, Japan: Taku Yamamoto; Kasai Naika Takasaki-shi, Japan: Hiroshi Kubo; Chiba Heart Clinic, Oita-shi, Japan: Takeshi Inoue; Kawakami Clinic, Junkanki Clinic, Nerima-ku, Japan: Takeaki Kasai; Chiba-shi, Japan: Mizuho Imamaki; Heart Clinic, Ota-shi, Japan: Koichi Kawakami; Kitazumi Clinic, Suzuki Medical Clinic, Minamiawaji-shi, Japan: Shunji Tatebayashi-shi, Japan: Masahiro Akiyama; Ueda Itabashi-ku, Japan: Hiromichi Kitazumi; Takagi Suzuki; KKR Tohoku Kosai Hospital, Sendai-shi, Heart Clinic, Tatsuno-shi, Japan: Takashi Ueda; Cardiology Clinic, Kyoto-shi, Japan: Tsutomu Takagi; Japan: Kikuyo Takahashi and Shu Suzuki; Dobashi Naika Iin, Sendai-shi, Japan: Hironori Hamaoka Clinic, Nishinomiya-shi, Japan: Mamoru Sakakibarakosekai Shinjuku Mitsui Building Clinic, Odakura; Inagaki Clinic, Itami-shi, Japan: Masahiko Hamaoka; Kojima Clinic, Odawara-shi, Japan: Jisho Shinjuku-ku, Japan: Nitaro Shibata; Omori Internal Inagaki; Katsube Clinic, Nishinomiya-shi, Japan: Kojima; Sasaki Heart Clinic, Shizuoka-shi, Japan: Medicine Cardiology Clinic, Fukushima-shi, Japan: Yoshiki Katsube; Nakata Naika Clinic, Akitoshi Sasaki; Ohashi Cardiovascular & Internal Masayuki Watanabe St Luke's International Hospital, Nishinomiya-shi, Japan: Atsuyuki, Nakata; Tojo Clinic, Medicine Clinic, Fukuoka-shi, Japan: Yoshihiro Chuo-ku, Japan: Hiroyuki Niinuma and Yasuhiro Kato-shi, Japan: Shinobu Tomimoto; Juzenkai Tsuchiya; Tokyo Tenshi Hospital, Hachioji-shi, Japan: Yokoyama and Hirotsugu Mitsuhashi and Ryo Tateyama Junkankinaika Geka, Tateyama-shi, Japan: Tetsuo Betsuyaku; Hiratsuka Kyosai Hospital, Nakazato and Takeaki Shirai and Yumi Shiina and Mitsuhiro Shibuya; Kaiseikai Nakano Hospital, Hiratsuka-shi, Japan: Koji Higuchi; Honda Clinic, Atsushi Mizuno and Toru Adachi and Taku Asano and Shibukawa-shi, Japan: Masayuki Nakano; Ito Izumo-shi, Japan: Masaaki Honda; Hasegawa Ikki Komatsu and Masahiro Yamazoe and Yosuke Cardiovascular Clinic, Saiki-shi, Japan: Kenichiro Ito; Outpatients Clinic for Cardiovascular Disease, Nishihata and Yosuke Nishihata and Yutaro Nishi; Matsuta Heart Clinic, Yamatokoriyama-shi, Japan: Takamatsu-shi, Japan: Koichi Hasegawa; Baba Clinic, Yamaichi Building Medical Clinic, Adachi-ku, Japan: Masahiro Matsuta; Yi Yuan Hui Ishiguro Clinic, Nishitokyo-shi, Japan: Takao Baba; Mineoi Clinic, Toru Arino; Okuyama Clinic, Murayama-shi, Japan: Gifu-shi, Japan: Motoyuki Ishiguro; Minagawa Clinic, Matsuyama-shi, Japan: Kazuaki Mineoi; Saien Masaki Okuyama; Wakiyama Clinic, Karatsu-shi, Gifu-shi, Japan: Taro Minagawa; Wada Clinic Cardiovascular Medicine Clinic, Morioka-shi, Japan: Japan: Tetsushi Wakiyama; Juntendo University (Gunma), Tomioka-shi, Japan: Masamichi Wada; Toshihiko Koeda; Hirasawa Cardiovascular Medicine Hospital, Bunkyo-ku, Japan: Tomoko, Kato; Mukawa Heart Clinic, Ogaki-shi, Japan: Hiroaki Clinic, Asahikawa-shi, Japan: Kunihiko Hirasawa; Sasagawa Clinic, Shibata-shi, Japan: Yasuo Sasagawa; Mukawa; Mizuguchi Clinic, Suzuka-shi, Japan: Sunomata Clinic, Ogaki-shi, Japan: Toshihide Shuri Jokamachi Clinic Daiichi, Naha-shi, Japan: Masato Mizuguchi; Kosumosukai Okuda Clinic, Kumazaki; Nakagomi Medical Clinic, Akita-shi, Japan: Takeshi Tana and Ayano Ishihara; Internal Medicine Ube-shi, Japan: Fumio Okuda; Meihokai Meiho Clinic, Akira Nakagomi; Otaki Cardiology Clinic, Bunkyo-ku, Cardiology Hayashi Clinic, Asahikawa-shi, Japan: Tsuruga-shi, Japan: Teruaki Kimura; Keiyukai Taga Japan: Eiji Otaki; Shindo Clinic, Amagasaki-shi, Yoshihito Hayashi; Ueki Hospital, Kumamoto-shi, Naika Junkankika Iin, Fukui-shi, Japan: Kuniaki Taga; Japan: Takashi Shindo; Chiyo Clinic, Kitakyushu-shi, Japan: Shinichi Hirota; Abe Clinic, Fukushima-shi, Techigawara Clinic, Koriyama-shi, Japan: Masaaki Japan: Hiroyoshi Hirayama; Toyoda Heart Clinic, Japan: Yukihiko Abe; Hidamari no Mori Clinic, Japan: Techigawara; Asunarokai Igarashi Clinic, Iwata-shi, Japan: Chikako Sugimoto; Yamagishi Yoshihiro Saito; Uchiyama Clinic, Japan: Hirohide Shirakawa-shi, Japan: Morio Igarashi; HAL Clinic, Medical Clinic, Yamaguchi-shi, Japan: Takashi Uchiyama; Takeda Heart Clinic, Japan: Hiroshi Niigata-shi, Japan: Hiroshi Watanabe; Seo Naika Yamagishi; Orange Clinic, Yokohama-shi, Japan: Takeda; Sakanoue Family Clinic, Japan: Hiroshi Ono; Clinic, Osaka-shi, Japan: Toshihiko Seo; Hiramitsu Ichiro Mizuguchi; Nico Nico Heart Clinic, Hoden Clinic, Japan: Shuichi Tohyo; Clinic Hanazono Heart Clinic, Nagoya-shi, Japan: Shinya Hiramitsu; Higashimatsuyama-shi, Japan: Kazunori Sezaki; Niwa Naika Iin, Japan: Naoto Hanazono; Miyajima Yuaikai Higashi Junkanki Clinic, Toyohashi-shi, Japan: Medical Clinic, Kyoto-shi, Japan: Isamu Niwa; Junkanki Naika, Japan: Seiichi Miyajima; Shimono Hiroaki Hosokawa; Hoshiai Clinic, Owariasahi-shi, Takenaka Clinic, Kyoto-shi, Japan: Ken Takenaka; Clinic, Japan: Hisashi Shimono; Koseikai Kizawa Japan: Mitsumoto Hoshiai; Hibino Naika Clinic, Nakatani Clinic, Yao-shi, Japan: Osamu Iiji; Taya Memorial Hospital, Japan: Takuma Aoyama and Toyota-shi, Japan: Michitaka Hibino; Miyagawa Clinic, Tsuchiura-shi, Japan: Koichi Taya; Tachikawa Shusaku Miyata Shigekiyo Takahashi and Takahisa Clinic, Nisshin-shi, Japan: Koichi Miyagawa; Heart General Hospital, Nagaoka-shi, Japan: Hitoshi Ido and Makoto Yamaura and Keita Suzuki and Yuto Naika Clinic, Yatomi-shi, Japan: Hideki Horie; Kitazawa; Okinawa Tokushukai Chiba Tokushukai Kumai and Gen Tanabe and Takehiro Yamada and Wakeikai Sugishita Iin, Gujo-shi, Japan: Nobuyoshi Hospital, Funabashi-shi, Japan: Osamu Ueda; Kakuda Yuka Kawada; Shozawa Clinic, Japan: Yasunobu Sugishita; Meisei Shiga Clinic, Obu-shi, Japan: Yukio Clinic, Kahoku-shi, Japan: Hirokazu Kakuda; Ono Shozawa; Kanetsu Chuo Hospital, Japan: Yawara Shiga; Heart Clinic Kokoro, Koka-shi, Japan: Akira Medical Clinic, Koto-ku, Japan: Takuya Ono; Oriso Niijima; Sekishinkai Kawasaki Saiwai Hospital, Japan: Soma; Neya Naika Clinic, Itabashi-ku, Japan: Kazuo Internal Medicine Cardiology Clinic, Ninohe-shi, Osamu Murai; Sekishinkai Kawasaki Saiwai Clinic, Neya; Onga Hospital, Onga-gun, Japan: Tetsuro Japan: Seizo Oriso; Odori Kamata Medicine Clinic, Japan: Osamu Murai; Teikyo University School of Yoshida; Akahane Clinic, Nagano-shi, Japan: Kunio Morioka-shi, Japan: Junya Kamata; Gakuen Heart Medicine University Hospital, Mizonokuchi, Japan: Akahane; Shofukai Naito Hospital, Kurume-shi, Clinic, Machida-shi, Japan: Toshihiko Nanke; Hideko Inaba; Nomura Medical Clinic, Japan: Japan: Sen Adachi; Takanaka Clinic, Hamamatsu-shi, Miyanomori Memorial Hospital, Sapporo-shi, Japan: Katsumasa Nomura; Saiseikai Fukuoka General Japan: Chiei Takanaka; Ueda Neurosurgery, Itaru Maeda and Takashi Kawamoto; Sakaemachi Hospital, Japan: Masatsugu Nozoe; Kenkokan Suzuki Miyazaki-shi, Japan: Takashi Ueda; Matsui Clinic, Clinic, Tottori-shi, Japan: Yoshifusa Matsuura; JR Clinic, Japan: Kazuo Suzuki; St Marianna University Hamamatsu-shi, Japan: Saori Matsui; Heart Clinic Hiroshima Hospital, Hiroshima-shi, Japan: Hiroki School of Medicine Hospital, Japan: Toshiyuki

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Furukawa; Shiraiwa Medical Clinic, Japan: Toshihiko Kawano; Okamoto Iin, Japan: Yutaka Okamoto; Park and Jung Joo Ahn; VHS Medical Center, Seoul, Shiraiwa; Grace Medical Clinic, Japan: Nobuhisa Ito; Nijumarukai Ubukata Heart Clinic, Japan: Satoshi South Korea: Hoon Ki Park and Hee Suk Choi; Hallym Nagai Clinic, Japan: Shunichi Nagai; Sendai Ekihigashi Ubukata; Juzenkai Kisarazu Heart Clinic, Japan: University Sacred Heart Hospital, Anyang-si, South Clinic, Japan: Kiyoharu Sato; Dokkyo Medical Kojiro Kodera; Shinseikai Oriuchi Clinic, Japan: Tatsuo Korea: Sang-Jin Han and Nari Ryu; CHA Bundang University Koshigaya Hospital, Japan: Shiro Oriuchi; Sanikai Tsurukawa Kinen Hospital, Japan: Medical Center, CHA University, Seongnam-Si, South Nakahara; Risshokoseikai Kosei General Hospital, Naoki Matsumoto; Inagaki Heart Clinic, Japan: Koichi Korea: Jung Hoon Sung and JiSun Kang; Chonnam Japan: Yujin Shimoyama; Kojinkai Tsuruhashi Clinic, Inagaki; Iseki Clinic, Japan: Atsushi Iseki; Yoshida National University Hospital, Gwangju, South Korea: Japan: Naoko Ohara; Omotecho Family Clinic, Japan: Clinic Internal & Cardiology, Japan: Tomohiro Jeong-Gwan Cho and JiSeon Kim and Haeim Kim; Teruhiko Kozuka; Okita Internal Medicine Clinic, Yoshida; Aishinkan Aishin Circulatory Organ Clinic, Asan Medical Center, Seoul, South Korea: Gi-Byoung Japan: Hideaki Okita; Endo Clinic (Miyagi), Japan: Japan: Toshihiro Goda; Katsuki Naika Clinic, Japan: Nam and Sulhee Lee and Keun Hye Lee; Samsung Masato Endo; Goto Iin, Japan: Tsutomu Goto; Hirose Tsukasa Katsuki; Sato Naika Shonika Toriage Iin, Medical Center, Seoul, South Korea: Young Keun On Clinic, Japan: Makoto Hirose; Harada Naika Clinic, Japan: Atsushi Sato; Chihaya Heart Clinic, Japan: and Sehyun Kim; Korea University Guro Hospital, Japan: Emiko Nagata; Kogakai Nakanishi Clinic, Etsuo Mori; Tsubokura Clinic, Japan: Toshio Seoul, South Korea: Hong Euy Lim and SeongWook Japan: Noriyuki Nakanishi; Mori Clinic (Osaka), Tsubokura; Hiro Clinic, Japan: Hiroshi Shudo; Hwang; Inje University Ilsan Paik Hospital, Japan: Toshizumi Mori; Seki Iin, Japan: Shuichi Seki; Hakuyokai Fujimoto Clinic, Japan: Shunichi Fujimoto; Gyeonggi-do, South Korea: JaeJin Kwak and Hyeji Okamoto Naika Iin, Japan: Katsuhiro Okamoto; Katsuya Clinic, Japan: Tomohiro Katsuya; Furukawa Bae HyeYoung Kye; Kosin University Gospel Hospital, Moriai Naika Clinic, Japan: Osamu Moriai; Emura Naika Clinic, Japan: Yoshiyuki Furukawa; Ichibangai Busan, South Korea: Tae-Joon Cha and Eun A Choi Clinic, Japan: Yoko Emura; Fukuda Clinic Sogo Clinic, Japan: Hiroshi Hosokawa; Narumiyakai and In Kyoung Noh; Pusan National University (Tondabayashi), Japan: Tsuyoshi Fukuda; Date Clinic, Narumiya Heart Clinic, Japan: Jun Narumi; Shozankai Hospital, Busan, South Korea: Taek Jong Hong and Japan: Haruhiko Date; Meikikai Uchimura Kawakami Yamamoto Naika Junkankika Iin, Japan: Kiichiro Ro Woon Lee and Kyeonghwa Hyun; Ewha Womans Naika, Japan: Shuichi Kawakami; Ebino Sentoro Yamamoto; Owari Cardiovascular & Diabetes Clinic, University Mokdong Hospital, Seoul, South Korea: Clinic, Japan: Sho Nagai; Ueyama Clinic, Japan: Yuya Japan: Masaki Owari; Keiaikai Inakura Clinic, Japan: Seong Hoon Park and Mi-Young Lee; Yonsei Ueyama; Fudo Clinic, Osaka-shi, Japan: Tetsuro Takuya Inakura; Anno Clinic, Japan: Takafumi Anno; University Wonju Severance Christian Hospital, Fudo; Ichikawa Iin, Japan: Mitsuru Imaizumi; Ogawa Shirakawa Clinic, Japan: Kazuyuki Shirakawa. Kangwon-do, South Korea: Jung Han Yoon and Jung Naika Clinic, Japan: Takuo Ogawa; Hakujinkai Take Singapore Ja Woo and Hye-suk Jang and Sunhui Han and Naika Clinic, Japan: Shunsuke Take; Ikeda Naika AReum Park and Won Sook Son and Hae Jung An; Hifuka Clinic, Japan: Hideo Ikeda; Nishioka Family National Heart Centre, Singapore: Chi Keong Ching Wonkwang University Hospital, Iksan-si, South Clinic, Japan: Hiroaki Nishioka; Ebisu Clinic, Japan: and Sandra Thng; National University Hospital, Korea: Nam-Ho Kim and Hae Kyeong Jeong and Ae Norihiko Sakamoto; Ikeoka Clinic, Japan: Kiyomitsu Singapore: Toon Wei Lim; Tan Tock Seng Hospital, Lee Baek; Daegu Catholic University Medical Center, Ikeoka; Wakaki Clinic, Japan: Nobuo Wakaki; Abe Singapore: Haiyan Li and David Foo; Changi General Daegu, South Korea: Kee-Sik Kim and Mi Sun Kim Junkanki Clinic, Japan: Masatake Abe; Kazahaya Hospital- Parent, Singapore: Siew Yoon Yap and Dan and JuHee Kim; Daegu Fatima Hospital, Deagu, Clinic, Japan: Junji Doiuchi; Kira Cardiovascular Clinic, Dan Chen and Geraldine Lim and Colin Yeo; South Korea: Byung Chun Jung; Ajou University Japan: Tetsuya Kira; Tada Naika (Hakodate), Japan: Singapore General Hospital- Parent, Singapore: Tan Hospital, Suwon-si, South Korea: Gyo-Seung Hwang Masato Tada; Eiseikai Tsuzaki Cardiovascular Yuyang and Fazlur Rehman Jaufeerally. and Doo Lae Lee and Young Mi Sohn; Kyung Hee Anesthesiology Clinic, Japan: Ken Tsuzaki; Miura South Korea University Hospital at Gangdong, Seoul, South Korea: Clinic (Sapporo), Japan: Naoya Miura; Fujisawa Seoul National University Hospital, Seoul, South Chong-Jin Kim and Hye-Young Lee; Inha University Cardio-Vascular Clinic, Japan: Yasuaki Fujisawa; Korea: Seil Oh and JiHyun Sim and HyunJu Yu; Hospital, Incheon, South Korea: Yeon Ji Kim. Furumoto Clinic, Japan: Wataru Furumoto; Rumoi SEVERANCE HOSPITAL, YONSEI UNIVERSITY, Seoul, Thailand Central Clinic, Japan: Susumu Suzuki; Honbetsu South Korea: Hui Nam Park and Mi Suk Lee; Kyung Burirum Hospital, Muang, Thailand: Riam Inphontan Cardiovascular Medicine Clinic, Japan: Akinori Hee University Hospital, South Korea: Woo-Shik Kim Fujisawa; Nakamurakai Nakamura Clinic, Japan: and Pimolwan Phunpinyosak and Sakda and Eunjung Hwang; Inje University Sanggye Paik Rungaramsin; Central Chest Institute of Thailand, Ryosai Nakamura; Soseikai Komatsu Iin, Japan: Hospital, Seoul, South Korea: HyeYoung Lee and Hiroyasu Komatsu; Seiwakai Fujiki Clinic, Japan: Rei Muang, Thailand: Piyanuch Sukklad and Peerapat Sun-joo Kim; The Catholic University of Korea, St Katekangplu; Inburi Hospital, Inburi, Thailand: Fujiki; Keiwakai Kawano Iin, Japan: Shuichi Kawano; Paul's Hospital, Seoul, South Korea: Sung-Won Jang Nishizawa Clinic, Japan: Keijiro Nishizawa; Kato Porames Khunrong; Lampang Hospital, Muang, and JiSuk Kwon; Inha University Hospital, Incheon, Thailand: Suree Yawila and Thanita Bunyapipat; Medical Clinic, Japan: Yoji Kato; Tsurugaoka Azuma South Korea: Dae Hyeok Kim and Kyung Mi Yoo; Clinic, Japan: Junya Azuma; Koseikai Yotsubashi Maharaj Nakorn Chiang Mai Hospital, Muang, Pusan National University Yangsan Hospital, South Thailand: Arintaya Phrommintikul and Wanwarang Clinic, Japan: Kiyoshi Yasui; Amano Naika, Japan: Korea: Sang Eun Lee and Jeongsu Kim; Kangwon Toshio Amano; Yuwakai Sekine Iin, Japan, Yasuhiro Wongcharoen and Siriluck Gunaparn; Maharat National University Hospital, Chuncheon, South Nakhon Ratchasima Hospital, Muang, Thailand: Pinij Sekine; Honzawa Medical Center, Japan: Tatsuo Korea: DongRyeol Ryu and KyoungOk Her and Eun Honzawa; Koshibu Clinic, Japan: Yuichiro Koshibu; Kaewsuwanna; Nakornping Hospital, Mae Rim, Hee Choi; Korea University Anam Hospital, Seoul, Thailand: Theewarut Suttana and Ketsanee SYU Cardiovascular Clinic, Japan: Yasuhide South Korea: Jaemin Shim and Young Ran Jeon and Sakamoto; Seta Clinic, Japan: Yukihiro Seta; Khunkong and Khanchai Siriwattana; Gyeong Hui Lee and Woo Jin Chi; Inje University Phramongkutklao Hospital, Rajathevee, Thailand: Miyaguchi Clinic, Japan: Shingo Miyaguchi; Morishita Busan Paik Hospital, Busan, South Korea: Naika Iin, Japan: Kojuro Morishita; Yoshikawa Panthipa Bamungpong and Waraporn Tiyanon; Dae-Kyeong Kim and Sun Min Lee and Yang-I Kim; Police General Hospital, Pathumwan, Thailand: Usa Medical Clinic, Japan: Yasuko Samejima; Ishizawa Iin, Seoul National University Bundang Hospital, Japan: Toyoshi Sasaki; Iseki Junkanki Naika, Japan: Kitmapawanont and Supalerk Pattanaprichakul; Seongnam-si, South Korea: Dong Ju Choi