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Trial details imported from ClinicalTrials.gov

For full trial details, please see the original record at https://clinicaltrials.gov/show/NCT00699998




Registration number
NCT00699998
Ethics application status
Date submitted
16/06/2008
Date registered
18/06/2008
Date last updated
7/05/2013

Titles & IDs
Public title
A Comparison of Prasugrel and Clopidogrel in Acute Coronary Syndrome Subjects
Scientific title
A Comparison of Prasugrel and Clopidogrel in Acute Coronary Syndrome Subjects With Unstable Angina/Non-ST-Elevation Myocardial Infarction Who Are Medically Managed
Secondary ID [1] 0 0
H7T-MC-TABY(b)
Secondary ID [2] 0 0
11058
Universal Trial Number (UTN)
Trial acronym
TRILOGY ACS
Linked study record

Health condition
Health condition(s) or problem(s) studied:
Acute Coronary Syndrome 0 0
Condition category
Condition code
Cardiovascular 0 0 0 0
Coronary heart disease
Other 0 0 0 0
Research that is not of generic health relevance and not applicable to specific health categories listed above

Intervention/exposure
Study type
Interventional
Description of intervention(s) / exposure
Treatment: Drugs - Clopidogrel
Treatment: Drugs - Prasugrel
Treatment: Drugs - Commercially-available Aspirin

Experimental: Prasugrel - Prasugrel and Low-dose Commercially-available Aspirin

Active Comparator: Clopidogrel - Clopidogrel and Low-Dose Commercially-available Aspirin


Treatment: Drugs: Clopidogrel
300 milligrams (mg), oral, once as loading dose (in those subjects who initiate study drug with a loading dose); and 75 mg, oral, once daily as maintenance dose through end of study

Treatment: Drugs: Prasugrel
30 milligrams (mg), oral, once as loading dose (in those subjects who initiate study drug with a loading dose); and either 5 mg or 10 mg (based upon weight and age), oral, once daily as maintenance dose through end of study

Treatment: Drugs: Commercially-available Aspirin
Low-dose aspirin, oral, as prescribed by physician through end of study

Intervention code [1] 0 0
Treatment: Drugs
Comparator / control treatment
Control group