and Eun Ramathibodi Hospital, Ratchathewi, Thailand: Bandit Fumiko Iseki; Clinica de Kobayashi, Japan: Toshiyuki Hee Lee and Hee Kyung Choi and Woo Yeon Lee and Kobayashi; Kano Clinic, Japan: Hiroshi Kano; Naratreekoon and Kolltis Pongmorakot and Somluck EunJi Yoon; The Catholic University of Korea, Seoul Ninwaranon and Wacharin Suebjaksing and Khanchit Akiyama Heart Clinic, Japan: Jaeyoung Kim; Hiroshi St Mary’s Hospital, Seoul, South Korea: Yong Seog Oh Yamaguchi Clinic, Japan: Hiroshi Yamaguchi; Takagi Likittanasombat; Ratchaburi Regional Hospital, and Yun Suk Son and Sae Rom Jeon; Chungbuk Muang, Thailand: Doungrat Cholsaringkarl; Siriraj Naika Junkankika, Japan: Yoichi Takagi; Galatea National University Hospital, Cheongju, South Korea: Pearce Clinic, Japan: Yoko Onuki Pearce; Medical Hospital, Bangkoknoi, Thailand: Warangkana Myeong-Chan Cho and Chung Suk Lee; Seoul Boonyapisit and Napawan Pornnimitthum and Clinic Suzuki, Japan: Yasuyuki Suzuki; Fukui Clinic, Metropolitan Government Seoul National University, Japan: Takayuki Fukui; Nakayama Clinic (Kochi), Satchana Pumprueg; Songklanagarind Hospital, Hat Seoul, South Korea: Sang Hyun Kim and Sang Hee Yai, Thailand: Ratchanee Sirichai and Arthiya Japan: Toru Nakayama; Kanai Clinic, Japan: Hideaki Kim and EuMi Jang; Pharmacy of The Catholic Kanai; Tenshindo Hetsugi Hospital, Japan: Yoshiyuki Sriwichian and Treechada Wisaratapong and Sirichai University of Korea, Uijeongbu St Mary's Hospital, Cheewatanakornkul; Srinagarind Hospital, Muang, Kawano; Souseikai Fukuoka Mirai Hospital, Japan: Uijeongbu, South Korea: Hui-Kyung Jeon And Tetsuji Ino; Miyoshi Junkanki Clinic, Japan: Hironori Thailand: Benjaporn Silaruks and Kittisak Gyeong Hui Lee and Ki Tae Kim; Yeungnam Sawanyawisuth and Songkwan Silaruks; Thammasat Miyoshi; Jonan Koen Clinic, Japan: Yasufumi University Hospital, Daegu, South Korea: Dong-Gu Miyamoto; Shigekiyo Naika Geka, Japan: Masahito University Hospital, Klongluang, Thailand: Siripan Shin and EuMi Jang and Kyung Hui Yim Hyewon Hongsuppinyo and Oranong Thangpet and Pisit Shigekiyo; Marugame Ono Clinic, Japan: Shimato Medical Foundation SeJong General Hospital, Ono; Tenshindo Hetsugi Clinic, Japan: Yoshiyuki Hutayanon; Uthai Hospital, Uthai, Thailand: Siriwan Bucheon-si, South Korea: Jin Sik Park and Jae Seok Ratchasikaew and Chuleerat Kongsin and Seksan

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Chawanadelert; King Chulalongkorn Memorial Had and Andres Javier Kleiban; Sanatorio Rio Negro, Carlos Alberto Studart Gomes, Fortaleza, Brazil: Hospital, Pathumwan, Thailand: Rudeewan Cipolletti, Argentina: Nestor Centurion; Corporacion Dafne Lopes and João David de Souza Neto; Khattaroek and Yongkasem Vorasettakarnkij and Medica de Gral. San Martin S.A., San Martin, Consultório Dr José Márcio Ribeiro, Belo Horizonte, Pairoj Chattranukulchai; Saint Louis Hospital, Argentina: Andrea Alvarez D'Amelio and Vanina Brazil: José Márcio Ribeiro; Hospital Cidade, Sathorn, Thailand: Boonsert Chatlaong; Campisi and Mariano Fanuele and Agustina Ahuad Salvador, Brazil: Denise Guanaes and Marcelo Silveira Sunprasitthiprasong Hospital, Muang, Thailand: Calvelo and Rodolfo Andres Ahuad Guerrero; Teixeira; Núcleo de Pesquisa Clínica S/S, Curitiba, Yingsak Santanakorn; Banphaeo Hospital, Banphaeo, Hospital Provincial Enrique F. Erill, Capital Federal, Brazil: Verena Araujo Paulo Ross and Luana Herek; Thailand: Khompiya Kanokphatcharakun; Maharaj Argentina: Flavio Javier Zurbrigk and Anabela Instituto de Cardiologia do Rio Grande do Sul, Porto Nakornsrithammarat Hospital, Muang, Thailand: Martinelli and Leonel Adalberto Di Paola; Sanatorio Alegre, Brazil: Silvia Poletti and Leonardo Pires; Janwamol Phangyota and Atthakorn Wutthimanop Mariano Pelliza, Munro, Argentina: Ricardo Dario ICSC - Instituto de Cardiologia de Santa Catarina, São and Thanawan Chaiyapong and Piya Dran and Carlos Hector Gimenez; Instituto Medico José, Brazil: Vera Lucia Pereira and Daniel Moreira; Mongkolwongroj; Chiang Rai Prachanukroh Hospital, CER, Quilmes, Argentina: Alicia Sossich and Santa Casa De Curitiba, Curitiba, Brazil: Leonardo Muang, Thailand: Kanchana Sanit and Wattana Fernando Colombo Berra and Cintia Schenkel and Spolaor and Mariana Rodrigues Pius and Juliane Wongtheptien and Sasivimon Jai-Aue; Naresuan Javier Egido and Salinger Melina; Fundacion Woehl and José Carlos Moura Jorge; IMC - Instituto University Hospital, Muang, Thailand: Ampai Favaloro, Buenos Aires, Argentina: Emilio Daniel de Moléstias Cardiovasculares de São José do Rio Tangsirira and Suthasinee Poomiphol and Thanakorn Alaguibe and Lucia Campo and Enrique Pablo Preto, São José do Rio Preto, Brazil: Eduardo Laksomya. Gurfinkel and Branco Mautner and Matias Jose Palmegiani and Priscila Fabri and Adalberto Menezes Turkey Fosco; Hospital Interzonal de Agudos Eva Peron, San Lorga Filho and Clotildes Queirantes; Hospital São Martin, Argentina: Victor Alfredo Sinisi; Hospital Lucas da PUCRS, Porto Alegre, Brazil: Tulio Ruaro Baskent University Istanbul Training and Research Italiano de La Plata, La Plata, Argentina: Andrea Reichert and Fernanda Chieza and Luiz Bodanese Hospital, Istanbul, Turkey: Armagan Altun and Ozge Santoro and Luis Rodolfo Cartasegna and Maria and Rosa Vieira Homem and Ellen Hettwer Ayar; Uludag University Medical Faculty, Bursa, Fernanda Alzogaray and Viviana Novas and Jesica Magedanz; Hospital Pró-Cardíaco, Rio de Janeiro, Turkey: Ali Aydinlar and Hulya Saribocek and Mustafa Florencia Tinto; Sanatorio San Martin, Venado Brazil: Roberta Perreira and Marcelo Westerlund Fehmi Bireciklioglu; Erciyes University Medical Tuerto, Argentina: Romina Cabrini and Javier Montera; Incor - Instituto do Coração - HCFMUSP, Faculty, Kayseri, Turkey: Ramazan Topsakal and Matkovich and Valentina Garate and Oscar Alberto São Paulo, Brazil: Carlos Henrique Del Carlo and Emine Yilmaz and Serpil Kilic and Kurtulus Ozdemir Gomez Vilamajo and Maria Eugenia Said Palladino; Eliane Fernandes; Hospital Felício Rocho, Belo and Beyza Sakli; Istanbul University Cerrahpasa Hospital Italiano Garibaldi, Rosario, Argentina: Laura Horizonte, Brazil: Maria Celia Marinho and Tânia Félix Medical Faculty, Istanbul, Turkey: Zeki Ongen and Susana Sanziani and Fabian Diez and Jose Luis Lorenzato Fonseca and Jamil Abdalla Saad and Fuat Polat and Gamze Avinc; Ankara Diskapi Yildirim Ramos and Cintia Martinelli and Amaru Lopez; Eduardo Belisario Falchetto; Clínica Paulista de Beyazit Training and Research Hospital, Ankara. Centro Medico Dra Laura Maffei Investigacion Clinica Doenças Cardiovasculares Ltda., São Paulo, Brazil: Turkey: Mehmet Ali Felekoglu and Faruk Yilmaz and Aplicada, Ciudad Autonoma Buenos Aires, Raquel Franchin Ferraz and Fernando Augusto Alves Tilbe Kundak; Adana Numune Training and Research Argentina: Miguel Angel Vallejo and Marcelo da Costa; Hospital Sao Paulo, São Paulo, Brazil: Hospital, Adana, Turkey: Durmus Yildiray Sahin and Yantorno and Lucas Tonelli and Laura Maffei and Renato Lopes and Mayara Vioto Valois; HRAN - Hasan Koca and Balci Funda; Ondokuz Mayis Univ. Roxana Del Valle Martinez and Maria Goicoechea and Hospital Regional da Asa Norte, Brasilia, Brazil: Med. Fac., Samsun, Turkey: Cansu Kiris and Ozcan Sonia Sassone and Micaela Vallejo and Graciela Lenisa Vila Boas and Gilson Roberto de Araújo; IMV - Yilmaz; Cumhuriyet Uni. Med. Fac., Sivas, Turkey: Beatriz Perez Prados and Marina Ingratta; Instituto Instituto De Medicina Vascular Hospital Mae de Funda Aras and Osman Beton and Mehmet Birhan Cardiovascular de Rosario, Rosario, Argentina: Anibal Deus, Porto Alegre, Brazil: Livia Pereira and Patricia Yilmaz; Inonu Uni. Med. Fac., Malatya, Turkey: Hasan Agustin Damonte and Luciana Arias and Alejandro Ely Pizzato and Milene Santos and Euler Roberto Pekdemir and Murdem Keten; Cukurova University Meirino and Gerardo Zapata; Instituto Cardiovascular Manenti and Rafael Luiz Rech; HMCP - Hospital e Medical Faculty, Adana, Turkey: Mesut Demir and Buenos Aires, Ciudad Autonoma Buenos Aires, Maternidade Celso Pierro - PUC-Campinas, Gulsum Daglik; Gaziantep University Medical Faculty Argentina: Ignacio Nicolas De Urquiza and Jorge Campinas, Brazil: Larissa Trama and Carla Vicente Sahinbey Educational Research Hospital, Gaziantep, Atilio Belardi and Diego Conde and Alexandra and Camila Ormundo and Midia Costa and Jose Turkey: Sinan Bilecen and Murat Sucu; Hacettepe Navarro and Juan Pablo Costabel; Unidad de Francisco Kerr Saraiva; ICM - Instituto do Coração de University Medical Faculty, Ankara, Turkey: Levent Cardiologia Clinica, Buenos Aires, Argentina: Maria Marília, Marília, Brazil: Lilian Stefanie da Silva and Sahiner and Deniz Koca; Memorial Ankara Hospital, Paula Giacomi and Guillermo Giacomi and Ana Laura Daiane Santos and Alexandre Rodrigues and João Ankara, Turkey: Sercan Okutucu and Begum Yetis Tufare and Ramon Carrizo and María Florencia Edén; Carlos Ferreira Braga and Fábio Villaça Guimarães Sayin and Ali Oto and Deniz Koca and Sebnem Sanatorio Modelo Quilmes SA, Bu enos Aires, Filho; Unicárdio Unidade Clínica e Cardiológica Ltda., Sebnem; Istanbul University Cardiology Institute, Argentina: Roberto Nicolás Potito and Silvina João Pessoa, Brazil: Paulo Gottardo and Alexandre Istanbul, Turkey: Gamze Avinc and Murat Ersanli; Borchowiec and Tatiana Bruno and Adrian Demetrio Negri; Centro Multidisciplinar de Estudos Clínicos – Bagcilar Training and Research Hospital, Istanbul, Hrabar and Alberto Alfredo Fernandez and Jorgelina CEMEC, São Caetano do Sul, Brazil: Carlos Moncada Turkey: Ertugrul Okuyan and Ekrem Bilal Karaayvaz Casala and Claudia Funosas and Ana Lucia Cappi; and Marcos Vinicius Seroqui; Sociedade Hospitalar and Rifat Yildirim and Sinan Varol and Fatih Kizkapan Hospital Dr Jose Maria Cullen, Santa Fe, Argentina: Angelina Caron, Campina Grande do Sul, Brazil: and Gamze Avinc; Turkiye Yuksek Ihtisas Training and Mario Alberto Berli and Paula Berli and Florencia Berli Cristina Paula Corrêa and Luiz Gustavo Vieira Torres Research Hospital, Ankara, Turkey: Dursun Aras and Milagros and Germán Maehara; Hospital and Dalton Precoma; Hospital Ipiranga, Sao Paulo, Didem Civit. Universitario Austral, Pilar, Argentina: Mariana Foa Brazil: Fernando Roquette; CARDRESEARCH - Argentina Torres and Celso Arabetti and Fabian Ferroni. Cardiologia Assistencial, Belo Horizonte, Brazil: CENPEC Investigaciones, Ciudad A. de Buenos Aires, Brazil Ludmila Carvalho and Gilmar Reis; Hospital de Ensino Argentina: Florencia Rolandi and Natalia Vensentini Padre Anchieta, São Bernardo do Campo, Brazil: HUOC-UPE - Hospital Universitário Oswaldo Cruz da Caroline Nanzer Vital and José Da Silveira and and Vanesa Hansen; Sanatorio NOSTI, Rafaela, Universidade de Pernambuco, Recife, Brazil: Dário Argentina: Mariana Zillo and Martin Racca and Adrian Rodrigo Pavani and Roberto Álvaro Ramos Filho; Celestino Sobral Filho and Eveline Lustosa; Hospital Hospital Lifecenter, Belo Horizonte, Brazil: Bruna Cesar Ingaramo and Carola Ricotti and Osvaldo Jose Santa Marcelina, São Paulo, Brazil: Luis Soares and Angel Costamagna; Sanatorio Jozami, La Banda, Edilena Paulino Azevedo and Estêvão Lanna Isabel Santos and Jefferson Jaber; Instituto Dante Figueiredo and Gustavo Fonseca Werner; ICT - Argentina: Gustavo Alberto Sambadaro; Clinica Pazzanese de Cardiologia, São Paulo, Brazil: Simone Instituto Medico Adrogue, Adrogue, Argentina: Instituto do Coração do Triângulo, Uberlândia, Brazil: Barroso and Luciana Vidal Armaganijan and leber Roberto Vieira Botelho and Iara Resende; Hospital Andrea Alvarez D'Amelio and Pablo Omar Schygiel Serafim and Maria Isabel Del Monaco; Hospital and Vanina Fernandez Caputi; Hospital Centro de São Vicente de Paulo, Rio de Janeiro, Brazil: Melissa Cardiologico Costantini, Curitiba, Brazil: Carolina Stoll Mazzoni and Cláudio Munhoz da Fontoura Tavares; Salud Zenon Santillan, San Miguel de Tucuman, and Costantino Roberto Frack Costantini and Argentina: Hector Luciardi; SOS San Bernardo IPCEM - Instituto de Pesquisa Clínica para Estudos Costantino Costantini Ortiz and Daniele Komar; Multicêntricos - Universidade de Caxias do Sul, Medicina Prepaga SA, San Miguel de Tucuman, Santa Casa de Misericórdia de Pelotas, Pelotas, Argentina: Sofia Graciela Berman; Instituto Ave Caxias do Sul, Brazil: Silvia Oss Emmer and Fábio Brazil: Camila Fonseca and Felipe da Silva Paulitsch Eduardo Camazzola and Edimar Daros and Helius Pulmo, Mar del Plata, Argentina: Felicitas Fernandez and André Steffens; Via Médica, Goiânia, Brazil: Voena and Pablo Dragotto; Sanatorio de la Mujer, Carlos Finimundi and Sara Cardoso Boscato; Incor - Lohana Borges Queiroz and Weimar Kunz Sebba Instituto do Coração - HCFMUSP, São Paulo, Brazil: Rosario, Argentina: Maria de los Milagros Mercedes Barroso de Souzaem; Hospital de Messejana Dr

538 JAMA Cardiology June 2019 Volume 4, Number 6 (Reprinted) jamacardiology.com