Outcomes
Primary outcome [1] 0 0
Percentage of Participants With a Composite Endpoint of Cardiovascular (CV) Death, Myocardial Infarction (MI), or Stroke - The percentage of participants is the total number of participants experiencing a CV death, nonfatal MI, or nonfatal stroke divided by number of participants in the treatment arm multiplied by 100. Endpoint events were adjudicated by the Clinical Endpoint Committee.
Timepoint [1] 0 0
Randomization through end of study (30-month visit)
Secondary outcome [1] 0 0
Percentage of Participants With a Composite Endpoint of CV Death and MI - The percentage of participants is the total number of participants experiencing a CV death or nonfatal MI divided by number of participants in the treatment arm. Endpoint events were adjudicated by the Clinical Endpoint Committee.
Timepoint [1] 0 0
Randomization through end of study (30-month visit)
Secondary outcome [2] 0 0
Percentage of Participants With a Composite Endpoint of CV Death, MI, Stroke, or Re-hospitalization for Recurrent Unstable Angina (UA) - The percentage of participants is the total number of participants experiencing a CV death, nonfatal MI, nonfatal stroke or re-hospitalization for a recurrent UA divided by number of participants in the treatment arm. Endpoints events were adjudicated by the Clinical Endpoint Committee.
Timepoint [2] 0 0
Randomization through end of study (30-month visit)
Secondary outcome [3] 0 0
Percentage of Participants With a Composite Endpoint of All-cause Death, MI, or Stroke - The percentage of participants is the total number of participants experiencing an all-cause death, nonfatal MI, or nonfatal stroke divided by number of participants in the treatment arm. Endpoint events were adjudicated by the Clinical Endpoint Committee.
Timepoint [3] 0 0
Randomization through end of study (30-month visit)
Secondary outcome [4] 0 0
Platelet Aggregation Measures - Platelet aggregation was measured by as measured by Accumetrics Verify Now™ P2Y12. Results were reported in P2Y12 Reaction Units (PRU). PRU represents the rate and extent of adenosine (ADP)-stimulated platelet aggregation. Lower values indicate greater P2Y12 platelet inhibition and lower platelet activity and aggregation. ANCOVA Model was used and values were corrected for treatment + baseline value + clopidogrel status at randomization.
Timepoint [4] 0 0
Day 30 and 12 Months
Secondary outcome [5] 0 0
Biomarker Measurements of Inflammation/Hemodynamic Stress: Brain Natriuretic Peptide (BNP) - Brain natriuretic peptide (BNP) is secreted by the ventricles of the heart in response to hemodynamic stress and is a biomarker associated with increased CV risk. Results are presented as geometric least squares means (Geometric LS means). Geometric LS means were adjusted for treatment + baseline value + clopidogrel status at randomization.
Timepoint [5] 0 0
Day 30 and 6 Months
Secondary outcome [6] 0 0
Biomarker Measurements of Inflammation/Hemodynamic Stress: C-Reactive Protein (CRP) - C-Reactive Protein (CRP) is a biomarker associated with inflammation and increased CV risk. Results are presented as geometric least squares means (Geometric LS means). Geometric LS means were adjusted for treatment + baseline value + clopidogrel status at randomization.
Timepoint [6] 0 0
Day 30 and Month 6
Secondary outcome [7] 0 0
Genotyping Related to Drug Metabolism - Variation in the genes encoding the cytochrome P450 (CYP) enzymes (CYP2C19) can reduce the ability to metabolize clopidogrel and a reduced platelet response and have been associated with increased rates of CV events including CV death. Participants were classified as extensive metabolizers (EM); reduced metabolizers (RM); or unknown (UNK) metabolizers based on their CYP2C19 genotype. Possible extensive metabolizer (EM) phenotypes include EM=extensive metabolizer, UM=ultra-rapid metabolizer, and EM (non-UM) that are not UM. Possible reduced metabolizer (RM) phenotypes include IM=intermediate metabolizer and PM=poor metabolizer. Genotypes associated with each predicted phenotype are presented; predicted phenotype is presented first followed by the genotype. Percentage=(number of participants with the predicted phenotype and genotype divided by the total number of participants per arm) multiplied by 100.
Timepoint [7] 0 0
Baseline
Secondary outcome [8] 0 0
Economic and Quality of Life Outcomes - Seattle Angina Questionnaire (SAQ) is a validated, disease-specific questionnaire containing 11 questions (Q) yielding 5 summary scales related to angina: physical limitations, angina stability, angina frequency, treatment satisfaction and disease perception. In this study only angina frequency and the physical limitations scales were assessed. Anginal Frequency was assessed using Q3 and Q4 which consists of a Likert scale ranging from 1 to 6 (higher values equals better quality of life) to assess how often a patient is having symptoms now. Physical limitations was assessed using Q1 which contains 9 items each assessed via Likert scale ranging from 1 to 6 (higher values equals better quality of life) to assess how much a participant's condition is hampering their ability to do what they want to do. Scale scores are transformed to a 0-100 by subtracting the lowest possible score, dividing by the range of the scale, and multiplying by 100. Higher values equal better quality of life.
Timepoint [8] 0 0
Baseline and follow-up (24 months)
Secondary outcome [9] 0 0
Summary of All Deaths - All deaths, regardless of possible relatedness, with the exception of 1 event, were adjudicated by the Clinical Endpoint Committee (CEC) and are reported in this table. The 1 event which was not adjudicated was a result of the revocation of consent by the participant prior to their death. Deaths possibly related to study drug in the opinion of the investigator are also contained in the Serious Adverse Event (SAE) module.
Timepoint [9] 0 0
Randomization through end of study (30-month visit)

Eligibility
Key inclusion criteria
Key

- Have had a Unstable Angina/Non-ST-Elevation Myocardial Infarction (UA/NSTEMI) index
event within 10 days prior to randomization

- Had a medical management strategy decision made with reasonable certainty that neither
percutaneous coronary intervention (PCI) nor coronary artery bypass graft (CABG) is
planned for treatment of the index event

- Had at least 1 of 4 specified high-risk features at the time of the UA/NSTEMI event

Key
Minimum age
18 Years
Maximum age
No limit
Gender
Both males and females
Can healthy volunteers participate?
No
Key exclusion criteria
- Decision for medical management greater than 72 hours after onset of index event
without commercial clopidogrel treatment within 72 hours following onset of the index
event.