Cristiano Pisani and Muhieddine Omar Chokr and Mexico CardioPrevent SC, Durango, Mexico: Lidia Martínez Hurgo Bellotti Lopes and Ricardo Clemente Unidad de Investigacion Clinica en Medicina S.C., Lares and Roxana Reyes Sanchez and Paulina Sida Mingireanov and Talita Barbosa and Selma Cristina Monterrey, Mexico: Carlos Jerjes Sanchez Diaz and Perez; Centro de Investigacion Alberto Bazzoni S.A. Quaia Fortunato and Eliane Fernandes; Hospital de Unidad de Investigacion Clinica Cardiometabolica de de C.V., Torreon, Mexico: Erika Jeanette Gonzalez Clínicas de Porto Alegre, Porto Alegre, Brazil: Priscila Occidente S.C., Guadalajara, Mexico: Maria Ruiz Felix and Karla Daniela Monreal de Luna and Aglaé Agliardi and Adriano Kochi and Fernanda Igansi; IMV Cornejo and Marissa Gonzalez and Jesus Jaime Romo Cerda and Alberto Esteban Bazzoni Ruiz and - Instituto De Medicina Vascular Hospital Mae de Illescas Diaz; Hospital General Dr Miguel Silva, Juan Carlos Ubillo Davila and Jose Luis Recio Deus, Porto Alegre, Brazil: Nurma Ramos Pereira and Morelia, Mexico: Conne Lizbeth Gonzalez Garcia and Gonzalez; Phylasis Clinicas Research S. de R.L. de Aline de Cassia Vieira dos Santos and Máurer Pereira Raul Leal Cantu; Consultorio Médico del Dr Ernesto C.V., Cuautitlan Izcalli, Mexico: Fatima Perez and Luis Martins and Ana Paula Macagnan; INACTIVE Trymed Germán Cardona Muñoz, Guadalajara, Mexico: Maria Alberto Martinez Cruz and Julio Alberto Perez Biocancer Centro de Pesquisa Clínica S.A., Belo Guadalupe Ramos Zavala; Hospital Angeles del Sanchez and Nayeli Soto and Oscar Martin Lopez Horizonte, Brazil: Jakeline Alves de Oliveira Gomes Pedregal S.A. de C.V., Mexico, Mexico: Ricardo Ruiz and Eduardo Montiel and Oscar Nandayapa and César Cássio Broilo França and Ana Paula Cabrera Jardines; The American British Cowdray Flores; Centro para el desarrollo de la Medicina y de Drummond Wainstein and Edmar Geraldo Ribeiro; Centro Medico ABC, Mexico City, Mexico: Victor Roa Asistencia Medica Especializada S.C., sede Mexico, IPCARDI - Instituto de Pesquisa Cardiovascular, Castro and Salome Altamirano Bellorin and Nilda Distrito Federal, Mexico: Patricia Padilla Macias and Caxias do Sul, Brazil: Fábio Alban and Gisele Biazus; Espinola Zavaleta; Centro Medico de las Americas, Roberto Arriaga Nava; Accelerium S de RL de CV, HRPC - ULBRA, Canoas, Brazil: Guido Bernardo Merida, Mexico: Sergio Villarreal Umaña; Centro de Monterrey, Mexico: Antonio Salinas and Sergio Piña Aranha Rosito and Heveline Roesch and Larissa Especialidades Medicas del Estado de Veracruz Dr Toledano and Jesus David Morales Cerda; Centro de Pacheco and Tatiana Vargas and Diego Alcoba; Rafael Lucio, Jalapa, Mexico: Sukey Ochoa Aybar and Investigacion Cardiovascular y Metabolica, Tijuana, Hospital Agamenon Magalhães, Recife, Brazil: Enrique Lopez Rosas; Hospital Cardiologica Mexico: Daniela Cienfuegos and Marittza Arasely Fernanda Freire and Sheylla Ribeiro and João Batista Aguascalientes, Aguascalientes, Mexico: Irma Uribe Rios and Guadalupe Susan Ramos Garcia and de Moura Xavier Moraes Junior; Hospital São Vicente Espinosa and Guillermo Antonio Llamas Esperón and Pedro Fajardo Campos and Pedro Fajardo Garcia and de Paulo, Passo Fundo, Brazil: Gilmar Junior and Ana Ramirez Ibarra and Maria Elena Felix Hernandez; Adriana Garcia Mejia and Patricia Ortiz and Glenda Norberto Toazza Duda and Rogério Tadeu Tumelero Instituto de Cardiologia y Medicina Vascular, Hernandez and Irene Ortega; Universidad Autonoma and Leticia Mortari; Hospital de Medicina de São José Monterrey, Mexico: Priscila Guajardo and Gerardo de Nuevo Leon, Hospital Universitario Dr Jose do Rio Preto, São José do Rio Preto, Brazil: Osvaldo Pozas; Consultorio Médico del Dr Ernesto Germán Eleuterio Gonzalez, Monterrey, Mexico: Carlos Rivera Lourenço da Silva Júnior and Daniele Cristine Esteves Cardona Muñoz, Guadalajara, Mexico: Sandra Ramos and Mario Benavides Gonzalez. and Osana Maria Coelho Costa Mouco and Maria Hernandez Gonzalez and Ernesto Cardona Muñoz; Austria Angelica Benez Teixeira Lemos and Nadielly Centro de Investigación cardiovascular, Acapulco, LKH - Universitätsklinikum Graz, Graz, Austria: Codonho Góes and Lilia Maia and Marcelo Arruda Mexico: Maria Candelaria Mancilla Ortiz and Nakazone; IMC - Instituto de Moléstias Marianne Brodmann and Thomas Gary and Claudia Norberto Matadamas Hernandez; Instituto Nacional Wöhrer; Barmherzige Brueder Konventspital Linz, Cardiovasculares Tatuí, Tatuí, Brazil: Roberto Simões de Neurologia y Neurocirugia Manuel Velasco de Almeida and Bruna Unterkircher; Vivecor Clínica Linz, Austria: Kurt Lenz; Praxis für Innere Medizin - Suarez, Mexico, Mexico: Adriana Ortiz and Adolfo Dr Claus Hagn - Voels, Voels, Austria: Claus Hagn; Médica e Cardiológica - Unidade Campinas, Leyva Rendon; Centro Medico Nacional 20 de Campinas, Brazil: Fernanda Jannuzzi and Marco Ordination - Dr Foechterle - Linz, Linz, Austria: Noviembre, Mexico, Mexico: Rafael Trujillo Cortes Johannes Foechterle and Johannes Foechterle; Antonio Dias and Ney Carter do Carmo Borges; and Norberto Garcia Hernandez; Centro para el ICDF - Instituto de Cardiologia do Distrito Federal, Landeskrankenhaus Feldkirch, Feldkirch, Austria: Desarrollo de la Medicina y de Asistencia Medica Karl-Martin Ebner and Alexander Vonbank and Heinz Brasília, Brazil: Etineia Gomes Lino and Angela Lopes Especializada S.C., Culiacan, Mexico: Luis Gerardo and Luís Gustavo Gomes Ferreira. Drexel and Susanne Wäger and Peter Schwerzler and Gonzalez Salas and Nora Mendoza and Manuel de los Helga Winkler; Wilhelminenspital der Stadt Wien, Chile Rios Ibarra; Virgen Cardiovascular Research SC, Wien, Austria: Claudia Wegmayr and Claudia Centro de Investigaciones Clínicas de la Universidad Guadalajara, Mexico: Jose Vega Gonzalez and Wegmayr and Kurt Huber and Ioannis Tentzeris; SMZ Católica, Santiago, Chile: Ivonne Padilla and Jara Humberto Jimenez and Luis Ramon Virgen Carrillo; Süd - Kaiser Franz Josef Spital Wien, Wien, Austria: Carmen and Ivonne Padilla and Ramón Corbalán; Unidad de Investigación Clinica en Medicina, S.C., Andrea Podczeck-Schweighofer and Andrea Centro Medico Stockins y Larenas, Temuco, Chile: Monterrey, Mexico: David Lopez Villezca; Instituto Podczeck-Schweighofer and Fritz Freihoff and Carola Lara and Benjamin Aleck Joseh Stockins Cardiovascular de Monclova, S de RL de CV, Thomas Priesnitz; Hanusch Krankenhaus der WKGG Fernandez; Hospital Sotero del Rio, Santiago, Chile: Monclova, Mexico: Carlos Hernandez Herrera and Wien, Wien, Austria: Michael Winkler and Roland Humberto Montecinos and Yessica Campisto; Daniel Martinez Vasquez; Hospital Angeles Breier; LKH Kirchdorf, Kirchdorf an der Krems, Centro de Estudios Cardiologicos y de Medicina Chihuahua, Chihuahua, Mexico: Juan Jose Lopez Austria: Thomas Mark and Bruno Schneeweiss and Interna, Temuco, Chile: Ana Rebolledo and Elda Prieto; Centro para el Desarrollo de la Medicina y de Adrian Mirtl; LKH - Bad Ischl, Bad Ischl, Austria: Molina and Fernando Lanas; Hospital Padre Alberto Asistencia Medica Especializada S.C., Saltillo, Mexico: Alfons Gegenhuber; Krankenhaus der Barmherzigen Hurtado, Santiago, Chile: Martín Larico Gómez; Rodolfo Gaona Rodriguez; Hospital de Jesus. I.A.P., Brueder Wien, Wien, Austria: Wilfried Lang and Hospital Carlos Van Buren, Valparaiso, Chile: Cuauhtemoc, Mexico: Angelica Villeda and Efrain Agnes Lischka-Lindner; AKH - Medizinische Margarita Vergara and Carlos Astudillo; Hospital Villeda Espinosa and Miriam Chavarria; Unidad de Universität Wien, Vienna, Austria: Sabine Complejo Asistencial Barros Luco, Santiago, Chile: Investigacion en Salud de Chihuahua SC, Sede Eichinger-Hasenauer and Lisbeth Eischer; Carlos Conejeros; Hospital de Talca, Talca, Chile: Juarez, Ciudad Juarez, Mexico: David Flores Ordination - Dr Kaserer - Salzburg, Salzburg, Austria: Patricio Marin Cuevas; Hospital Clinico de la Fuerza Martinez; Hospital Angeles Puebla, Puebla, Mexico: Peter Kaserer and Peter Kaserer; Humanomed Aerea de Chile, Santiago, Chile: Alejandro Forero; Jose Velasco Barcena; Unidad de Investigacion en Zentrum - Althofen, Althofen, Austria: Josef Sykora; Hospital San Juan de Dios La Serena, La Serena, Salud de Chihuahua SC, Sede Chihuahua, Chihuahua, KRAGES Burgenlaendische Krankenanstalten - LH Chile: Claudio Bugueño Gutiérrez and Patricia Mexico: Rosalva Avena and Omar Fierro Fierro; Güssing, Güssing, Austria: Heribert Rasch; LKH - Cortes; Hospital Clinico de Magallanes Dr Lautaro Cardioarritmias e Investigacion S.C., San Luis Potosi, Universitätsklinikum der PMU Salzburg, Salzburg, Navarro Avaria, Punta Arenas, Chile: Juan Aguilar; Mexico: Ignacio Rodriguez Briones and Irene Austria: Uta Hoppe and Bernhard Strohmer and Hospital Base Osorno, Osorno, Chile: Sergio Elizabeth Lira González; Hospital Central Dr Ignacio Bernhard Strohmer and Lynne Hinterbuchner and Potthoff Cardenas and Nelly Garcia Dominguez; Morones Prieto, San Luis Potosi, Mexico: Natalia Erika Prinz. Nikitina and Teresa Izquierdo and Jose Luis Leiva Hospital Base Valdivia, Valdivia, Chile: Jessica Belgium Munoz Oyarzon and German Eggers; Clinica Santa Pons; Hospital de Especialidades Centro Medico Lucia, Santiago, Chile: Veronica Olguin and Cesar Puerta de Hierro, Zapopan, Mexico: Gabriela Santana Parqué, Jean-Luc, Mouscron, Belgium: Jean-Luc Houzvic; Hospital del Salvador, Santiago, Chile: and Humberto Alvarez Lopez; Clinica de Estudios Parqué; BVBA Dr Luc Capiau, Wetteren, Belgium: Carlos Rey; Hospital Clinico Regional Dr Guillermo Medicos SC, Guadalajara, Mexico: Rafael Olvera Ruiz; Hilde Capiau and Luc Capiau and Farah Banaeian; AZ Grant Benavente, Talcahuano, Chile: Germán Instituto Nacional de Ciencias Médicas y Nutricion Dr Sint-Maarten, Mechelen, Belgium: Ellen Deweerd Arriagada and Claudio Villan Araneda; Hospital Salvador Zubiran, Mexico, Mexico: Fernando Flores and Oscar Semeraro and Muriel Delvigne and Tom Naval Almirante Nef, Viña del Mar, Chile: Gustavo Silva and Carlos Gerardo Cantu Brito; Centro de Vydt and Hans Rombouts and Chris Scheurwegs Charme Vilches. Investigacion Cardiologica EPI M, Mexico, Mexico: andGeert Vervoort and Ellen Potoms and Inez Eduardo Julian Jose Roberto Chuquiure Valenzuela; Mestdagh and Sofie Drieghe; ZNA Stuivenberg,

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Antwerpen, Belgium: Benjamin Scott and Tim Weyn General practitioner s.r.o., Ostrava - Vitkovice, Czech Finland: Juhani Koistinen and Tuija Vasankari and and Emile Keyzer and Bart Wollaert and Marleen Republic: Daniel Michalik and Josef Olsr; Carmela Viitanen. Bogaert and Martine Oreglia and Inge Joris and Dirk Thomayerova nemocnice, Praha, Czech Republic: France Denie and Christine Jacobs; A.Z. KLINA, Brasschaat, Lubos Kotik and Marketa Lajnerova; Nemocnice Belgium: Dieter De Cleen and Steven Hellemans and Slany, Slany, Czech Republic: Michaela Horejsi and Hôpital Nord - CHU Marseille, Marseille, France: Johan Salembier and Frank Cools and Jef Verheyen Lenka Janska and Tomas Drasnar and Blazej Racz; Didier Sanchez and Franck Paganelli and Floriane and Walter Smolders and Nancy Simons and Veerle Poliklinika Masarykuv Dum, s.r.o, Trutnov, Czech Robin; Groupe Hospitalier Sud - Hôpital Thyssen; Private Practice Cardiology, De Pinte, Republic: Richard Ferkl; Privatni interni a Haut-Lévêque, Pessac, France: Frédéric Casassus; Belgium: Geert Hollanders; VZW Regionaal kardiologicka ambulance, Chrudim, Czech Republic: Hôpital Européen Georges Pompidou, Paris Cedex Ziekenhuis Jan Yperman, Ieper, Belgium: Veerle Vera Hubacova and Jan Hubac; Ustredni vojenska 15, France: Jean-Yves Le Heuzey; CHU de Toulouse - Soufflet and Jan De Keyser and Dries De Cock and nemocnice Praha, Praha 6, Czech Republic: Ilja Kotik Hôpital Rangueil, Toulouse cedex 9, France: Michel Jan Vercammen and Melissa de Vos; Maria and Jaroslava Novakova and Petr Krca and Eva Galinier and Nathalie Rosolin; Clinique Saint Joseph Ziekenhuis Noord-Limburg vzw, Overpelt, Belgium: Krcova; Nemocnice Znojmo, Znojmo, Czech - Groupe Hospitalier Prive du Centre Alsace, Colmar Bert Vanhauwaert and Dirk Van Lier and Cathy Republic: Eva Prochazkova and Zdenek Monhart and Cedex, France: Yannick Gottwalles; Hôpital Nord - Kuppens and Dirk Faes and Ann Vandorpe; SPRL MG Maria Majerníkova; Poliklinika Humanitas, Bilovec, CHU Marseille, Marseille, France: Audrey Morioni Balthazar & Ballard, Natoye, Belgium: Yohan Czech Republic: Hana Burianova; Poliklinika RAVAK, and Pauline Armangau; Centre Hospitalier Public du Balthazar; Centre Hospitalier Hutois, Huy, Belgium: Pribram 8, Czech Republic: Martina Valtova and Iva Cotentin, Cherbourg - Octeville, France: Philippe Marc Delforge and Francoise Gits; CHU UCL Namur, Kopeckova and Ondrej Jerabek; Kardio-Pisova, s.r.o., Loiselet; Cabinet du Dr Jean-Joseph Muller, Mont-Godinne, Yvoir, Belgium: Olivier Xhaet and Hradec Kralove, Czech Republic: Jana Pisova; Strasbourg, France: Jean-Joseph Muller; Centre Fabien Dormal; Heilig Hart Ziekenhuis, Mol, Belgium: Kardiologicka ambulance-Petrova, Usti nad Labem, Hospitalier de Chateauroux, Chateauroux, France: Harry Striekwold and Dirk Vandenbroeck; AZ Czech Republic: Iveta Petrova; Orlickoustecka Mohamed Bassel Koujan; CH de Frejus-Saint Turnhout - Campus Sint-Elisabeth, Turnhout, nemocnice, a.s., Usti nad Orlici, Czech Republic: Raphael, Frejus, France: André Marquand; Centre Belgium: John Thoeng; AZ Sint-Lucas - Campus Vratislav Dedek; AVICENA -KARDIOLOGIE INTERNA Hospitalier du Val d'Ariege, Saint Jean de Verges, Sint-Lucas, Gent, Belgium: Hans Vandekerckhove s.r.o., Praha 1, Czech Republic: Jakub Honek and France: Sylvain Destrac; Centre Cardiologique du and Chantal Smessaert and Hugues Verloove and Michaela Honkova; Interni lekarstvi-ALINPED s.r.o., Nord, Saint-Denis, France: Baptiste Dubois and Katarina Van Beeumen and Jan Nimmegeers and Praha 6, Czech Republic: Petr Podrazil; Krajska Olivier Piot; Centre Hospitalier de Pau, Pau Cedex, Christophe Borin and Frauke Gorre and Kurt zdravotni, a.s. - Nemocnice Teplice, o.z., Teplice, France: Josette Couleru and Christine Hermans and An-Kristin Ascoop and Nancy de Czech Republic: Petr Reichert and Lenka Zizkova; Murguet-Badia and Nicolas Delarche and Anne Weerdt; Cliniques du Sud-Luxembourg, Arlon, Fakultni nemocnice Brno, Brno, Czech Republic: Colomes; Nouvelles Cliniques Nantaises, Nantes Belgium: Monique Raepers and Georges Mairesse; Ruzena Labrova and Jindrich Spinar; Fakultni Cedex 2, France: Jean-Pierre Cebron and Nathalie AZ Delta, Roeselare, Belgium: Emma Vanhalst and nemocnice u sv. Anny v Brne, Brno, Czech Republic: Decarsin; Cabinet medical prive, Plan de Cuques, Peter Pollet and Wim Anné and Tine Casier; CHU de Veronika Vyhlidalova and Miroslav Novak and Jolana France: Maxime Guenoun; Cabinet prive, Paris, Charleroi - Hôpital André Vésale, Montigny-le-Tilleul, Lipoldova; Fakultni nemocnice v Motole, Praha 5, France: Dominique Guedj-Meynier; CH d'Albi, Albi Belgium: Veronica Piamonte and Ivan Blankoff and Czech Republic: Alexandra Lindourkova and Vaclav cedex 9, France: Lokesh A G and Christine Beltra; Asuncion Conde Y Bolado; Huisartsen Het Laar, Durdil; Nemocnice Novy Jicin a.s., Novy Jicin, Czech Cabinet medical de cardiologie, Cannes, France: Merksem, Belgium: Peter Vandenbossche and Republic: Katarina Plocova; Krajska zdravotni, a.s. - Serge Assouline; Hôpital Saint Joseph - Paris, Paris, Sophie Deckers and Michel Beutels and Lisa Masarykova nemocnice v Usti nad Labem, o.z., France: Mathieu Zuber and Anne Bonnetain; Helvasto; AZ Zeno, Knokke-Heist, Belgium: Flor Usti nad Labem, Czech Republic: Sarka Hôpital Bichat - Claude Bernard, Paris, France: Kerkhof and Stefan Verstraete and Ann Dhondt; Smetankova and Lenka Zizkova and Jiri Lastuvka Pierre Amarenco and Agnes Kemmel; Centre BVBA Peter Vandergoten Cardiologie, Overijse, and Jakub Sveceny. Hospitalier de la côte Basque, Bayonne, France: Emmanuel Ellie; Cabinet prive de cardiologie, Paris, Belgium: Peter Vandergoten; Clinique Saint Jean, Denmark Brussel, Belgium: Joseph Richa and Philippe Purnode France: James Kadouch; Centre Hospitalier de and Severine Tahon; CHU Ambroise Paré, Mons, Rigshospitalet, Copenhagen, Denmark: Jørn Nielsen; Beziers, Beziers cedex, France: Pierre-Yves Belgium: Pascal Godart and Anna-Maria Barbuto and Bispebjerg_Hospital, Copenhagen NV, Denmark: Fournier; Cabinet prive de cardiologie, Houilles, Marianne Blockmans; AZ Groeninge - Kennedylaan, Helena Dominguez; Sydvestjyds Sygehus Esbjerg, France: Jean-Pierre Huberman and Nestor Lemaire; Kortrijk, Belgium: David Derthoo and Christiaan De Esbjerg, Denmark: Anne-Mette Oksbjerg CH de Mulhouse - Hôpital Emile Muller, Mulhouse Niel and Van Hulle Tim and Hannelore Svenningsen and Joan Hummelshøj and Lene Cedex, France: Gilles Rodier; Centre Hospitalier - La Van Eeckhoutte and Tim Boussy and Marlies De Margrethe Tanggaard and Ulrik Hintze and Annette Rochelle, La Rochelle cedex, France: Xavier Coninck; CHC - Cliniques de l'Espérance, Montegnée, Nygaard; Hvidovre_Hospital, Hvidovre, Denmark: Vandamme; Groupe Hospitalier Pellegrin - Hôpital Belgium: Philippe Desfontaines and Gabriella Søren Rasmussen; Næstved Sygehus, Næstved, Pellegrin, Bordeaux Cedex, France: Sylvain Ledure Tincani; AZ Glorieux, Ronse, Belgium: Charlotte Denmark: Arne Bremmelgaard and Christina Ellervik; and Igor Sibon and Sabrina Debruxelles and Camille Vantomme and Alex Heyse and Becker Alzand and Fredericia Sygehus, Fredericia, Denmark: John Girollet and Stephane Olindo and Mathilde Poli and Frederik Van Durme and Isabelle Stockman and Markenvard and Kirsten Vesterager; Lægerne Pauline Renou and Sharmila Sagnier and Nathalie Marloes Everaert; AZ Nikolaas, Belgium: Lies Nordens plads, Frederiksberg, Denmark: Jan Børger; Heyvang and Ledure Sylvain; CHU Poitiers - Hôpital Vergauwen and Martine Lauwers and Yasmina Tønder Lægehus Nord, Tonder, Denmark: Jorgen la Milétrie, Poitiers Cedex, France: Jean-Philippe Steyaert and Joeri Voet; RZ Heilig Hart Tienen Solgaard; Lægerne Dommergaarden, Vejle, Neau; CHU Nice - Hôpital Saint Roch, Nice Cedex 1, Campus Mariendal, Tienen, Belgium: Axel De Wolf Denmark: Ebbe Eriksen and Peter Simonsen and France: Marie Hélène Mahagne and Alain Suissa; and Chris Brike. Jakob Tilma; Lægerne Henrichsen Bonde og Cabinet Medical Marseille (GP), Marseille, France: Løkkegaard, Lyngby, Denmark: Thomas Løkkegaard; Antoine Mielot; Cabinet Medical, Seysses, France: Czech Republic Michael Bruun, Struer, Denmark: Michael Bruun; Marc Bonnefoy; Cabinet Médical, Le Pradet, France: Ordinace interniho lekarstvi, Praha 2, Czech Lægehuset i Jerslev, Jerslev, Denmark: Jacob Mertz; Jean-Baptiste Churet and Cabinet medical, Toulon, Republic: Jan Bultas; Fakultni nemocnice v Motole, Herlev Hospital, Herlev, Denmark: Annie Therkelsen France: Vincent Navarre and Cabinet medical privé, Praha 5, Czech Republic: Petra Antonova and Jiri Zika and Morten Schou; Frederiksberg Hospital, Roquevaire, France: Frederic Sellem and Cabinet and Alexandra Lindourkova and Petr Jansky and Fredriksberg, Denmark: Jesper Hansen and Frank medical privé, Saint Mandrier sur Mer, France: Gilles Jaromir Chlumsky and Petr Potuznik and Renata Paganelli and Ilan Raymond and Helena Dominguez Monniot and Cabinet médical privé, Seysses, Kratochvilova; Nemocnice na Frantisku, Praha 1, and Dorte Raae; Holbæk Sygehus, Holbæk, France: Jean-Paul Boyes and Docteur Bernard Czech Republic: Lucie Mahdalikova and Lucie Denmark: Lise Jensen and Therese Bang-Hansen and Doucet, Wassy, France: Bernard Doucet and Centre Bockova and Adam Sulc and Lenka Dastychova and Michael Olsen. Hospitalier de Langres, Langres, France: Michel Rudolf Spacek; InterKardioML s.r.o., Marianske Finland Martelet and Cabinet medical prive, Aubagne, Lazne, Czech Republic: Vilma Machova; Ordinace France: Désiré Obadia and Cabinet prive de interniho lekarstvi, Prague, Czech Republic: Hana Tampereen yliopistollinen sairaala, Tampere, Finland: cardiologie, Salon de Provence, France: Bernard Lubanda and Milan Zidek and Eva Zidkova and Alena Pekka Raatikainen and Kati Helleharju and Crousillat and Centre Hospitalier de Langres, Lorenzova; Privatni interni ambulance, Brno, Czech Hannaleena Nappila and Virpi Palomaki and Olli Langres, France: Joseph Mouallem and Centre Republic: Ondrej Ludka and Alexandra Ludkova; Arola; Turun yliopistollinen keskussairaala, Turku, Hospitalier d'Arras, Arras cedex, France: Corinne

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Lepot and Etienne Bearez; Cabinet medical -Jean Gunter Hergdt; Praxis Dr Reimer, Anderbeck, and Jusztina Feil; COROMed-SMO Kft., Pecs, Philippe Brugnaux, PARIS, France: Jean Philippe Germany: Cornelia Reimer and Dietrich Reimer; Hungary: Balazs Gaszner; CEE Research Kft., Brugnaux; CHU de Reims, Houilles, France: Alain Praxis Dr Hauk, Nussbach, Germany: Christl Hubrich Kisvarda, Hungary: Ferenc Juhasz and Peter Jen; Fedorowsky; Centre Hospitalier de la côte Basque, and Joachim Hauk; GP Wuttke/Michel, Lutherstadt Dental-Med Co. Bt., Satoraljaujhely, Hungary: Bayonne, France: Angeline Barreau and Aurélie Eisleben, Germany: Holger Michel; Praxis Dres. Erdle Veronika Forgo and Gizella Juhasz and Szilvia Pons and Estelle Corrihons and Jean-Baptiste und Budelmann, Ense, Germany: Werner Erdle; Gergely and Petra Gombos; Gottsegen Gyorgy Berneau; APRCL, Bordeaux, France: Margaux Praxis Dr Dorsch, Paderborn, Germany: Aneta Tetlak Orszagos Kardiologiai Intezet, Budapest, Hungary: Treuil-Peraldi and Nadege Ansoult and Frédéric and Wilfried Dorsch; Praxis Dr Dshabrailov, Eszter Fulop and Sandor Kancz; Szent Janos Korhaz Chemin and Caroline Moreau. Osnabrueck, Germany: Janna Dshabrailov; Praxis Dr es Eszak-budai Egyesitett Korhazak, Budapest, Germany Rapp, Haigerloch, Germany: Karl-Albrecht Rapp; Hungary: Boglarka Vandrus and Zoltan Laszlo and Fachuebergreifende Praxisgemeinschaft Dr med. H. Zoltan Radics; Obudai Egeszsegugyi Centrum Kft., Staedtisches Klinikum Dresden Standort Boeneke/ R. P. Vormann, Lienen - Kattenvenne, Budapest, Hungary: Zsolt May and Fruzsina Sztanyik; Dresden-Friedrichstadt, Germany: Andreas Ulbrich Germany: Reinhold Vormann and Daniela Nicolaus; Semmelweis Egyetem, Budapest, Hungary: and Vivantes Klinikum Neukoelln, Berlin, Germany: Praxis Dr Mueller, Berlin, Germany: Thomas Mueller; Marianna Szabo and Bela Merkely and Nora Sydo; Friederike Girke and Harald Darius and Roya Sartipi Praxis Dr Mayer, Langenfeld, Germany: Peter Mayer; Fejer Megyei Szent Gyorgy Egyetemi Oktato Korhaz, and Viola Jaerisch and Elke Luczak and Carsten Praxis Dr Horstmeier, Harsewinkel, Germany: Jan Zak Szekesfehervar, Hungary: Maria Hollósiné Kovács Meincke and Stefan Sommer and Astrid Maselli; and Uwe Horstmeier; Praxis Birkenallee, Papenburg, and Ebrahim Noori; Pecsi Tudomanyegyetem, Pecs, Praxis Dr Koeniger, Ebrach, Germany: Georg Germany: Volker Eissing and Gabriele Menken; Hungary: Tamas Habon and Szilvia Kovacsne Levang; Koeniger; Praxis, Berlin, Germany: Andreas Kopf; Gemeinschaftspraxis Dres Hey und Krenzel, SzSzB Megyei Korhazak es Egyetemi Oktatokorhaz, Gemeinschaftspraxis, Loehne, Germany: Uwe Paderborn, Germany: Heinz Hey; Praxis Dr Nyiregyhaza, Hungary: Attila Szilagyi and Peter Gerbaulet; Gemeinschaftspraxis, Camburg, Leuchtgens, Bad Woerishofen, Germany: Heinz Polgar; Sopron Medical Egeszsegugyi Szolgaltato Germany: Bernd-Thomas Kellner; Leuchtgens; Praxis Dr Lilienweiss, Kamen, Germany: Kft., Csorna, Hungary: Gabriella Szalai; Belinus Bt., Gemeinschaftspraxis Internisten Kelkheim, Volker Lilienweiss; Berufsausübungsgemeinschaft Debrecen, Hungary: Sandor Vangel; Bacs-Kiskun Kelkheim, Germany: Gabriele Jass and Thomas Dres. med. Kolitsch / Mueller, Katzhuette, Germany: Megyei Korhaz, Kecskemet, Hungary: Andras Nagy; Schaefer; Gesundheitszentrum Gelstertal, Anja Fleck and Heiner Mueller; Praxis Dr med. QUALICLINIC Eu-i Szolg. es Kutatasszervezo Kft, Grossalmerode, Germany: Ute Weiser and Jan Purr; Christian Schubert, Leipzig, Germany: Christian Budapest, Hungary: Eszter Kiralyhazine Gyorke and Praxis Dr Eißfeller, Woellstein, Germany: Karla Schubert; Praxis Dr med. Herrmann Lauer, Viersen, Gabriella Engelthaler; Clinexpert Kft., Budapest, Kirchner-Volker and Enno Eißfeller; Germany: Herrmann Lauer; Praxis Dipl. med. Hungary: Judit Ferenczi and David Gulyas and Emese Gemeinschaftspraxis Dr Zauzig, Dr Weber, Koeln, Thomas Buchner, Neustrelitz, Germany: Thomas Dohovits and Mihaly Egyutt. Germany: Heinz-Dieter Zauzig; Praxis Dr Riegel, Buchner; Praxis Dr med. Gunter Brauer, Cottbus, Italy Wolfsburg, Germany: Peter Riegel; Cardiologicum Germany: Gunter Brauer and Diana Kroll; Dresden und Pirna, Dresden, Germany: Juergen Praxisgemeinschaft Dr med. H. Gliem und FA S. Azienda Socio Sanitaria Territoriale degli Spedali Civili Wurziger and Adrienne Heuer and Christoph Kamin, Goehren, Germany: Susanne Kamin; Praxis Dr di Brescia (Presidio Spedali Civili), Brescia, Italy: Axthelm and Benjamin Schaefer; Praxis Dr Heinz, med. Karsten Mueller, Graefenhainichen, Germany: Giuliana Martini; Arcispedale S. Maria Nuova Azienda Bergisch Gladbach, Germany: Afra Heinz and Gabriela Mueller and Karsten Mueller; Fachärztin für Ospedaliera di Reggio Emilia, Italy: Leone Maria Gerd-Ulrich Heinz; Praxis Dr Menke, Hannover, Allgemeinmedizin, Apolda, Germany: Kerstin Cristina and Ospedale degli Infermi, Rimini, Italy: Germany: Holger Menke; Gemeinschaftspraxis, Schmidt and Sylvia Baumbach; Praxis Dr med. Eros Tiraferri; Azienda Ospedaliera Pugliese Ciaccio, Berlin-Neukoelln, Germany: Andreas Pustelnik; Ihr Abdel-Qader, Winsen, Germany: Dagmar Mohrmann Catanzaro, Italy: Rita Santoro; Azienda Socio Landarzt Praxis fuer Familienmedizin, Neubukow, and Muwafeg Abdel-Qader; Gemeinschaftspraxis Sanitaria Territoriale di Cremona (Istituti Ospitalieri di Germany: Stefan Zutz and Andrea Talkenberger; Stenzel, Ebert, Otto, Riesa, Germany: Lisa Mann and Cremona), Cremona, Italy: Sophie Testa and Cinzia Praxis Dr Eder, Karlsfeld, Germany: Wolfgang Eder Antje Richter and Gunter Stenzel and Romy Zecca; Azienda Ospedaliera Universitaria "Federico and Zuzana Babjakova; Praxis Dr Rehling, Sand am Meinecke and Hans-Holger Ebert; II", Napoli, Italy: Giovanni Di Minno and Pasquale Main, Germany: Guenter Rehling; Praxis Dr med. Universitaetsklinikum Hamburg-Eppendorf, Ambrosino; Fondazione IRCCS CA' Granda Ospedale Glatzel, Hannover, Germany: Dirk Glatzel; Hamburg, Germany: Stefanie Boehme and Kerstin Maggiore Policlinico, Milano, Italy: Simon Braham Gemeinschaftspraxis Prof. Ludwig, Dr Honl, Willich, Flint and Carsten Schwencke; Staedtisches Klinikum and Marco Moia; Azienda Socio Sanitaria Territoriale Germany: Norbert Ludwig; Praxis Dr med. Sandow, Dresden Standort Dresden-Friedrichstadt, Dresden, Niguarda (Grande Ospedale Metropolitano Berlin, Germany: Petra Sandow; Praxis Dr med. Germany: Thomas Wolf and Sebastian Schellong and Niguarda), Milano, Italy: Roberta Fritella and Teresa Wiswedel, Fuerth, Germany: Henning Wiswedel; Carsen Mueller and Johannes Ullrich and Roswitha Maria Caimi and Roberta Frittella and Stefania Praxis Dr med. Wildenauer, Bad Brueckenau, Frommhold and Kerstin Spranger and Birgit Voigts Brusorio; Azienda Ospedaliero-Universitaria Germany: Cosmas Wildenauer; Klinikum Pirna and Sylvia Weichelt and Mario Hahn; "Policlinico-Vittorio Emanuele", Catania, Italy: Maria GmbH, Pirna, Germany: Christoph Reichelt and Universitaetsklinikum Ulm, Ulm, Germany: Dominik Tessitori; Azienda Ospedaliera di Perugia Ospedale S. Stephanie Zincke and Marian Christoph and Steffen Buckert and Peter Bernhardt and Uta Dichristin; FAZ Maria della Misericordia, Perugia, Italy: Giancarlo Schoen; Internistische Facharztpraxis Dr Schwarz, Dresden-Neustadt GbR, Dresden, Germany: Kerstin Agnelli and Federica Macellari and Erika D’Agostini Zwenkau, Germany: Toralf Schwarz and Heike Bonin and Kerstin Mikes and Franziska Guenther and and Marta Fedele; A.O.U. Senese Policlinico Santa Riessbeck; Praxis Dr med. Babyesiza, Laszlo Karolyi; Praxis Dr med. Britta Sievers, Maria alle Scotte, Siena, Italy: Roberto Cappelli; Engelskirchen-Ruenderoth, Germany: Regina Henstedt-Ulzburg, Germany: Britta Sievers and Azienda Ospedaliera Universitaria Careggi, Firenze, Voelkel-Babyesiza and Adyeri Babyesiza; Praxis Dr Charite - Campus Virchow-Klinikum, Berlin, Italy: Daniela Poli; Azienda Ospedaliero Universitaria med. Kropp, Luebeck, Germany: Sylvia Simon and Germany: Nesrin Nasser and Wilhelm Haverkamp di Parma, Parma, Italy: Roberto Quintavalla and Piera Maximilian Kropp and Hildegard Floegel; Praxis Dr and Philipp Lacour and Paula Muenkler and Luis Maria Ferrini; Azienda Ospedaliera S. Anna e S. med. Zimny, Bad Pyrmont, Germany: Marianne Weitbrecht and Katja Hubert; Vivantes Klinikum Sebastiano, Caserta, Italy: Claudio Femiano; Hintze and Hans-Hermann Zimny; Hellersdorf, Berlin, Germany: Florian Busch and Ospedale della Val di Chiana Santa Margherita, Gemeinschaftspraxis Dres. Kahl, Ibrom, Fredenbeck, Jens-Uwe Roehnisch and Maria Schuppe. Cortona, Italy: Franco Cosmi; IRCCS Ospedale Casa Germany: Friedhelm Kahl; Praxis Dr med. Caspar, Sollievo della Sofferenza, San Giovanni Rotondo, Ottenbach, Germany: Andreas Caspar; Praxis Dr Hungary Italy: Raimondo Massaro and Raffaele Fanelli and med. Omankowsky, Berlin, Germany: Sabine Szent Rokus Korhaz es Intezmenyei, Budapest, Carmela DArienzo; Azienda Ospedaliera Bianchi Omankowsky; Gesundheitszentrum Halle-Neustadt, Hungary: Andras Papp and MeDOC Melacrino Morelli, Reggio Calabria, Italy: Vincenzo Halle, Germany: Torsten Laessig; Praxis Dr med. EGeszsegkozpont, Budapest, Hungary: Andras Oriana and Vincenzo Oriana and Gianluca Sottilota; Hartmann, Krombach, Germany: Hermann-Josef Vertes and Szantai MED Bt., Hodmezovasarhely, Presidio Ospedaliero SS. Trinità Sora, Sora, Italy: Hartmann and Diana Amrhein and Ramona Heeg; Hungary: Gabor Szantai and Kanizsai Dorottya Raffaele Reggio; Azienda Ospedaliera Nazionale Gemeinschaftspraxis Dres med. Lehmann, Fuldatal, Korhaz, Nagykanizsa, Hungary: Andras Matoltsy and Santi Antonio e Biagio e Cesare Arrigo, Alessandria, Germany: Aileen Grytzmann and Gunter Lehmann; Tunde Kiss; UNO Medical Trials Kft., Budapest, Italy: Roberto Santi; Ospedale di Bentivoglio, Praxis Dr Bindig, Geogensgmuend, Germany: Hungary: Nikosz Kanakaridisz; Debreceni Egyetem, Bentivoglio, Italy: Leonardo Pancaldi and Giulio Hans-Walter Bindig; Praxis Dr Hergdt, Debrecen, Hungary: Zoltan Boda; Tolna Megyei Boggian; Policlinico Universitario Agostino Gemelli, Obermichelbach, Germany: Susanne Hergdt and Balassa Janos Korhaz, Szekszard, Hungary: Erno Kis Roma, Italy: Raimondo De Cristofaro and Leonardo