- Insignificant coronary artery disease (CAD) on coronary angiography if performed for
Index Event (absence of greater than or equal to 30% stenosis in at least one native
vessel)

- Previous or planned PCI or CABG as treatment for the index event

- PCI/CABG within previous 30 days

- ST-segment elevation myocardial infarction (STEMI) as the index event

- Cardiogenic shock, Refractory ventricular arrhythmias, New York Heart Association
(NYHA) Class IV congestive heart failure (CHF) within the previous 24 hours

- History of ischemic or hemorrhagic stroke, transient ischemic attack (TIA),
Intracranial neoplasm, arteriovenous malformation, or aneurysm

- History of spontaneous gastrointestinal (GI) or non-GI bleeding requiring
hospitalization for treatment, unless definitive treatment has occurred and there is
low likelihood of recurrence

- Hemodialysis or peritoneal dialysis

Study design
Purpose of the study
Treatment
Allocation to intervention
Randomised controlled trial
Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Masking / blinding
Blinded (masking used)
Who is / are masked / blinded?
The people receiving the treatment/s
The people administering the treatment/s
The people assessing the outcomes
The people analysing the results/data
Intervention assignment
Parallel
Other design features
Phase
Phase 3
Type of endpoint(s)
Statistical methods / analysis

Recruitment
Recruitment status
Completed
Data analysis
Reason for early stopping/withdrawal
Other reasons
Date of first participant enrolment
Anticipated
Actual
Date of last participant enrolment
Anticipated
Actual
Date of last data collection
Anticipated
Actual
Sample size
Target
Accrual to date
Final
Recruitment in Australia
Recruitment state(s)
NSW,QLD,SA,TAS
Recruitment hospital [1] 0 0
For additional information regarding investigative sites for this trial, contact 1-877-CTLILLY (1-877-285-4559, 1-317-615-4559) Mon - Fri from 9 AM to 5 PM Eastern Time (UTC/GMT - 5 hours, EST), or speak with your personal physician. - Coffs Harbour
Recruitment hospital [2] 0 0
For additional information regarding investigative sites for this trial, contact 1-877-CTLILLY (1-877-285-4559, 1-317-615-4559) Mon - Fri from 9 AM to 5 PM Eastern Time (UTC/GMT - 5 hours, EST), or speak with your personal physician. - Lismore
Recruitment hospital [3] 0 0
For additional information regarding investigative sites for this trial, contact 1-877-CTLILLY (1-877-285-4559, 1-317-615-4559) Mon - Fri from 9 AM to 5 PM Eastern Time (UTC/GMT - 5 hours, EST), or speak with your personal physician. - Newcastle
Recruitment hospital [4] 0 0
For additional information regarding investigative sites for this trial, contact 1-877-CTLILLY (1-877-285-4559, 1-317-615-4559) Mon - Fri from 9 AM to 5 PM Eastern Time (UTC/GMT - 5 hours, EST), or speak with your personal physician. - Wollongong
Recruitment hospital [5] 0 0
For additional information regarding investigative sites for this trial, contact 1-877-CTLILLY (1-877-285-4559, 1-317-615-4559) Mon - Fri from 9 AM to 5 PM Eastern Time (UTC/GMT - 5 hours, EST), or speak with your personal physician. - Herston
Recruitment hospital [6] 0 0
For additional information regarding investigative sites for this trial, contact 1-877-CTLILLY (1-877-285-4559, 1-317-615-4559) Mon - Fri from 9 AM to 5 PM Eastern Time (UTC/GMT - 5 hours, EST), or speak with your personal physician. - Nambour
Recruitment hospital [7] 0 0
For additional information regarding investigative sites for this trial, contact 1-877-CTLILLY (1-877-285-4559, 1-317-615-4559) Mon - Fri from 9 AM to 5 PM Eastern Time (UTC/GMT - 5 hours, EST), or speak with your personal physician. - Redcliffe
Recruitment hospital [8] 0 0
For additional information regarding investigative sites for this trial, contact 1-877-CTLILLY (1-877-285-4559, 1-317-615-4559) Mon - Fri from 9 AM to 5 PM Eastern Time (UTC/GMT - 5 hours, EST), or speak with your personal physician. - Southport
Recruitment hospital [9] 0 0
For additional information regarding investigative sites for this trial, contact 1-877-CTLILLY (1-877-285-4559, 1-317-615-4559) Mon - Fri from 9 AM to 5 PM Eastern Time (UTC/GMT - 5 hours, EST), or speak with your personal physician. - Bedford Park
Recruitment hospital [10] 0 0
For additional information regarding investigative sites for this trial, contact 1-877-CTLILLY (1-877-285-4559, 1-317-615-4559) Mon - Fri from 9 AM to 5 PM Eastern Time (UTC/GMT - 5 hours, EST), or speak with your personal physician. - Elizabeth Vale
Recruitment hospital [11] 0 0
For additional information regarding investigative sites for this trial, contact 1-877-CTLILLY (1-877-285-4559, 1-317-615-4559) Mon - Fri from 9 AM to 5 PM Eastern Time (UTC/GMT - 5 hours, EST), or speak with your personal physician. - Hobart
Recruitment postcode(s) [1] 0 0
2450 - Coffs Harbour
Recruitment postcode(s) [2] 0 0
2480 - Lismore
Recruitment postcode(s) [3] 0 0
2305 - Newcastle
Recruitment postcode(s) [4] 0 0
2500 - Wollongong
Recruitment postcode(s) [5] 0 0
4029 - Herston
Recruitment postcode(s) [6] 0 0
4560 - Nambour
Recruitment postcode(s) [7] 0 0
4020 - Redcliffe
Recruitment postcode(s) [8] 0 0
4215 - Southport
Recruitment postcode(s) [9] 0 0
5042 - Bedford Park
Recruitment postcode(s) [10] 0 0
5112 - Elizabeth Vale
Recruitment postcode(s) [11] 0 0
7000 - Hobart
Recruitment outside Australia
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Croatia
State/province [152] 0 0
Zagreb
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Czech Republic
State/province [153] 0 0
Decin
Country [154] 0 0
Czech Republic
State/province [154] 0 0
Frydek-Mistek
Country [155] 0 0
Czech Republic
State/province [155] 0 0
Hradec Kralove
Country [156] 0 0
Czech Republic
State/province [156] 0 0
Karlovy Vary
Country [157] 0 0
Czech Republic
State/province [157] 0 0
Kromeriz
Country [158] 0 0
Czech Republic
State/province [158] 0 0
Liberec
Country [159] 0 0
Czech Republic
State/province [159] 0 0
Novy Jicin
Country [160] 0 0
Czech Republic
State/province [160] 0 0
Pardubice
Country [161] 0 0
Czech Republic
State/province [161] 0 0
Prague
Country [162] 0 0
Czech Republic
State/province [162] 0 0
Zlin
Country [163] 0 0
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State/province [163] 0 0
Copenhagen
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Denmark
State/province [164] 0 0
Hellerup
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Denmark
State/province [165] 0 0
Kobenhavn
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Egypt
State/province [166] 0 0
Alexandria
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Egypt