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Di Gennaro; Azienda Ospedaliera Universitaria Lucassen; Trombosedienst Apeldoorn-Zutphen, Poland: Beata Wozakowska-Kaplon and Beata Policlinico Sant'Orsola Malpighi, Bologna, Italy: Luisa Apeldoorn, Netherlands: Mirjam Debordes and Henk Wozakowska-Kaplon and Radoslaw Bartkowiak and Salomone and Giuliana Guazzaloca and Giuliana Adriaansen and Jan Jaap van Putten; Kamila Wesolowska and Rafal Bzymek and Elzbieta Guazzaloca; Ospedale Santa Maria Goretti, Latina, Trombosedienst Ziekenhuis Rivierenland, Tiel, Jaskulska-Niedziela; Dolnoslaski Szpital Italy: Angelo De Blasio and Carlo Ciabatta; Azienda Netherlands: Jannie Boon and Maarten Bongaerts; Specjalistyczny im.T.Marciniaka- Centrum Medycyny Socio Sanitaria Territoriale Sette Laghi (Presidio Stichting Cardiologie Amsterdam, Amsterdam, Ratunkowej, Wroclaw, Poland: Edyta Szuchnik and Ospedale di Circolo e Fondazione Macchi), Varese, Netherlands: Misannia Boersma-Slootweg and Krystyna Loboz-Grudzien and Magdalena Dziuba Italy: Alfredo Bianchi and Jorge Salerno Uriate and Salcudean Tania and Mathijs Pieterse and Kris and Barbara Rzyczkowska and Maria Riccardo Gorla; Ospedale San Paolo, Savona, Italy: Gorrebeeck; WECOR, Etten-Leur, Netherlands: Coen Loboz-Rudnicka; Mazowiecki Szpital Specjalistyczny Flavia Lillo and Cinzia Scarone; Azienda Socio Guldener; Onze Lieve Vrouwe Gasthuis, Locatie Sp. z o.o., Radom, Poland: Jaroslaw Kosior and Sanitaria Territoriale di Monza (Presidio San Oost, Amsterdam, Netherlands: Femmy Bosman and Jaroslaw Kosior and Ewa Pawlik-Rak; Samodzielny Gerardo), Monza, Italy: Monica Carpenedo and Laura Breukel and Jean-Paul Herrman and Jennifer Publiczny Szpital Wojewodzki, Gorzow Wielkopolski, Enrico Maria Pogliani; Istituto Auxologico Knaake and Sander Niehe and Sandra Bruin and Poland: Wieslaw Supinski and Wieslaw Supinski and Italiano -I.R.C.C.S., Milano, Italy: Dr Luca Grappiolo A.J.K. Roelse; Bethesda Diabetes Research Center, Anna Szulowska and Jerzy Bartnik; Szpital and Laura Maria Lonati; Azienda Ospedaliera Card. G. Hoogeveen, Netherlands: Josien Krikken and S.H.K. Wojewodzki nr2wRzeszowie,Rzeszow,Poland: Panico, Tricase, Italy: Simona Longo and Michele The and Eileen Van Warners and Floor Geerlings; Jerzy Kuzniar and Elzbieta Korczowska and Janusz Accogli; Presidio Ospedaliero ASUR-Senigallia, Franciscus Gasthuis, Rotterdam, Netherlands: P.R. Romanek; Mazowiecki Szpital Specjalistyczny im. Dr Senigallia, Italy: Antonio Mariani and Francesca Nierop and Ingrid Danse; Diaconessenhuis Meppel, Józefa Psarskiego w Ostrołęce, Ostroleka, Poland: Calcagnoli and Anna Patrignani; ASL CN1 Ospedale Meppel, Netherlands: Pieter Hoogslag and Agaath Janusz Jankielewicz and Roman Zaluska and Dariusz Maggiore Strada Statale Trinità, Fossano, Italy: Mauro Stallinga-de Vos; ETZ Elisabeth, Tilburg, Netherlands: Andrzejewski and Dorota Kruczyk and Przemyslaw Feola; Fondazione IRCCS Policlinico San Matteo, Paul Melman and Tim van der Kley and Guido Chojnowski and Wojciech Rogowski and Adam Pavia, Italy: Arturo Raisaro and Katharina Granzow; van Leeuwen and Walter Hermans and A. Pronk and Komlo; Niepubliczny Zaklad Opieki Zdrowotnej, Ospedale San Giuseppe e Melorio, Santa Maria Riny van de Loo and Jeanne de Graauw; Gelre Nowa Sol, Poland: Jaroslaw Hiczkiewicz and Capua Vetere, Italy: Luciano Fattore and Cosimo Ziekenhuizen, Apeldoorn, Apeldoorn, Netherlands: Jaroslaw Hiczkiewicz and Wojciech Faron; NZOZ - Nave; Azienda Sanitaria Locale 2 Olbia, Olbia, Italy: Anastazia Jerzewski and B.E. Groenemeijer and Przychodnia Zespolu Lekarzy Rodzinnych w Andrea Mauric; USL 2 Umbria - Distretto di Perugia, E. M. Koomen and Suzanne Jansen and Rina Mulder; Szamocinie, Szamocin, Poland: Lucyna Perugia, Italy: Fabrizio Germini and Piero Grilli and Slingeland Ziekenhuis, Doetinchem, Netherlands: Swiatkowska-Byczynska and Lucyna Giuliana Duranti and Gregorio Baglioni; ASL 2 W. Terpstra and Anneke Grunewald; Swiatkowska-Byczynska and Wojciech Wieczorek; Umbria, Perugia, Italy: Massimo Alunni; AUSL 2 Huisartsenpraktijk Ewijk, Ewijk, Netherlands: Paul Szpital Specjalistyczny im. S. Zeromskiego SPZOZ, Umbria, Perugia, Italy: Luca Tedeschi and Maria Buiks; St Antonius Ziekenhuis, Nieuwegein, Krakow, Poland: Joanna Araminowicz and Diana Settimi and Mario Berardi; USL 2 Umbria - Distretto Netherlands: Josine te Kaat and Wesley Jetten and Kociolek and Lech Kucharski and Adriana di Perugia, Perugia, Italy: Valerio Pannacci and Fulvio Malu Kelderman and Judith De Graaf and L.V.A. Jaremczuk-Kaczmarczyk; Specjalistyczne Centrum Forcignanò and Angelo Giombolini; Medicina di Boersma and Mike Bosschaert and Boudewijn Medyczne CORDIMED, Gdansk, Poland: Marcin Gruppo - Borgo di Terzo, Bergamo, Italy: Sergio Uppelschoten and Pim Tonino. Gruchala and Bartosz Curyllo and Anna Frankiewicz; Nicoli; ASL Arezzo, Arezzo, Italy: Paolo Ricciarini and Norway Miejskie Centrum Medyczne im. dr Karola Jonschera Roberto Nasorri; ASL CN 1, Cuneo, Italy: Antonio w Łodzi, Lodz, Poland: Justyna Rychta and Jolanta Argena and Pierdomenico Bossolasco and Oslo Universitetssykehus HF, Ullevål, Oslo, Norway: Niedek and Piotr Minc and Halina Krystyna Bartolomeo Allasia; AUSL Parma, Parma, Italy: Paolo Ingrid Dominguez and Dan Atar and Bjørn Løvås and Kowalczyk and Karol Cieslak; NZOZ Amamed, Ronchini and ASL Bergamo, Bergamo, Italy: Claudio Trude Berge and Eivind Berge and Hege Claussen; Warszawa, Poland: Maciej Olszewski and Pawel Bulla and Luciano Foppa; ASL Milano, Milano, Italy: Østlandske Hjertesenter, Moss, Norway: Per Anton Szalecki; Clinmedica Research OMC, Skierniewice, Filippo Tradati and Maria Luisa Bottarelli and Sirnes and Vivi Nilsen; Asker Legesenter, Asker, Poland: Grzegorz Kania and Pawel Wojewoda and Antonino Tomasello; Azienda Ospedaliera Norway: Erik Gjertsen; Helse Møre og Romsdal HF, Agnieszka Sidor; Zespol Opieki Zdrowotnej, Sant'Andrea-Università di Roma La Sapienza, Roma, Ålesund, Norway: Torstein Hole and Rigmor Bøen Ostrowiec Swietokrzyski, Poland: Malgorzata Krzciuk Italy: Massimo Volpe; Azienda Ospedaliera di Rilievo and Silje Rasmussen; Vestlandske Hjertesenter AS, and Malgorzata Krzciuk and Piotr Walasik and Anna Nazionale A. Cardarelli, Napoli, Italy: Maria D'Avino; Bergen, Norway: Knut Erga; Spesialistgruppen, Szpotowicz and Anna Barszcz and Malgorzata Azienda Ospedaliero Universitaria Pisana, Pisa, Italy: Nesttun, Norway: Arne Hallaråker and Marie Ozgowicz; COPERNICUS Podmiot Leczniczy Sp. z o. Maria Grazia Bongiorni and Luca Segreti; Presidio O'Donovan; Trondheim Hjeresenter, Trondheim, o., Gdansk, Poland: Zbigniew Lajkowski and Ospedaliero della Misericordia, Grosseto, Italy: Silva Norway: Gunnar Skjelvan and Sissel Strand; Zbigniew Lajkowski; Wojskowy Instytut Medyczny, Severi and Marco Breschi; Azienda Ospedaliero Gransdalen Legesenter, Oslo, Norway: Anders Warszawa, Poland: Agata Krzesiak-Lodyga and Universitaria Ospedali Riuniti, Torrette di Ancona, Østrem; Løvenstadtunet Legesenter, Løvenstad, Ewelina Kowal and Bozenna Ostrowska-Pomian and Italy: Federico Guerra and Graziela Rangel and Norway: Beraki Ghezai; Nymoen Legekontor Anna Jackun-Podlesna and Katarzyna Kalin; Alessandro Capucci; Istituto Clinico Humanitas, (General Practice), Kongsberg, Norway: Arne Svilaas Wojewodzki Szpital Specjalistyczny we Wroclawiu, Rozzano, Italy: Elena Banfi and Veronica Pacetti and and Kristin Ringdalen; Stavanger Medisinske Senter Wroclaw, Poland: Jerzy Lewczuk and Marzena Corrado Lodigiani; ASL 3 Genovese di Genova, AS, Stavanger, Norway: Peter Christersson; Hallset Stopyra-Poczatek and Agata Kaczmarzyk-Radka and Genova, Italy: Enrico Salomone; Azienda Ospedaliero legesenter, Trondheim, Norway: Torbjørn Øien and Magdalena Wilgat-Szecowka and Renata Universitaria Ospedali Riuniti di Foggia, Foggia, Italy: Aase Jekthammer; Langbølgen legesenter, Oslo, Romaszkiewicz and Daniel Blaszczyk; Szpital Rosanna Villani and Aurelio Lo Buglio and Gaetano Norway: Svein Høegh Henrichsen and Anne Berit Wojewodzki im. M. Kopernika w Koszalinie, Koszalin, Serviddio; Centro Cardiologico Monzino-IRCCS, Lensebraaten; Sykehuset i Vestfold HF, Tønsberg, Poland: Elzbieta Zinka and Elzbieta Zinka and Agata Roma, Italy: Viviana Biagioli and Claudio Tondo; Norway: Jan Erik Otterstad and Karin Ausen; Vestfold Pawelska-Buczen and Karolina Azienda Ospedaliera di Perugia Ospedale S. Maria Hjertesenter, Sandefjord, Norway: Jan Zakutynska-Kowalczyk and Anita Biernacka; della Misericordia, Terni, Italy: Giuseppe Ciliberti and Berg-Johansen and Hege Antonsen. Indywidualna Specjalistyczna Praktyka Lekarska dr n. Ezio Mesolella and Giuseppe Ambrosio; Azienda Poland med. Agnieszka Karczmarczyk Specjalista Chorob, Ospedaliera S. Anna e S. Sebastiano, Caserta, Italy: Instytut Kardiologii im. Prymasa Tysiaclecia Szczecin, Poland: Agnieszka Karczmarczyk and Giovanni Cimmino and Paolo Golino; Azienda Servizi Kardynala Stefana Wyszynskiego, Warszawa, Poland: Agnieszka Karczmarczyk and Robert Kaliszczak; Sanitari 1 Triestina, Trieste, Italy: Carmine Mazzone; Janina Stepinska and Elzbieta Kremis and Anna I Szpital Miejski im dr E.Sonnenberga, Lodz, Poland: Anthea Hospital, Reggio Calabria, Italy: Giuseppe Konopka; SPZOZ w Lubartowie, Lubartow, Poland: Malgorzata Chmielnicka-Pruszczynska and Dorota Campagna and Pierpaolo Occhilupo and Saverio Andrzej Gieroba; Indywidualna Specjalistyczna Lesniewska-Krynska; SPSK Nr 7 SUM w Katowicach Iacopino. Praktyka Lekarska Małgorzata Biedrzycka, Starogard Gornoslaskie CM im. prof. Leszka Gieca, Katowice, The Netherlands Gdanski, Poland: Malgorzata Biedrzycka and Poland: Seweryn Nowak and Iwona Malgorzata Biedrzycka and Lukasz Biedrzycki; Wozniak-Skowerska; Samodzielny Publiczny Stichting Trombosedienst Maastricht, Maastricht, Centralny Szpital Kliniczny, Warszawa, Poland: Netherlands: Hugo ten Cate; Noordwest Prywatny Gabinet Lekarski, Piotrkow Trybunalski, Poland: Michal Ogorek and Aleksandra Szczepanska; Grzegorz Opolski and Agnieszka Kolodzinska and Ziekenhuisgroep, Alkmaar, Netherlands: J.H. Ruiter; Marek Kiliszek; Szpital Wielospecjalistyczny im. dr St Jans Gasthuis, Weert, Netherlands: Andreas Wojewodzki Szpital Zespolony w Kielcach, Kielce,

542 JAMA Cardiology June 2019 Volume 4, Number 6 (Reprinted) jamacardiology.com

Ludwika Blazka w Inowroclawiu, Inowroclaw, Ewelina Lichota and Jadwiga Nessler and Ewa Gasior Moscow State Medical University n.a. I.M. Sechenov" Poland: Marek Bronisz and Jacek Szafranski and and Marta Wegrzynowska and Pawel Rostoff and of the MoH of the RF, Moscow, Russia: Vladimir Artur Jarzebowski and Malgorzata Brzustowska and Rafal Mariankowski; Kutnowski Szpital Ivashkin and Oksana Drapkina and Olga Korneeva; Marcin Mielcarek; NZOZ ALL-MED Centrum Samorzadowy Sp. z o.o., Kutno, Poland: Jozef Lesnik. SPb SBIH "City Pokrovskaya Hospital", Medyczne Specjalistyczne Gabinety Lekarskie, Lodz, Russia Saint-Petersburg, Russia: Alexander Vishnevsky; Poland: Nikolina Roszczyk and Dorota FSBMEI HPE "Military Medical Academy n.a. S.M. Rozewska-Furmanek and Marcin Ogorek and Pawel Medical Centre "Alians", Kirovsk, Russia: Vera Kirov" of the MoD of the RF, St Petersburg, Russia: Ptaszynski; NZOZ Medicus Sp. z o.o., Gliwice, Poland: Eltishcheva; SBEI HPE "Orenburg State Medical Galina Nagibovich and Galina Monako and Oleg Grazyna Glanowska and Grazyna Glanowska and University" of the MoH of the RF, Orenburg, Russia: Nagibovich and Elena Kuznetsova; Therapeutic Przemyslaw Wilczewski; Szpital Wojewodzki im. Roman Libis and Irina Kulchenkova and Natalia Department of Clinical Hospital n.a. N.A. Semash, Prymasa Kardynala Stefana Wyszynskiego, Sieradz, Shkatova; SAIH "Republican Clinical Hospital # 2", Yaroslavl, Russia: Elena Novikova and Tatyana Poland: Jerzy Leszczynski and Piotr Ruszkowski and Kazan, Russia: Gadel Kamalov; SBIH of Novosibirsk Medvedeva and Petr Chizhov and Yulia Ivanova and Monika Smichura and Mateusz Splawski; Region "Clinical Emergency Hospital #2", Marina Gurmach; RBIH "Cardiological Dispensary", Wojewodzki Szpital Zespolony im. L. Rydygiera w Novosibirsk, Russia: Olga Volodicheva and Olga Ivanovo, Russia: Olga Lebedeva and Elena Toruniu, Torun, Poland: Lukasz Bernat and Grzegorz Kungurtseva and Dmitry Belenky; StP SHI Clinical Shutemova and Svetlana Romanchuk and Svetlana Skonieczny and Anna Raczynska and Malgorzata hospital of St Luka, Saint-Petersburg, Russia: Rachkova and Svetlana Rachkova and Margarita Troszczynska and Agnieszka Metzgier-Gumiela and Liudmila Egorova; SBEI HPE "Yaroslavl State Medical Ovchinnikova; SPb SBHI "City Policlinic #74", Maria Jaworska-Drozdowska and Tomasz Traczyk University" of the MoH of the RF, Yaroslavl, Russia: Kronshtadt, Russia: Daria Konyushenko and Polina and Grzegorz Trzcinski and Ryszarda Piotrowicz; Alexander Khokhlov and Olga Sinitsina and Svetlana Kuchuk and Mikhail Sergeev; Alupka City Hospital, Szpital Powiatowy SP ZOZ, Olawa, Poland: Ryszard Speshilova and Svetlana Chugunnaya and Elena Alupka, Russia: Borys Kurylo; State Institution Sciborski and Ryszard Sciborski and Ewa Bekieszczuk Lileeva; State Autonomous Healthcare Institution "Crimean state medical university named after S.I. and Beata Dolecka and Joanna Starak-Marciniak; SP "City Clinical Hospital #7", Kazan, Russia: Eduard Georgievskiy", Simferopol, Russia: Alexey Ushakov. Yakupov; SBIH of Moscow "City Clinical Hospital # CSK im. prof. K. Gibinskiego SUM, Katowice, Poland: Spain Malgorzata Klata and Boguslaw Okopien and Iwona 17", Moscow, Russia: Dmitry Zateyshchikov and Irina Kobielusz-Gembala and Marcin Basiak and Witold Zotova; FSBI “Scientific-research Institute for Hospital de la Santa Creu i Sant Pau, Barcelona, Szkrobka and Tomasz Dybala; Szpital Specjalistyczny Complex Problems of cardiovascular disease”, Spain: Enrique Rodriguez F and Jose Mara Guerra im.H.Klimontowicza w Gorlicach, Gorlice, Poland: Kemerovo, Russia: Evgeniya Zhuravleva and Elena and Concepcion Alonso and Marcos Rodriguez Wojciech Kurdzielewicz and Elzbieta Broton and Gorbunova and Tatyana Gorshkova and Olga Garcia and Douglas Alvarez and Anna Espallargas Piotr Kukla and Piotr Kukla and Maciej Kluczewski Barbarash and Yulia Belenkova and Tatiana and Enrique Pena Garcia and Xavier Vinolas and and Marcin Czamara; Medicus Bonus Sp z o.o., Kupriyanova; SBIH of Novosibirsk Region "Clinical Francisco Mendez Zurita; Policlinic Viladecans, Wagrowiec, Poland: Krzysztof Galbas; Medicus Emergency Hospital #2", Novosibirsk, Russia: Olga Viladecans, Spain: Nieves Palomo Merchan and Pere Bonus Sp z o.o., Sroda Wielkopolska, Poland: Agata Kungurtseva and Marina Blinkova and Olga Miller; Alvarez Garcia and Vianeth Rios; Complejo Markiewicz; Indywidualna Specjalistyczna Praktyka SHI “Regional Clinical Hospital”, Tver, Russia: Dmitry Hospitalario Universitario A Coruña, A Coruña, Spain: Lekarska w Dziedzinie Kardiologii lek. med. Krzysztof Platonov and Yurij Orlov and Evgeniy Mazur; SPb Beatriz Herrero Maeso and Carmen Gomez Castillo Cymerman, Gdynia, Poland: Krzysztof Cymerman SBIH "City Hospital # 38 n.a. N.A. Semashko", and Marta Fernandez and Diego Otero Tomera and and Alina Cieszynska; Poradnia Kardiologiczna Saint-Petersburg, Russia: Konstantin Zrazhevskiy; Javier Batlle Fonrodona and Maria Fernanda Lopez Jarosław Jurowiecki, Gdansk, Poland: Jaroslaw SPb SBIH "City Pokrovskaya Hospital", Fernandez and Joana Costa Pinto Prego de Faria and Jurowiecki and Monika Machnikowska and Jolanta Saint-Petersburg, Russia: Tatyana Novikova and Teresa Martinez; Hospital Universitario Virgen de las Neubauer-Geryk and Sebastian Tybura and Monika Fatima Bitakova; City Clinical Hospital n.a. Botkin, Nieves, Granada, Spain: Alejandro Molina Leyva and Figura-Chmielewska; NZOZ Pro-Cordis Sopockie Moscow, Russia: Yulia Moiseeva; SHI “Center of Rosa Macias and Manuel Molina and Miriam Jimenez Centrum Bad. Kardiolog., Sopot, Poland: Pawel Occupational Pathology”, Saint-Petersburg, Russia: and Francisco Jose Bermudez Jimenez and Daniel Miekus; NZOZ Centrum Medyczne HCP, Poznan, Elena Polkanova; SBIH of Moscow "City Clinical Castro Fernandez and Maria Jose Jimenez Fernandez Poland: Waldemar Myszka and Agata Nowak and Hospital # 61", Moscow, Russia: Konstantin Sobolev and Mercedes Cabrera Ramos and Luis Tercedor Aleksandra Wierzbicka and Karolina Majewska; and Svetlana Erofeeva; TSBIH "Krasnoyarsk Sanchez and Miguel Alvarez and Maria Molina Centrum Medyczne Medyk, Rzeszow, Poland: Ewa Interdistrict Clinical Hospital of Emergency Medical Jiménez and Carolina Torres; Centro de Salud El Miedlar and Monika Ambicka and Stanislaw Mazur Care n.a. N.S. Karpovich, Krasnoyarsk, Russia: Maria Cristo, Oviedo, Spain: Norberto Sierra and Salvador and Karolina Bugajska and Anna Starok and Artur Rossovskaya and Igor Motylev and Alexander Tranche Iparraguirre and Joaquin Aracil