State/province [167] 0 0
Beni Sweif
Country [168] 0 0
Egypt
State/province [168] 0 0
Cairo
Country [169] 0 0
Egypt
State/province [169] 0 0
Ismailia
Country [170] 0 0
Egypt
State/province [170] 0 0
Menoufiya
Country [171] 0 0
Finland
State/province [171] 0 0
Jyvaskyla
Country [172] 0 0
France
State/province [172] 0 0
Angers
Country [173] 0 0
France
State/province [173] 0 0
Arras
Country [174] 0 0
France
State/province [174] 0 0
Besancon
Country [175] 0 0
France
State/province [175] 0 0
Cambrai
Country [176] 0 0
France
State/province [176] 0 0
Chartres Cedex
Country [177] 0 0
France
State/province [177] 0 0
Dijon
Country [178] 0 0
France
State/province [178] 0 0
Douai
Country [179] 0 0
France
State/province [179] 0 0
La Roche Sur Yon
Country [180] 0 0
France
State/province [180] 0 0
Lagny Sur Marne
Country [181] 0 0
France
State/province [181] 0 0
Nantes
Country [182] 0 0
France
State/province [182] 0 0
Nice
Country [183] 0 0
France
State/province [183] 0 0
Paris
Country [184] 0 0
France
State/province [184] 0 0
Pessac
Country [185] 0 0
France
State/province [185] 0 0
Poitiers
Country [186] 0 0
France
State/province [186] 0 0
Strasbourg
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France
State/province [187] 0 0
Toulouse
Country [188] 0 0
France
State/province [188] 0 0
Valenciennes
Country [189] 0 0
France
State/province [189] 0 0
Vandoeuvre Les Nancy
Country [190] 0 0
Germany
State/province [190] 0 0
Bad Nauheim
Country [191] 0 0
Germany
State/province [191] 0 0
Darmstadt
Country [192] 0 0
Germany
State/province [192] 0 0
Dortmund
Country [193] 0 0
Germany
State/province [193] 0 0
Frankfurt
Country [194] 0 0
Germany
State/province [194] 0 0
Halle
Country [195] 0 0
Germany
State/province [195] 0 0
Idar-Oberstein
Country [196] 0 0
Germany
State/province [196] 0 0
Köln
Country [197] 0 0
Germany
State/province [197] 0 0
Leipzig
Country [198] 0 0
Germany
State/province [198] 0 0
Mainz
Country [199] 0 0
Germany
State/province [199] 0 0
Mannheim
Country [200] 0 0
Germany
State/province [200] 0 0
Stuttgart
Country [201] 0 0
Germany
State/province [201] 0 0
Tuebingen
Country [202] 0 0
Greece
State/province [202] 0 0
Athens
Country [203] 0 0
Greece
State/province [203] 0 0
Haidari/Athens
Country [204] 0 0
Greece
State/province [204] 0 0
Kallithea
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Greece
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Magoula
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Greece
State/province [206] 0 0
Patras
Country [207] 0 0
Greece
State/province [207] 0 0
Rhodos
Country [208] 0 0
Greece
State/province [208] 0 0
Trikala
Country [209] 0 0
Hungary
State/province [209] 0 0
Baja
Country [210] 0 0
Hungary
State/province [210] 0 0
Bekescsaba
Country [211] 0 0
Hungary
State/province [211] 0 0
Budapest
Country [212] 0 0
Hungary
State/province [212] 0 0
Kalocsa
Country [213] 0 0
Hungary
State/province [213] 0 0
Kecskemet
Country [214] 0 0
Hungary
State/province [214] 0 0
Komarom
Country [215] 0 0
Hungary
State/province [215] 0 0
Miskolc
Country [216] 0 0
Hungary
State/province [216] 0 0
Satoraljaujhely
Country [217] 0 0
Hungary
State/province [217] 0 0
Sopron
Country [218] 0 0
Hungary
State/province [218] 0 0
Szekszard
Country [219] 0 0
Hungary
State/province [219] 0 0
Zalaegerszeg
Country [220] 0 0
India
State/province [220] 0 0
Ahmedabad
Country [221] 0 0
India
State/province [221] 0 0
Anand
Country [222] 0 0
India
State/province [222] 0 0
Aurangabad
Country [223] 0 0
India
State/province [223] 0 0
Bangalore
Country [224] 0 0
India
State/province [224] 0 0
Baramati
Country [225] 0 0
India
State/province [225] 0 0
Bikaner
Country [226] 0 0
India
State/province [226] 0 0
Calicut
Country [227] 0 0
India
State/province [227] 0 0
Chidambaram
Country [228] 0 0
India
State/province [228] 0 0
Cochin
Country [229] 0 0
India
State/province [229] 0 0
Coimbatore
Country [230] 0 0
India
State/province [230] 0 0
Ernakulam
Country [231] 0 0
India
State/province [231] 0 0
Guntur
Country [232] 0 0
India
State/province [232] 0 0
Gurgaon
Country [233] 0 0
India
State/province [233] 0 0
Hyderabaad
Country [234] 0 0
India
State/province [234] 0 0
Indore
Country [235] 0 0
India
State/province [235] 0 0
Jaipur
Country [236] 0 0
India
State/province [236] 0 0
Jalandhar
Country [237] 0 0
India
State/province [237] 0 0
Kolkata
Country [238] 0 0
India
State/province [238] 0 0
Kottayam
Country [239] 0 0
India
State/province [239] 0 0
Lucknow
Country [240] 0 0
India
State/province [240] 0 0
Madurai
Country [241] 0 0
India
State/province [241] 0 0
Mumbai
Country [242] 0 0
India
State/province [242] 0 0
Mysore
Country [243] 0 0
India
State/province [243] 0 0
Nagpur
Country [244] 0 0
India
State/province [244] 0 0
Nashik
Country [245] 0 0
India
State/province [245] 0 0
New Delhi
Country [246] 0 0
India
State/province [246] 0 0
Patiala
Country [247] 0 0
India
State/province [247] 0 0
Pune
Country [248] 0 0
India
State/province [248] 0 0
Saket
Country [249] 0 0
India
State/province [249] 0 0
Secunderabad
Country [250] 0 0
India
State/province [250] 0 0
Shivamogga
Country [251] 0 0
India
State/province [251] 0 0
Solapur
Country [252] 0 0
India
State/province [252] 0 0
Surat
Country [253] 0 0
India
State/province [253] 0 0
Thrissur
Country [254] 0 0
India
State/province [254] 0 0
Tirupati
Country [255] 0 0
India
State/province [255] 0 0
Trivandrum
Country [256] 0 0
India
State/province [256] 0 0
Vadodara
Country [257] 0 0
India
State/province [257] 0 0
Vijayawada
Country [258] 0 0
India
State/province [258] 0 0
Visakhapatnam
Country [259] 0 0
Ireland
State/province [259] 0 0
Dublin
Country [260] 0 0
Ireland
State/province [260] 0 0
Galway
Country [261] 0 0
Israel
State/province [261] 0 0
Afula
Country [262] 0 0
Israel
State/province [262] 0 0
Ashkelon
Country [263] 0 0
Israel
State/province [263] 0 0
Beer Sheva
Country [264] 0 0
Israel
State/province [264] 0 0
Eilat
Country [265] 0 0
Israel
State/province [265] 0 0
Haifa
Country [266] 0 0
Israel
State/province [266] 0 0
Jerusalem
Country [267] 0 0
Israel
State/province [267] 0 0
Kfar Saba
Country [268] 0 0
Israel
State/province [268] 0 0
Nahariya
Country [269] 0 0
Israel
State/province [269] 0 0
Nazareth
Country [270] 0 0
Israel
State/province [270] 0 0
Rehovot
Country [271] 0 0
Israel
State/province [271] 0 0
Tel Aviv
Country [272] 0 0
Israel
State/province [272] 0 0
Tel Hashomer
Country [273] 0 0
Israel
State/province [273] 0 0
Tiberias
Country [274] 0 0
Israel
State/province [274] 0 0
Tzfat
Country [275] 0 0
Italy
State/province [275] 0 0
Albano Laziale
Country [276] 0 0
Italy