Villar; EAP Chmielowski and Michal Mazur; Lecznice Citomed Gubanov and Irina Konyukhova and Olga Suslova and Mataro-6 (Gatassa-El Maresme), Mataro, Spain: Sp. z o.o., Zespol Przychodni, Torun, Poland: Grazyna Galina Zubeeva; DCH on Station Chelyabinsk of JSC Antonio Negrete Palma and Stela Sanchez Parra and Jaguszewska and Aleksandra Lysek-Jozefowicz and "Russian Railways", Chelyabinsk, Russia: Ashot Pere Toran Monserrat and Josep Sorribes Lopez; Roman Lysek and Grazyna Szumczyk-Muszytowska Agakhanyan and Yulia Shapovalova; FSBI "Polyclinic Centro de Salud la Orden, Huelva, Spain: Emilio and Lukasz Wojnowski; NZOZ Przychodnia #3" of the Department for Presidential Affairs of the Marquez Contreras and CAP Llança, Llança, Spain: Specjalistyczna "Medica" Bogdan Walko, Lublin, RF, Moscow, Russia: Alla Kolesnikova; FSBSI Stela Sanchez Parra and Jordi Isart Rafecas; Centro Poland: Jacek Baszak and Bogdan Walko and “Scientific Research Institute of Therapy and de Especialidades Virgen de la Cinta, Huelva, Spain: Malgorzata Jargiello-Baszak and Wojciech Preventive Medicine”, Novosibirsk, Russia: Juan Motero Carrasco; Hospital Universitario Puerta Brzozowski; NZOZ Vitamed, Bydgoszcz, Poland: Konstantin Nikolaev and Alla Ovsyannikova; FSBI de Hierro Majadahonda, Majadahonda, Spain: Mateo Malgorzata Zyczynska-Szmon and Waldemar "Russian Cardiological Scientific and Industrial Cordoba and Ana Briceno Hinojo and Maria del Gadzinski and Joanna Luka and Rafal Cichomski and Complex" of the MoH of the RF, Moscow, Russia: Carmen Gutierrez del Val and Pablo Garcia Pavia and Teresa Rusicka-Piekarz and Marian Krzyzanowski; Elizaveta Panchenko and Ekaterina Kropacheva and Ariadna Gonzales Segovia; Complejo Hospitalario Uniwersyteckie Centrum Kliniczne, Gdansk, Poland: Oksana Zemlianskaia; SBIH of Moscow" City Clinical Ruber Juan Bravo, Madrid, Spain: Manuela Pereda Ewa Staniszewska and Pawel Gutknecht and Hospital # 51", Moscow, Russia: Ekaterina Volchkova Armayor and Miguel Perez Carasa and Carmela Agnieszka Niemirycz-Makurat and Michal Wrobel and Anna Zateyshchikova; SPb SBIH "City Polyclinic # Alonso and Casimiro Gomez Pajuelo; Hospital and Ewa Kochanska and Grzegorz Raczak and 109", St Petersburg, Russia: Victor Kostenko; FSBI Universitario Ramon y Cajal, Madrid, Spain: Miguel Mateusz Sciborski and Sebastian Tybura and Ewa "Research Institute for Cardiology" of Siberian Castillo Orive and Paz Gonzalez and Irene Lasuncion Lewicka and Ludmila Danilowicz-Szymanowicz and Branch RAMS, Tomsk, Russia: Sergey Popov and and Luis Miguel Rincon Diaz; Hospital Universitario Malgorzata Szwoch and Monika Figura-Chmielewska Roman Batalov; FSAEI HE " First Moscow State de Burgos, Burgos, Spain: Carolina Santolaya and and Jolanta Skalska and Barbara Opielowska-Nowak Medical University n.a. I.M. Sechenov" of the MoH of Luis Fernando Iglesias Alonso; Hospital Universitario and Lukasz Drelich and Justyna Kabat and Beata the RF, Moscow, Russia: Maria Poltavskaya and Anait Severo Ochoa, Leganes, Spain: Angel Grande Ruiz; Dudzik-Richter; Centrum Medyczne CDS, Wroclaw, Dumikyan and Olga Machilskaya; LLC "Alliance Hospital Universitari de Tarragona Joan XXIII, Poland: Malgorzata Guziewicz and Dorota Biomedical - Russian Group", Saint-Petersburg, Tarragona, Spain: Miriam Garcia Bermudez and Kustrzycka-Kratochwil and Ewa Domanska and Russia: Tamara Kolesova and Anton Edin; FSBI Veronica Quintern and Elisabet Serralvo and Jordi Malgorzata Sukiennik-Kujawa; Krakowski Szpital "Polyclinic # 5" of the Department for Presidential Merce Klein; Complejo Hospitalario Universitario de Specjalistyczny im. Jana Pawla II, Krakow, Poland: Affairs of the RF, Moscow, Russia: Elena Santiago, Santiago de Compostela, Spain: Lilian Aleksandrova and Olga Kropova; FSAEI HE " First Grigorian and Pilar Mazon and Venesa Garcia Millan

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and Jose Ramon Gonzalez Juanatey and Ana Seoane Marco and Gonzalo Marcos Gomez; Hospital Switzerland Blanco and Maria Moure Gonzalez; Hospital Meixoeiro, Vigo, Spain: Maria Belen Lage Universitaetsspital Zuerich, Zurich, Switzerland: Jan Universitario Virgen del Rocio, Sevilla, Spain: Marga Bouzamayor and Alicia Martin Vila and Marta Llobet Steffel and Ellen Saga and Stephan Winnik; Spital Gavira Saenz and Mariela Campo Moreno and Molina and Andres Iniguez Romo and Carlos Maria Uster, Ulster, Switzerland: Johann Debrunner and Gonzalo Baron Esquivias; C.A.P. Can Vidalet, Diaz Lopez and Marisol Amaro and Saleta Barbeira Daniela Amstutz and Alexander Westphalen; Esplugués de Llobregat, Spain: Ines Monte Collado; and Pablo Juan Salvadores and Diana Montes and Kantonsspital Baden AG, Baden, Switzerland: C.A.P. Sitges, Stiges, Spain: Stela Sanchez Parra and Seila Costas; Centro de Salud Vallobin-La Florida, Alexandra Grau and Isberg Henriette and Juerg H. Herminia Palacin Piquero; CAP Sardenya, Barcelona, Oviedo, Spain: Eduardo Hevia Rodriguez and Beer and Christian Gustav Lutz and Kirsten Steden Spain: Carles Brotons Cuixart; C.A.P. Horta, Norberto Sierra and Miguel Angel Prieto Diaz. and Laura Boos and Philipp Baumgartner and Jana Barcelona, Spain: Carmen Rodrigo and Maribel Sweden Efe and Marcel Frick and Emanuel Aegerter; Geneva Martines Mena and Ana Domenech Borras and Maria University Hospital, Genève 14, Switzerland: Teixido Fontanillas and Miguel Casanova GIL and Karolinska Universitetssjukhuset i Solna, Stockholm, Sweden: Mårten Rosenqvist; Andersbergs Jasmine Bruegger and Alexandre Guinand and Maria Ubeda Pastor and Aileen Austria and Edelmira Guillermet Elise and Dipen Shah. Barraquer Feu and Esther Fernandez Escobar and Hälsocentral, Gävle, Sweden: Alexander Wirdby; Xavier Robiro Robiro and Stela Sanchez Parra and Centrumkliniken, Stockholm, Sweden: Jan Lindén; Ukraine Maria Rodriguez Morato; C.A.P. El Clot, Barcelona, Capio vårdcentral Ringen, Stockholm, Sweden: GI L.T.Malaya Therapy National Institute of the NAMS Spain: Carme Roca Saumell and Maria Rosa Senan Kerstin Henriksson; Vårdcentralen Norrmalm, of Ukraine, Kharkiv, Ukraine: Valeriya Nemtsova and Sanz and Stela Sanchez Parra and Joan Bayo i Llibre; Skövde, Sweden: Micael Elmersson; Vårdcentralen Olena Medentseva and Iurii Rudyk and Sergiy Hospital Universitario Central de Asturias, Oviedo, Eda, Charlottenberg, Sweden: Arnor Egilsson; Pyvovar; CI of Healthcare Kharkiv CCH #8 Dept of Spain: Norberto Sierra and Cecilia Corros Vicente; Landstinget Dalarna, Gagnef, Sweden: Karin Floren Therapy Kharkiv MA of PGE of MOHU, Kharkiv, Hospital Virgen del Mar, Almeria, Spain: Manuel Vida and Ulf Börjesson; Kvarnsvedens vårdcentral, Ukraine: Vira Tseluyko and Olga Romanenko; Kyiv Gutierrez; Corporacio Sanitaria Parc Tauli, Sabadell, Borlänge, Sweden: Gunnar Svärd; S3 Clinical City Clinical Hospital #1, Kyiv, Ukraine: Oleksandr Spain: Roser Renom and Francisco Epelde Gonzalo; Research Centers, Vällingby, Sweden: Susanna Karpenko and Liudmyla Todoriuk and Svitlana Kizim; Complejo Asistencial de Avila, Avila, Spain: Sara Saez Dzeletovic and Bo Liu; Husläkarna Österåker, Cherkasy Regional Cardiological Center, Cherkasy, Jimenez and Carlos Alexandre Almeida Fernandez; Åkersberga, Sweden: Anders Lindh and Rose-Mari Ukraine: Svitlana Zhurba and Olga Proshak; Railway Centre d'Atencio Primaria Hostalets de Balenya, Kangert; Vårdcentralen Kristinehamn, Kristinehamn, Transport Kharkiv CH #1 of Healthcare Center Branch Hostalets de Balenyà, Spain: Gemma Tobajas and Sweden: Lars-Bertil Olsson and Catarina Grässjö; Kils of PJSC Ukr Railway, Kharkiv, Ukraine: Igor Kraiz and Marc Roca and Nuria del Val Plana and Laia Riquelme Vårdcentral, Kil, Sweden: Mikael Gustavsson; Sunne Ellina Kamenska; SI NSС M.D. Strazhesko Institute of Sola and Encarnacion Martinez Navarro; CAP Doctor vårdcentral, Sunne, Sweden: Lars Andersson; Cardiology of NAMSU, Kyiv, Ukraine: Oleksandr Subirós, La Jonquera, Spain: Stela Sanchez Parra and Luthagens specialistmottagning, Uppsala, Sweden: Parkhomenko and Oleksandr Shumakov; CI Inma Pareja Ibar and Enrique Escriva Montserrat Karina Rosenberg and Ann Mannermyr and Lars Ivano-Frankivsk Reg Cl Card Center Dept of Arterial and Jordi Isart Rafecas; EAP Mataró-3 Benson; Husläkarna i Margaretelund, Åkersberga, Hypertension SHEI Ivano-Frankivsk NMU, (Rocafonda–Palau), Mataro, Spain: Pilar Montero Alia Sweden: Claes Bothin; Hagakliniken, Göteborg, Ivano-Frankivsk, Ukraine: Irina Kutynska and and Ana Ferrer and Stela Sanchez Parra and Juan Sweden: Mina Shayesteh and Ruth Lissledal and Roxolana Belegai and Iryna Kupnovytska and Andriy Jose Montero Alia; Centro de Salud Paulino Prieto, Jessica Nyström and Ali Hajimirsadeghi; Arvika Sapatyi; Ivano-Frankivsk RCCD Dept of Oviedo, Spain: Norberto Sierra and Maria Barreda sjukhus, Arvika, Sweden: Birgitta Jansson and Björn Anesthesiology with ITR SHEI Ivano-Frankivsk NMU, Gonzalez; Centre d'Atencio Primaria El Remei, Vic, Martinsson; Vårdcentralen Hjorten, Trollhättan, Ivano-Frankivsk, Ukraine: Nestor Seredyuk and Spain: Manel Terns Riera and Roger Codinachs Alsina Sweden: Marianne Ericsson; Stockholm Heart Roman Petrovskyy; Private Small Enterprise, Medical and Maria Angels Moleiro Oliva and Marta Dachs and Center, Stockholm, Sweden: Lisa Bastani and Kristina Center Pulse, Vinnytsia, Ukraine: Yuriy Mostovoy and Anna Bartes; CS de Ventanielles, Oviedo, Spain: Skoglund and Faris Al-Khalili and Åke Ohlsson and Pia Lesia Rasputina; City Clinical Hospital #6 of Norberto Sierra and Aida Iglesias Garcia and Jose Löf; Karlskoga lasarett, Karlskoga, Sweden: Ann-Britt Emergency Medical Care, Simferopol, Ukraine: Iglesias Sanmartin; EAP Mataró-1 (La Riera), Mataro, Ekstrand and Håkan Lindvall; Skånes Oleksiy Ushakov and C.J.Em.H.,Card.dept.for treat.of Spain: Pilar Montero Alia and Stela Sanchez Parra and Universitetssjukhus, Malmö, Sweden: Peter pat.with myoc.infar.#2,DSMA, Dnipro, Ukraine: Juan Jose Montero Alia and Mercedes Jimenez Svensson and Camilla Nilsson; Capio vårdcentral Olena Koval' and Pavlo Kaplan and Andrii Ivanov; City Gonzalez; CAP Canet de Mar, Canet de Mar, Spain: Lidingö, Lidingö, Sweden: Katarina Thörne; Capio Hospital #1, Mykolaiv, Ukraine: Dmitry Plevak and Eva Calvo Martinez and Anna CORTADA CABRERA vårdcentral Solna, Solna, Sweden: Hans Händel; Igor Kovalskiy; M.D. Strazhesko Institute of and Monserrat OLLE BORQUE and Rolando Skånes Universitetssjukhus, Lund, Lund, Sweden: Cardiology of AMS of Ukraine, Kyiv, Ukraine: Larysa Armitano Ochoa and Martin Cebollada del Misterio Anna Osberg and Pyotr Platonov; Östersunds Bezrodna and Yevgeniya Svyshchenko and Olena and Johan Cabeza Ramirez and Victoria Marina Sjukhus, Östersund, Sweden: Orjan Stromqvist and Matova and Tetiana Ovdiienko and Maryna Mospan; Ortega and Carmen Gines Garcia and Antonio Fredrik Bernsten and Björn Eriksson and Agneta SI NSС M.D. Strazhesko Institute of Cardiology of Branjovich Tijuan and Eugeni Fernandez Mas and Lindberg and Annica Olofsson; Hässleholms Sjukhus, NAMSU, Kyiv, Ukraine: Olena Romanova and Oleg Stela Sanchez Parra and Benardi Jimeno Besa and Hässlehom, Sweden: Mari Stjernberg and Ingar Sychov; National Pirogov Memorial Medical Rosa Blanca Munoz Munoz and Maria del Mar Timberg; Karolinska Trial Alliance (KTA) PRIM, University, Vinnytsia, Ukraine: Galyna Berko and Rodriguez Alvarez; CAP La Llantia, Mataró, Spain: Stockholm, Sweden: Helena Aaröe and Katarina Mykola Stanislavchuk and Liudmyla Burdeina; CI Juan Herreros Melenchon; Hospital Son Llatzer, Risbecker and Daniel Bengtsberg and Sirin CCH #6, Zaporizhzhia, Ukraine: Vladislav Varenov Palma de Mallorca, Spain: Joan Torres Marques and Gudmundsson and Milita Crisby and Annelie Billger; and Oleg Kraydashenko and Roman Stets and Alina Javier Fosch and Salvador Marcus and Tomas Ripoll Länssjukhuset Ryhov, Jönköping, Sweden: Dawid Khmelyova; Lutsk City Hospital, Lutsk, Ukraine: Vera and Yolanda Gomez Perez; Hospital Clinico Kusiak and Grzegorz Bonkowski and Jan-Erik Mykhailo Pavelko and Andriy Yagensky; OSMU of Universitario Virgen de la Victoria, Malaga, Spain: Karlsson and Annika Koch and Jessika Samuelsson; Min.of Health of Ukr.,Ch.of In.Med.#2,Un.cl.of OSMU, Miguel Lopez and Gloria Millan Vazquez and Natalia Ljungby Lasarettet, Ljungby, Sweden: Marita Odesa, Ukraine: Olena Khyzhnyak and Susanna Andere and Manuel Jimenez Navarro and Lola Millborg and Ann-Marie Ohlin and Agneta Tykhonova; CI Zapor CCH#10 SI ZMA PGE Ch of Gomez and Hugo Nelson Orellana Figueroa and Andersson; Närsjukhuset Köping, Köping, Sweden: therapy clin pharmacol & endocrin, Zaporizhzhia, Victor Becerra Munoz and Alicia Guerrero Molina; Lennart Malmqvist and Gull-Britt Eriksson and Ukraine: Valentyn Mochonyi and Olena Chabanna Policlinico de Vigo-Povisa, Vigo, Spain: Luisa Sanchez Susanne Hahn; Länssjukhuset Halmstad, Halmstad, and Inna Daniuk and Ivan Fushtey and Olexandr Mendez and Marcelo Sanmartin Fernandez and Sweden: Johan Engdahl and Lisbeth Andersson; Palamarchuk. Capio Citykliniken Lund, Lund, Sweden: Carl-Johan Maria Vazquez Caamano; Hospital de Basurto, United Kingdom Bilbao, Spain: Izaskun Prieto and Maria Fe Arcocha Lindholm and Jörgen Thulin; Hjärt & Kärlcentrum, Torres and Aranza Manzanal Rey and Ane Elorriaga Södertälje, Sweden: Eva Ahbeck and Marie Aman Laurie Pike Health Centre, Aston, United Kingdom: Madariaga; Hospital San Pedro de Alcantara, and Aida Hot-Bjelak; Blekingesjukhuset Karlshamn, Dr Will Murdoch; River Brook Medical Centre, Caceres, Spain: Carolina Ortiz Cortes and Javier Karlshamn, Sweden: Steen Jensen and Katarina Stirchley, United Kingdom: Dr Naresh Chauhan; Mendoza Vazquez and Pablo Sanchez Calderon and Mansson and Carl Thorsen; Centralsjukhuset Wand Medical Centre, Highgate, United Kingdom: Dr Luis Enrique Lezcano Gort and Carmen Simon Valero Karlstad, Karlstad, Sweden: Hakan Ahlmark and Per Daryl Goodwin; Greenridge Surgery, Billesley, United and Gema Cancho Corchado and Maria Isabel Cotilla Stalby and Anna Pedersen and Annika Lettenström Kingdom: Dr Louise Lumley; Grange Hill Surgery, and Johan Lugnegård. Kings Norton, United Kingdom: Dr Ramila Patel;