State/province [276] 0 0
Ascoli Piceno
Country [277] 0 0
Italy
State/province [277] 0 0
Bari
Country [278] 0 0
Italy
State/province [278] 0 0
Bergamo
Country [279] 0 0
Italy
State/province [279] 0 0
Brescia
Country [280] 0 0
Italy
State/province [280] 0 0
Caserta
Country [281] 0 0
Italy
State/province [281] 0 0
Forli
Country [282] 0 0
Italy
State/province [282] 0 0
Lecco
Country [283] 0 0
Italy
State/province [283] 0 0
Legnago
Country [284] 0 0
Italy
State/province [284] 0 0
Legnano
Country [285] 0 0
Italy
State/province [285] 0 0
Milano
Country [286] 0 0
Italy
State/province [286] 0 0
Novara
Country [287] 0 0
Italy
State/province [287] 0 0
Parma
Country [288] 0 0
Italy
State/province [288] 0 0
Perugia
Country [289] 0 0
Italy
State/province [289] 0 0
Pescara
Country [290] 0 0
Italy
State/province [290] 0 0
Reggio Emilia
Country [291] 0 0
Italy
State/province [291] 0 0
Rimini
Country [292] 0 0
Italy
State/province [292] 0 0
Rome
Country [293] 0 0
Italy
State/province [293] 0 0
San Daniele Del Friuli
Country [294] 0 0
Italy
State/province [294] 0 0
Santa Maria Capua Vetere
Country [295] 0 0
Italy
State/province [295] 0 0
Saronno
Country [296] 0 0
Italy
State/province [296] 0 0
Sorrento
Country [297] 0 0
Italy
State/province [297] 0 0
Terni
Country [298] 0 0
Italy
State/province [298] 0 0
Trieste
Country [299] 0 0
Korea, Republic of
State/province [299] 0 0
Busan
Country [300] 0 0
Korea, Republic of
State/province [300] 0 0
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Country [301] 0 0
Korea, Republic of
State/province [301] 0 0
Daejeon
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Korea, Republic of
State/province [302] 0 0
Gangwon-Do
Country [303] 0 0
Korea, Republic of
State/province [303] 0 0
Gwangju
Country [304] 0 0
Korea, Republic of
State/province [304] 0 0
Incheon
Country [305] 0 0
Korea, Republic of
State/province [305] 0 0
Jeon Ju-City
Country [306] 0 0
Korea, Republic of
State/province [306] 0 0
Jin-Ju-Si
Country [307] 0 0
Korea, Republic of
State/province [307] 0 0
Seoul
Country [308] 0 0
Korea, Republic of
State/province [308] 0 0
Ulsan-Si
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Lithuania
State/province [309] 0 0
Kaunas
Country [310] 0 0
Lithuania
State/province [310] 0 0
Klaipeda
Country [311] 0 0
Lithuania
State/province [311] 0 0
Siauliai
Country [312] 0 0
Lithuania
State/province [312] 0 0
Vilnius
Country [313] 0 0
Malaysia
State/province [313] 0 0
Cheras, Kuala Lumpur
Country [314] 0 0
Malaysia
State/province [314] 0 0
Johor Bahru
Country [315] 0 0
Malaysia
State/province [315] 0 0
Kelantan
Country [316] 0 0
Malaysia
State/province [316] 0 0
Kuala Lumpur
Country [317] 0 0
Malaysia
State/province [317] 0 0
Kuantan Pahang
Country [318] 0 0
Malaysia
State/province [318] 0 0
Perak
Country [319] 0 0
Malaysia
State/province [319] 0 0
Sarawak
Country [320] 0 0
Malaysia
State/province [320] 0 0
Selangor
Country [321] 0 0
Malaysia
State/province [321] 0 0
Taiping Perak
Country [322] 0 0
Malta
State/province [322] 0 0
Gozo
Country [323] 0 0
Malta
State/province [323] 0 0
Msida
Country [324] 0 0
Mexico
State/province [324] 0 0
Aguascalientes
Country [325] 0 0
Mexico
State/province [325] 0 0
Culiacan
Country [326] 0 0
Mexico
State/province [326] 0 0
Durango
Country [327] 0 0
Mexico
State/province [327] 0 0