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Ridgacre House Surgery, Quinton, United Kingdom: Kingdom: Dr Julian Thompson; Creffield Medical Medical Centre, Ballynahinch, United Kingdom: Dr Philip Saunders; The Greens Health Centre, Centre, Colchester, United Kingdom: Dr Hasan Dr K Poland; Nottinghill Medical Practice, Dudley, United Kingdom: Dr Bennett Wong; Chowan; Dr Taylor & Partners, Woodbridge, United Newtownabbey, United Kingdom: Dr Conor Marysville Medical Practice, Belle Vue, United Kingdom: Dr Gary Taylor; Ely Bridge Surgery, Ely, Mulolland; Lisburn Health Centre, Linenhall Street, Kingdom: Dr Alex Cameron; The Nechells Practice, United Kingdom: Dr John Wakeling; Firsway Health United Kingdom: Dr A Warke; Ballygomartin Group 63 Rupert Street, United Kingdom: Dr Philip Centre, Sale, United Kingdom: Dr Dawn Tragen; Practice, Belfast, United Kingdom: Dr Paul Conn; Saunders; The Village Surgery, Shirley, United Harvey Group Practice, St Albans, United Kingdom: Duncairn Medical Practice, Belfast, United Kingdom: Kingdom: Dr Niranjan Patel; Kingsbury Road Surgery, Dr Matt Parfitt; The Surgery, Honiton, Honiton, Dr D Burns; Birchwood Medical Practice, Lincoln, Erdington, United Kingdom: Dr P Jhittay; Northfield United Kingdom: Dr Claire Seamark; Kiltearn Medical United Kingdom: Dr R Smith; Newmarket Medical Health Centre, Northfield, United Kingdom: Dr Centre, Nantwich, United Kingdom: Dr Carolyn Paul; Practice, Louth, United Kingdom: Dr R Kamath; The Andrew Ross; Primrose Lane Surgery, Low Hill, Lindum Medical Practice, Cabourne Avenue, United Butchery Surgery, Sandwich, United Kingdom: Dr United Kingdom: DrMSKainth; Dovecote Surgery, Kingdom: Dr Mark Richardson; Litchdon Medical Jonathan Webster; Buckfastleigh Medical Centre, Oldbury, United Kingdom: Dr Karim Ladha; Centre, Barnstaple, United Kingdom: Dr Angus Buckfastleigh, United Kingdom: Dr Ian Hodgins; Ide Claremont Medical Practice, Exmouth, United Jefferies; Magdalen Medical Practice, Norwich, Lane Surgery, Exeter, United Kingdom: Dr Stephen Kingdom: Dr Kevin Douglas; The Newbridge Surgery, United Kingdom: Dr Helen Sharp; Mattishall Surgery, Vercoe; Kingswood Surgery, Tunbridge Wells, United Wolverhampton, United Kingdom: Dr Gill Mattishall, United Kingdom: Dr Hywel Jones; Mount Kingdom: Dr Paul Roome; Whitstable Medical Pickavance; Wychall Lane Surgery, Kings Norton, Farm Surgery, Bury St Edmunds, United Kingdom: Dr Practice (Estuary View), Whitstable, United United Kingdom: Dr Joanna McDonnell; King Street Claire Giles; The Fleetwood Health Centre (prev Kingdom: Dr Hilary Pinnock; Downsway Medical Surgery, Hereford, Hereford, United Kingdom: Dr Mountview Surgery), Dock Street, United Kingdom: Practice, Istead Rise, United Kingdom: Dr Jayesh Laura Handscombe; The Surgery, Atherstone, Dr Matthew Bramley; Nettleham Medical Practice, Patel; Oakenhurst Medical Practice, Simmons Street, Atherstone, United Kingdom: Dr Trevor Gooding; Nettleham, United Kingdom: Dr Philip Williams; United Kingdom: Dr Amar Ali; Crossgar Surgery, Rising Brook Health Centre, Rising Brook, United Portmill Surgery, Hitchin, United Kingdom: Dr Jehad Crossgar, United Kingdom: Dr Nigel Hart; Bideford Kingdom: Dr Helga Wagner; Saville Medical Group, Aldegather; Queen Square Medical Services Ltd, Medical Centre, Bideford, United Kingdom: Dr Newcastle upon Tyne, United Kingdom: Dr Lancaster, United Kingdom: Dr Simon Wetherell; Richard Davies; Coleridge Medical Centre, Ottery Cumberlidge; Marsden Medical Practice, South Sedbergh Medical Practice, Sedbergh, United Saint Mary, United Kingdom: Dr Nigel De-Sousa; East Shields, United Kingdom: Prof Colin Bradshaw; Guide Kingdom: Dr William Lumb; St Leonard’s Practice, Cliffe Practice, Ramsgate, United Kingdom: Dr Post Medical Group, Chappington, United Kingdom: Exeter, United Kingdom: Dr Phil Evans; St Stephens Catherine Neden; Pool Health Centre, Redruth, Dr Catherine Bromham; Oxford Terrace Medical Gate Medical Practice, Norwich, United Kingdom: Dr United Kingdom: Dr Mark Danielsen; Gravesend Group, Gateshead, United Kingdom: Dr Kevin Jones; Frances Scouller; Stowhealth Limited, Violet Hill Medical Centre, Gravesend, United Kingdom: Dr The Surgery, Bilston, Bradley, United Kingdom: Dr Road, United Kingdom: Dr Neil Macey; The Rise Purnima Sharma; Steyning Health Centre, Steyning, Shoeb Suryani; Seaton Park Medical Group, Norham Group Practice, Hornsey Rise, United Kingdom: Dr United Kingdom: Dr Sophia Galloway; Beccles Road, United Kingdom: Dr Richard Coates; Stephen Rogers; Victoria Road Surgery, Lowestoft, Medical Centre, Beccles, United Kingdom: Dr Northgate Practice, Anchor Meadow, United Oulton Broad, United Kingdom: Dr Yvette Stipp; Charlotte Hawkins; Cromer Group Practice, Cromer, Kingdom: Dr Bhupinder Sarai; Rolle Medical Woolpit Health Centre, Woolpit, United Kingdom: Dr United Kingdom: Dr Raife Oliver; Dr Bouch & Partnership, Claremont Grove, United Kingdom: Dr Richard West; Wymondham Medical Partnership, Partners, Lowestoft, United Kingdom: Dr Martin W Willcock; The Surgery (Bideford way), Cannock, Wymondham, United Kingdom: Dr Philip Pinney; Aylward; The Manor Practice, Sutton Coldfield, United Kingdom: Dr S Sircar; Library House Surgery, Ash Trees Surgery, Carnforth, United Kingdom: Dr United Kingdom: Dr Mira Pattni; Grove Surgery Chorley, United Kingdom: Dr John Cairns; The Paul Wadeson; Crescent Surgery, Kelso Avenue, (Thetford), Thetford, United Kingdom: Dr Gordon Elmwood Practice, 1 Dunluce Avenue, United United Kingdom: Dr John Matthews; Village Practice Irvine; Fakenham Medical Practice, Trinity Road, Kingdom: Dr A Gilliand; Dr Bilas (75 Griffiths Drive), (Thornton-Cleveleys), Church Road, United United Kingdom: Dr Shahid Ahmad; Llandaff North Wolverhampton, United Kingdom: Dr Roman Bilas; Kingdom: Dr Preeti Pandya; Rosebank Medical Medical Centre, Cardiff, United Kingdom: Dr Penn Manor Medical Practice, Penn, United Practice, Lancaster, United Kingdom: Dr Andrew Catherine Rothwell; Mexborough Health Centre, Kingdom: Dr E Strieder; Rother House Medical Gallagher; Brown Clee Surgery, Bridgnorth, United Mexborough, United Kingdom: Dr Fiaz Choudhary; Centre, Stratford-Upon-Avon, United Kingdom: Dr Kingdom: Dr T Railton; Waterfront Medical Centre, Attleborough Surgeries, Norfolk, United Kingdom: Dr Peter Hutchinson; Russell House Surgery, Codsall, Barry, United Kingdom: Dr Emyr Davies; Whinpark Sabrina Khalaque; Saffron Group Practice, Leicester, United Kingdom: Dr Anne Wakeman; Sandy Lane Medical Practice, 6 Saughton Road, United Kingdom: United Kingdom: Dr Stephanie Short; Hobs Moat Surgery, Rugeley, United Kingdom: Dr Michael Dr Jonathan McClure; Edzell Health Centre, Edzell, Medical Centre, Solihull, United Kingdom: Dr Sharon Stokes; Warders Medical Centre, Tonbridge, United United Kingdom: Dr Marc Jacobs; Mauve Practice, Peters; Albany House Medical Centre, Northampton, Kingdom: Dr Graham Kirby; Westgate Surgery, North Methven Street, United Kingdom: Dr Claire United Kingdom: Dr Warwick Coulson; Leicester Westgate-on-Sea, United Kingdom: Dr Bhaskhar Hutton; Bridgewater Family Medical Practice, Terrace Health Centre, Northampton, United Vishwanathan; Beaconsfield Medical Practice, Bridgewater Street, United Kingdom: Dr R Kingdom: Dr Neil Roberts; Danetre Medical Centre, Brighton, United Kingdom: Dr Nigel Bird; Wish Park Thompson; The Medical Centre, Boston, Old Leake, Daventry, United Kingdom: Dr Amy Butler; Surgery, Hove, United Kingdom: Dr Paul Evans; United Kingdom: Dr Bijoy Sinha; Tasburgh Lodge Wychbury Medical Group, Wollescote, United Cranleigh Surgery, Cranleigh, United Kingdom: Dr M Surgery, Woodhall Spa, United Kingdom: Dr Keith Kingdom: Dr Steven Coates; Bovey Tracey & Clark; Cathedral Medical Group, Cawley Road, United Butter; Lakeside Healthcare at St Mary's Medical Chudleigh Practice, Chudleigh, United Kingdom: Dr Kingdom: Dr John Bisatt; Pound Hill Medical Group, Centre, Stamford, United Kingdom: Dr Susan Ben Ward; Greensands Medical Practice, Gamlingay, Pound Hill, United Kingdom: Dr Jennifer Litchfield; Barrow; The New Sheepmarket Surgery, Stamford, United Kingdom: Dr Daniel Jackson; Stonecroft Park Surgery, Horsham, United Kingdom: Dr E Fisher; United Kingdom: Dr Helen Little; Mount Pleasant Medical Centre, Sheffield, United Kingdom: Dr Steve Pulborough Medical Group, Pulborough, United Health Centre, Exeter, United Kingdom: Dr David Walton; Dearne Valley Group Practice, Thurnscoe, Kingdom: Dr Tim Fooks; Worden Medical Centre, Russell; Mill Bank Surgery, Stafford, United Kingdom: United Kingdom: Dr Diane Shepherd; Westbank Leyland, United Kingdom: Dr Richard Kelsall; Dr Ulka Choudhary; Winyates Health Centre, Practice, Starcross, United Kingdom: Dr Toh Wong; Sandbach GPs, Middlewich Road, United Kingdom: Redditch, United Kingdom: Dr Ikram Haq; Conisbrough Group Practice, Doncaster, United Dr Neil Paul; Barton Surgery (Dawlish), Dawlish, Sherbourne Medical Centre, Leamington Spa, United Kingdom: Dr Mark Boon; Brannam Medical Centre, United Kingdom: Dr Elizabeth Alborough; Broadway Kingdom: Dr Paul Ainsworth; Spring Gardens Group Barnstaple, United Kingdom: Dr Melanie Deacon; Medical Centre, Broadway, United Kingdom: Dr Medical Practice, Spring Gardens, United Kingdom: St Andrews Surgery, Tonypandy, United Kingdom: Dr Michael Aziz; Bellevue Medical Centre, Fleetwood, Dr Claire Jones; Framfield House Surgery, Ipswich David Cornelius; Haltwhistle Medical Group, Fleetwood, United Kingdom: Dr C Ramesh; Road, United Kingdom: Dr Phil Weeks; Marden Haltwhistle, United Kingdom: Dr Sarah Davies; Sele Bollington Medical Centre, Bollington, United Medical Practice, Shrewsbury, United Kingdom: Dr Medical Group, Hexham, United Kingdom: Dr Ben Kingdom: Dr Pete Wilson; Budleigh Salterton Jane Eden; St Thomas Health Centre, Exeter, United Frankel; Burn Brae Medical Group, Hexham, United Medical Centre, Budleigh Salterton, United Kingdom: Kingdom: Dr Lisa Gibbons; Belvoir Vale Surgery, Kingdom: Dr Nick Hargreaves; Drs Cloak, Choi and Dr Simon Franklin; Cleveleys Group Practice, Bottesford, United Kingdom: Dr Janet Glencross; Milligan, The Green, United Kingdom: Dr Henry Choi; Cleveleys, United Kingdom: Dr Sue Fairhead; Bay Medical Group (prev Coastal), Morecambe, Dr Stephenson & Partners, Concord, United Cossington House Surgery, Canterbury, United United Kingdom: Dr Alison MacLeod; The Montalto Kingdom: Dr Jon Sumner; Rothwell & Desborough

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Surgery, Rothwell, United Kingdom: Dr Tim Myhill; and Damien Cresp and William van Gaal and Jann Parkinson and Jane Rose; St George Hospital, Oak Street Medical Practice, Norwich, United Elizabeth Buckley and Rinku Rayoo and Mary Park Kogarah, New South Wales, Australia: Maurits Kingdom: Dr Salah Estifanos; Greens Norton Medical and Uwais Mohamed and Naveen Sharma and Vivek Binnekamp and Jennifer Brimley and Ellie Watson Centre, Towcester, United Kingdom: Dr Diane Muhta and Elizabeth Vardon and Amie Cho; The and Prakriti Shrestha and Megan Higgs; Cardiac Geatch; The Scott Practice, Balby, United Kingdom: Canberra Hospital, Garran, Austl. Cap. Terr., Australia: Diagnostic Centre, Wollongong, New South Wales, Dr Justin Wilkinson; Brunel Medical Practice, Emily Wilford and Katherine Johnson and Kate Australia: Stephen Mackay and Miyar Prathap Hegde Babbacombe, United Kingdom: Dr Richard Veale; Hayes and Natasha Thomas and Renee Eslick and and Taufik Fetahovic and Astin Lee and Martin Bentley Surgery, Doncaster, United Kingdom: Dr Walter Abhayaratna and Mehdi Eskandari and Ben Walker and Janene Gibbs. Karen Forshaw; Yealm Medical Centre, Yealmpton, Jacobson; Royal Hobart Hospital, Hobart, Tasmania, Canada United Kingdom: Dr Rob Hirst; Danes Camp Surgery, Australia: Vicki OMay and Philip Thomson and Northampton, United Kingdom: Dr Kashif Zaman; Nathan Dwyer and Catherine McIntosh and Lynette Hamilton General Hospital, Hamilton, Ontario, Dove Valley Practice, Worsbrough, United Kingdom: Reid and Teresa Grabek and Karen Patching and Canada: John Eikelboom and Sam Schulman and Dr Catherine Liley; Walderslade Surgery, Barnsley, Andrew Black and Ben Costello and Rachel Lloyd and Marlene Robinson; Oxford AIM Clinic, London, United Kingdom: Dr Rebecca Wastling; The Rame George Lukas and Joseph Amin; Ashford Cardiac Ontario, Canada: Robert Luton and Shannen Group Practice, Trevol Road, United Kingdom: Dr Clinic, Ashford, South Australia, Australia: Ron Douglass and Fraser Gibson and Krystine Cooper; Paul McEleny; Dorking Medical Practice, Dorking, Lehman and Cameron Singleton and Hazel Morrison Brampton Research Associates, Brampton, Ontario, United Kingdom: Dr Andre Beattie; Carryduff and Tanya Patching and Mandy Lehman and Sam Canada: Milan Gupta and Ana Maria Sindilar and Lidia Surgery, Carryduff, United Kingdom: Dr Philip Cooke; Lehman; Bankstown-Lidcombe Hospital, Lepore and Lekraj Nimraj and Mitra Mohammadi and King Street Surgery, Lancaster, Lancaster, United Bankstown, New South Wales, Australia: Marika Ranjit Kahlon; Cambridge Cardiac Care Centre, Kingdom: Dr Mike Wong; Park Road Surgery, Surrey, Seremetkoska and Jo-Dee Myers and Deirdre Upton Cambridge, Ontario, Canada: Amritanshu Shekhar United Kingdom: Dr Mark Pugsley; Roundwell and Jens Kilian and Alla Waldman and Changjie Song Pandey and Michelle Pandey and Linda Snell; Surrey Medical Centre, Norwich, United Kingdom: Dr and Joanna Ramachenderan; Nepean Hospital, Memorial Hospital, Surrey, British Columbia, Canada: Chaminda Dooldeniya; Barton-on-Sea Surgery, New Kingswood, New South Wales, Australia: Michael Stephen Cheung and Jan Kornder and Lynn Milton, United Kingdom: Dr Greg Rogers; Wareham Fitzpatrick and Michele MacKenzie and Lisa Barry Breakwell and Tracy Cleveland and Jordana Largy Surgery, Dorset, United Kingdom: Dr James Bennett; and David Coulshed and George Touma and Inaam and Alayna Ewert and Shannon Wong; Leader, Wilton Health Centre, Salisbury, United Kingdom: Dr Ullah; Royal Perth Hospital, Perth, Western Australia, Rolland, Ajax, Ontario, Canada: Rolland Leader and Polly Jacobs; Leslie Medical Practice, Glenrothes, Australia: Andrei Catanchin and Michelle Bonner and Loris Aro; Dr Philippe Beaudry, Burlington, Ontario, United Kingdom: Dr Rajesh Muvva; Academy Claire Batta and Mary Vorster and Vincent Paul and Canada: Philippe Beaudry and Kathryn Beaudry and Medical Centre, Angus, United Kingdom: Dr Nikola Stoyanov and Samantha Thompson; Core Judy Dunnigan; Dr Philippe Beaudry, Montréal, Matthew Adam; Bicester Health Centre, Bicester, Research Group, Milton, Queensland, Australia: Quebec, Canada: Celine Bergeron; Dr Philippe United Kingdom: Dr Robin Fox; Windrush Medical Aurelia Connelly and David Colquhoun and Lara Beaudry, Downsview, Ontario, Canada: Gordhan Practice, Witney, United Kingdom: Dr Nicolas Petelin and Dylan Barnes and Nigel Appleby and Tara Jethoo; CHUS - Hôpital Fleurimont, Sherbrooke, Thomas; The White Horse Medical Practice, Kinnane and Hilary Morrison and Antonio Quebec, Canada: Félix Ayala-Paredes and Caroline Volunteer Way, United Kingdom: Dr Simon Ferreira-Jardim and Bojana Petrovic; Macquarie Lamoureux and Suzanne Maltais and Sonia Cartwright; Westongrove PMS Partnership, Aston University Hospital, North Ryde, New South Wales, Nadeau-Lapointe and Veronique Dagenais and Clinton, United Kingdom: Dr Rory Reed; Park Terrace Australia: Lisa Wallis and Helena Setio and Anil Marie-Claude Grenier and Claude Jean; JBN Medical Medical Practice, Stirling, United Kingdom: Dr Simon Aggarwala and Kiran Swaraj and Imran Kassam and Diagnostic Services Inc., Burlington, Ontario, Canada: Randfield; The Broadshires Health Centre, Carterton, Hosen Kiat; Balwyn Consulting Suites, Epping, Joseph Berlingieri and Fern Petrie; JBN Medical United Kingdom: Dr Christine A'Court; Kirkcaldy Victoria, Australia: David Eccleston and Karen Diagnostic Services Inc., Windsor, Ontario, Canada: Health Centre, Whyteman's Brae, United Kingdom: Patching; Liverpool Hospital, Liverpool, New South Stephen Lewis and Chris MacRae; Alder Medical Dr Ann Flynn; Rothes Medical Practice, Glamis Wales, Australia: Maria Plotz and John French and Centre, Campbell River, British Columbia, Canada: Centre, United Kingdom: Dr Andrew Halpin; The Craig Juergens and Suzanne Raynes and Natalia John Heath and Linette Scott and Jane Drown; Medical Centre, Redditch, Crabbs Cross, United Sequalino and Kelsey O'Brien and Sally-Anne Hoddy Centre de santé et de services sociaux Kingdom: Dr Shoeb Suryani; Clarence Medical and Tuan Nguyen and Christian Mussap and Hany Champlain-Charles-Le Moyne, Greenfield Park, Practice, Rhyl, United Kingdom: Dr Simon Dobson; Dimitri and Krishna Kadappu and Dominic Leung and Quebec, Canada: Sandrine Spearson and Emilie Plas Menai Surgery, Conway, United Kingdom: Dr Alexandra Croucher; SA Heart, Ashford, South Douville and Germain Poirier and Karine Primeau and Louise Lomax; Plas Y Bryn Surgery, Wrexham, United Australia, Australia: Jessie Palmer and Jean Tarrant Isabelle Neas and Julie Gaudreault; The Medical Arts Kingdom: Dr Minnal Nadaph; Tryst Medical Centre, and Leon Zimmett and Tanya Patching and Marilyn Health Research Group, Kelowna, British Columbia, Stenhousemuir, United Kingdom: Dr Iain Munro; Dolman and Bronte Ayres; The Avenue Canada: Patricia Roberts and The Medical Arts Frome Valley Medical Centre, Frampton Cotterill, Cardiovascular Centre, Dandenong, Victoria, Health Research Group, Kamloops, British Columbia, United Kingdom: Dr Jane Goram; Kingswood Health Australia: Peter Blombery and Helen Rashad and Canada: Miranda du Preez and Anna Kubanska and Centre, Bristol, United Kingdom: Dr Helen Stoddart; Claire McCarthy; Monash Medical Centre, Clayton, Judy Vicic and Nathaly Reynoso; The Medical Arts Charlotte Keel Health Centre, Bristol, United Victoria, Australia: Thanh Phan and Kitty Wong and Health Research Group, Powell River, British Kingdom: Dr Phil Simmons; Llanedeyrn Health Lauren Sanders; Gosford Hospital, Gosford, New Columbia, Canada: Patti Roberts; Centre Intégré Centre, Llanedeyrn, United Kingdom: Dr John South Wales, Australia: Bets Conway and James Universitaire de Santé et de Services Sociaux du Shewring; Chawton Park Surgery, Alton, United Rogers and Jonathan Sturm and Margaret Webb and Nord-de-l’Île-de-Montréal, Montréal, Quebec, Kingdom: Dr Emma Bowen-Simpkins; Park and Veronica Zenteno and David Crimmins and Anna Canada: Reginald Nadeau and Georgeta Sas and St Francis Surgery, Valley Park, United Kingdom: Dr Schutz and Susanne Rhodes; Heart Care Victoria - Zahra Djaidani and Sadia Daheb; London Health Mark Rickenbach; Salisbury Medical Practice, Heidelberg, Heidelberg, Victoria, Australia: Karen Sciences Centre, London, Ontario, Canada: Donald Fountain Way, United Kingdom: Dr Polly Jacobs. Patching and David O'Donnell; Pitt Town Family Farquhar and Richard Kim and George Dresser and Rita Moor and Heather Vosper and Lara Whatmore Australia Practice, Pitt Town, New South Wales, Australia: Sang Cheol Bae; The Alfred Hospital, Melbourne, and Natalie Crown; Dhillon, Ripple, Oshawa, Ontario, Lismore Base Hospital, Lismore, New South Wales, Victoria, Australia: Harry Gibbs and Vathy Canada: Ripple Dhillon and Julie Bigcanoe and Nanci Australia: Adam Blenkhorn and Harry Gibbs and Nagalingam; Redcliffe Hospital, Redcliffe, Bignell; University of Alberta Hospital-SCC/WCM, Leverne Hesketh and Janice Boys and Charmaine Queensland, Australia: Megan Ratcliffe and Maree Edmonton, Alberta, Canada: Tomasz Hruczkowski Morahan and Tracey Mackney; Launceston General Duroux and Patrick Carroll and Megan Ratcliffe and and Maria Raines; The Medical Arts Health Research Hospital, Launceston, Tasmania, Australia: Samantha Shone and Mayank H Modi and Richard Group, Powell River, British Columbia, Canada: Bhuwanendu Singh and Carol Singh and Monica Geraghty; Cairns Hospital, Cairns, Queensland, Timothy Barkowski and Bradley Schweitzer and Campo and Rosemary Beveridge and Laurie McKeon Australia: Greg Starmer and Shane Preston and Stephen Burns and Sally Watson and Patti Roberts; and Elizabeth Vardon; Pendlebury Research, Cardiff, Michelle Gosley and Sue Richmond and Sue Dixon Regina General Hospital, Regina, Saskatchewan, New South Wales, Australia: Lyne Parsons and Lesley and Steven Sutcliffe; Lyell McEwin Hospital, Canada: Payam Dehghani and Laurie Ferleyko Cheryl Carlton and Penny Astridge and Geoffrey Oldfield; Elizabeth Vale, South Australia, Australia: Margaret Altwasser and Sheila Kelly; Regina General Hospital, The Northern Hospital, Epping, Victoria, Australia: Arstall and Katrina Macmillan and Purendra Pati and Marieville, Quebec, Canada: Andrea Lavoie and It Meng Tsay and Vicki Lawlor and Chelsea Webster William Semchuk; Queen Elizabeth II Health Sciences

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Centre, Halifax, Nova Scotia, Canada: Debbie Wright Marinda Karsten and Andonia Page; Murray, AN, Texas, United States: Celine Garcia and Miguel and Ratika Parkash and Lisa Carroll and Ann Fearon; Cape Town, South Africa: Andrew Murray and Franco and Paula Gentry and Melialoha Bartlett; James Cha, MD, Oshawa, Ontario, Canada: Rebecca Heather Christie and Cecilia Boshoff; Winelands Bryan Heart, Lincoln, Nebraska, United States: Otis and James Cha and Judy Otis and Elizabeth Medical Research Centre, Stellenbosch, South Africa: Andrew Merliss and Rose Saalfeld and Cheryl Orosco Burke; CHUM Hôtel-Dieu, Montreal, Quebec, Rikus Louw and Garath Tarr and Annalie Skein; and W.Michael Kutayli and Nicci Thompson; Truman Canada: Benoit Coutu and Denise Fournier and Julie Greyling, D, Cape Town, South Africa: Roelof Medical Centers, Inc., Kansas City, Missouri, United Fleury and Isabelle Denis; Nova Scotia Health Diederichs and Deon Greyling; Mntla, PS, Pretoria, States: Paramdeep Baweja and Daniel Pauly and Authority, Sydney, Nova Scotia, Canada: Jeanie South Africa: Pindile Mntla and Tiisetso Tau and Annette Quick and M. Javed Ashraf and Mickie MacIsaac and Kathleen Hines and Annette Wood and Lillian Rikhotso; Ismail, SM, Cape Town, South Africa: Keeling; Gwinnett Hospital System, Inc., Christine Hines and Paul MacDonald and Joy Anna Isaacs and Siddique Ismail and Aziza Davids Lawrenceville, Georgia, United States: Niraj Sharma Howard; First Line Medical Services Ltd., St John's, and Mariette Pelser and Sipho Hlengwa; Ahmed, FA, and Jowanna Kerr and Marsha Headlee; Cardiology Newfoundland, Canada: Wayne Gulliver and Brian Isipingo Rail, South Africa: Fayzal Ahmed and Consultants, Daytona Beach, Florida, United States: Ramjattan and Bonnie Clarke and Teri Trahey; Fraser Charmaine Chami; Dr JM Engelbrecht Practice, Terry Purcell and Jennifer Langdon and Pamela Clinical Trials Inc., New Westminster, British Somerset West, South Africa: Johannes Engelbrecht Jones and Vance Wilson; Jean Brown Research, Salt Columbia, Canada: Leanne Kwan and Dennis Rupka and Marlene Mostert and Wilhelmina Pretorius; Lake City, Utah, United States: Heather Theobald and Katherine Haveman; Fraser Clinical Trials Inc., Ramdass, AS, Durban, South Africa: Andrew and Kim Smith and Scott West and Allison Jones and New Westminster, British Columbia, Canada: Jorge Ramdass and Muhammed Moosa and Indhranie Stephen Miller and Lorlie Evans; University of Texas Bonet and Michael Kammermayer and Jacquie Naidoo; Maharajh, S, Assagay, South Africa: Shambu Southwestern Medical Center, Dallas, Texas, United Stevenson; Dr Saul Vizel Cardiac Research Office, Maharajh and Shambu Maharajh; Limaro Research, States: Patricia Knowles and Mark Alberts; Central Cambridge, Ontario, Canada: Saul Vizel and Beverley Bloemfontein, South Africa: Elizabeth Oosthuysen New Jersey Cardiology, South Plainfield, New Jersey, Fox; St Michael's Hospital, Toronto, Ontario, Canada: and Wessel Oosthuysen and Cornel Bester; MERC - United States: Edwin Blumberg and Susan Paserchia; Paul Angaran and Kamran Ahmad and Victoria Korley Cape Town, Cape Town, South Africa: Shireen WellSpan Cardiology, Ephrata, Pennsylvania, United and Arnold Pinter and Paul Dorian and Iqwal Mangat Safodien and Mishka Salie and Farhaad Shaik and States: Roddy Canosa and Elise Hartranft and Susan and Theresa Aves; Medicine Professional Mohammed Moosa and Rosemary Matthews and Felpel and Sarah Jasinski; Heart Specialists of Central Corporation, Kitchener, Ontario, Canada: Sameh Rehana Loghdey; Ueckermann, V, Pretoria, South Jersey, Freehold, New Jersey, United States: Susan Fikry and Sameh Fikry and Wagdy Basily and Ana Africa: Andre Ueckermann and Veronica Karl and Ted Gutowski; Community Health Care, Inc., Maria Jackson. Ueckermann. Canal Fulton, Ohio, United States: Tammy Lincoln Egypt United Arab Emirates and Butcher Stephanie and Paula Shaw and Rodney Ison; Cardiology Consultants LLP, Houston, Texas, Private Clinic, Giza, Egypt: Annie Ohanissian and Sheikh Khalifa Medical City, Abu Dhabi, United Arab United States: Jorge Garcia and Edward Massin and Hany Ragy; Private Clinic, Cairo, Egypt: Ahmed Emirates: Irfan Maqsood and Wael Al Mahmeed; Teresa Hicks; Coast Cardiovascular Consultants, Mowafy; Private Clinic, Cairo, Egypt: Azza Katta; Zayed Military Hospital, Abu Dhabi, United Arab PLLC, Biloxi, Mississippi, United States: Sherry Private Clinic, Cairo, Egypt: Mazen Tawfik; Private Emirates: Maher Makdad and Abdullah Al Naeemi; Raziano and Paul Mullen; DM Clinical Research, Clinic, Egypt: Eman Zaatout and Moustafa Nawar; Gulf Diagnostic Center Hospital, Abu Dhabi, United Edison, New Jersey, United States: Fatema Hakimi International Cardiac Center - I.C.C., Egypt: Ahmed Arab Emirates: Ralph Manzano and Karen Magdaluyo and Debra Merritt and Abbas Haideri and Howard Soliman and Mohamed Sobhy; Private Clinic, Egypt: and Steve Teves and Ghazi Yousef; Dubai Hospital, Noveck; Baptist Heart Specialists, Jacksonville Seif Kamal Abou Seif; Private Clinic, Egypt: Tarek Dubai, United Arab Emirates: Azbin Abdul and Beach, Florida, United States: Jill DePauw and Khairy; Private Clinic, Egypt: Ahmed Abd El-Aziz and Nooshin Bazargani; Rashid Governmental Hospital, Pamela Rama and Doran Cassidy;T&RClinic, Halton Michael Sobhy; Private Clinic, Egypt: Nasser Taha; Dubai, United Arab Emirates: Amna Al Mulla and City, Texas, United States: Melanie Bentley and Private Clinic, Egypt: Ashraf Reda and Nevein Sami Munther AlOmairi; Zulekha Hospital LLC, Dubai, Rajneesh Reddy; The Valley Hospital, Fairlawn, New and Mohamed Reda; Private Clinic, Egypt: Atef United Arab Emirates: Rajan Maruthanayagam and Jersey, United States: Jin Ah Lee and Marcus Elbahry; Om Al Qura Cardiac Center, Egypt: Abdul Rehman and Preetha Haridas; Zulekha Williams; University of California Davis Health Mohamed Setiha and Sameh Samir and Hanan Hospital, Sharjah, United Arab Emirates: Shereef El System, Sacramento, California, United States: Salem; Private Clinic, Egypt: Mohamed Gamal El Din; Bardisy and Sharmila Jadhav and Preetha Haridas Daniel Nishijima and Laura Jones and Toni Harbour Cardiotech for Medical Care, Egypt: Magdi Elkhadem and Rupesh Singh; Al Qassimi Hospital, Sharjah, and Ben Mooso and Deborah Diercks and Allyson and Ali Mohsen; Private Clinic, Egypt: Adel El-Etreby. United Arab Emirates: Ahmed Naguib; Kuwait Sage and Tirath Sanghera and Michaela Canova; South Africa Hospital, Sharjah, United Arab Emirates: Rehab Tulane University Heart & Vascular Institute, New Mohamed and Mohamed Ibrahim; Fujairah Hospital, Orleans, Louisiana, United States: Nana Asafu-Adjaye Kettles, DI, East London, South Africa: Gerda Du Fujairah, United Arab Emirates: Jameelah Plessis and Debbie Browne and David Kettles and and Suzanne Bowers and Gholam Ali and Patrice Dominguez and Amrish Agrawal; RAK Hospital, Ras Delafontaine and Keith Ferdinand; City Cardiology Penny Jackson; Coronary Care Unit, Durban, South Al Khaimah, United Arab Emirates: Mukesh Nathani; Africa: Junaid Bayat; Into Research, Pretoria, South Associates, Akron, Ohio, United States: Nicole Gulf Medical University Hospital, Ajman, United Arab Pickelsimer and Ihsan Haque; Jamaica Hospital Africa: Craig Phillip Franklin and Heidi Siebert and Emirates: Nidhi Sharma and Mohammed Thanzeel Petronella Nagel and Maria Booysen; Dr AR Horak Medical Center, Jamaica, New York, United States: and Rahul Sharma and Ehab M. Esheiba; Ibrahim Bin Tazrin Tripti and Janaya Raynor and Genna Pearl and Private Practice, Cape Town, South Africa: Elwyn Hamad Obaidullah Hospital, Ras-Al Khaimah, United Lloyd and Adrian Horak and Lindy Henley; Kelfkens, Kelly Cervellione and Robert Mendelson; University Arab Emirates: Adel Wassef; Kalba Hospital, Sharjah, of Texas Health Science Center at Tyler, Tyler, Texas, Y, Potchefstroom, South Africa: Ynez Kelfkens; United Arab Emirates: Rajeev Gupta. Garda, RA, Johannesburg, South Africa: Soraya United States: Sridevi Pitta and Benji Hawkins and Cassimjee and Riaz Garda and Loice Mavhusa; United States Michael Lay and Kent Davis and Debbie Fielder and Charlotte Maxeke Johannesburg Academic Hospital Cotton-O'Neil Clinical Research Center, Topeka, Christopher Herrick and Jay Shoemaker; Washington Haematology Department, Johannesburg, South Kansas, United States: Michael Cox and Erin Malone; University, Saint Louis, Missouri, United States: Africa: Barry Jacobson and Judy Sasto and Gladys Medical Associates of North Georgia, Canton, Daniel Theodoro and Daniel Theodoro and Kaharu Conway and Leonie Smith and Claire Cannon and Georgia, United States: Melanie Eley and April Brown Sumino and Vanetta Worthy and Anne Thatcher and Jeannie Marks; Dr Dawood, Mohamed and Pillay, and Scott Beach and Cheryl Verdi; FirstHealth of the Lynn Henson and Kelly Ball and Catharine Richard Cape Town, South Africa: Thayabran Pillay and Carolinas, Inc., Pinehurst, North Carolina, United and Jessica Peterson and Gregory Ewald; Margo Botha; Syzygy Clinical Research Services, States: Tim Richardson and Anne Dickerson and Cardiovascular Research Center of Knoxville, Atlanta, Pretoria, South Africa: Michele Guerra and Lelanie Valerie Palumbo and Peter Duffy and Shauna Georgia, United States: Candy Robertson and van Zyl and Anna-Marie Stapelberg and Deidre Eggertson and Pamela Mason; Southeast Clinical Michelle Parker and Lisa Treasure and Joseph Oosthuizen; Clinical Projects Research SA (PTY) LTD, Research, LLC, Jacksonville, Florida, United States: Minardo and Charles Treasure; SC Nephrology & Worcester, South Africa: Louis van Zyl and Judy Anne Elizabeth Burkett and Tammy Parrott and Karen Hypertension Center, Inc., Orangeburg, South Finlaison and Marshall Heradien and Tania Ellis and Johnson and Stephen Falkowski; Montefiore Medical Carolina, United States: Moustafa Moustafa and Francois van Zyl; Universitas Hospital Cardiology Center PRIME, Lake Success, New York, United Samuel Emelife; Crystal Coast Family Practice, P.A., Research, Bloemfontein, South Africa: Lorinda de States: Sandy Congal and Kevin Ferrick and Ronald Morehead City, North Carolina, United States: Cas Meyer and Hendrik Theron and Ellen Makotoko and Zolty and Auris Browne; MCA Research, Houston, Cader and Sommer Morton; Medication

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