Jalisco
Country [328] 0 0
Mexico
State/province [328] 0 0
Leon
Country [329] 0 0
Mexico
State/province [329] 0 0
Monterrey
Country [330] 0 0
Mexico
State/province [330] 0 0
Puebla
Country [331] 0 0
Mexico
State/province [331] 0 0
Queretaro
Country [332] 0 0
Mexico
State/province [332] 0 0
San Luis Potosi
Country [333] 0 0
Mexico
State/province [333] 0 0
Tijuana
Country [334] 0 0
Netherlands
State/province [334] 0 0
Alkmaar
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Netherlands
State/province [335] 0 0
Almelo
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Netherlands
State/province [336] 0 0
Amsterdam
Country [337] 0 0
Netherlands
State/province [337] 0 0
Apeldoorn
Country [338] 0 0
Netherlands
State/province [338] 0 0
Beverwijk
Country [339] 0 0
Netherlands
State/province [339] 0 0
Blaricum
Country [340] 0 0
Netherlands
State/province [340] 0 0
Delft
Country [341] 0 0
Netherlands
State/province [341] 0 0
Ede
Country [342] 0 0
Netherlands
State/province [342] 0 0
Eindhoven
Country [343] 0 0
Netherlands
State/province [343] 0 0
Gouda
Country [344] 0 0
Netherlands
State/province [344] 0 0
Hoorn
Country [345] 0 0
Netherlands
State/province [345] 0 0
Leeuwarden
Country [346] 0 0
Netherlands
State/province [346] 0 0
Leiden
Country [347] 0 0
Netherlands
State/province [347] 0 0
Leiderdorp
Country [348] 0 0
Netherlands
State/province [348] 0 0
Meppel
Country [349] 0 0
Netherlands
State/province [349] 0 0
Oss
Country [350] 0 0
Netherlands
State/province [350] 0 0
Roosendaal
Country [351] 0 0
Netherlands
State/province [351] 0 0
Venlo
Country [352] 0 0
New Zealand
State/province [352] 0 0
Auckland
Country [353] 0 0
New Zealand
State/province [353] 0 0
Christchurch
Country [354] 0 0
New Zealand
State/province [354] 0 0
Nelson
Country [355] 0 0
New Zealand
State/province [355] 0 0
Wellington
Country [356] 0 0
Panama
State/province [356] 0 0
Cocle
Country [357] 0 0
Panama
State/province [357] 0 0
David
Country [358] 0 0
Panama
State/province [358] 0 0
Panama
Country [359] 0 0
Peru
State/province [359] 0 0
Arequipa
Country [360] 0 0
Peru
State/province [360] 0 0
Callao
Country [361] 0 0
Peru
State/province [361] 0 0
Cuzco
Country [362] 0 0
Peru
State/province [362] 0 0
Lima
Country [363] 0 0
Philippines
State/province [363] 0 0
Cagayan De De Oro
Country [364] 0 0
Philippines
State/province [364] 0 0
Cavite City
Country [365] 0 0
Philippines
State/province [365] 0 0
Davao City
Country [366] 0 0
Philippines
State/province [366] 0 0
Iloilo City
Country [367] 0 0
Philippines
State/province [367] 0 0
Manila
Country [368] 0 0
Philippines
State/province [368] 0 0
Marikina City
Country [369] 0 0
Philippines
State/province [369] 0 0
Metro Manila
Country [370] 0 0
Philippines
State/province [370] 0 0
Pasig City
Country [371] 0 0
Philippines
State/province [371] 0 0
Quezon City
Country [372] 0 0
Poland
State/province [372] 0 0
Bydgoszcz
Country [373] 0 0
Poland
State/province [373] 0 0
Elblag
Country [374] 0 0
Poland
State/province [374] 0 0
Gdansk
Country [375] 0 0
Poland
State/province [375] 0 0
Katowice
Country [376] 0 0
Poland
State/province [376] 0 0
Koszalin
Country [377] 0 0
Poland
State/province [377] 0 0
Krakow
Country [378] 0 0
Poland
State/province [378] 0 0
Kutno
Country [379] 0 0
Poland
State/province [379] 0 0
Lodz
Country [380] 0 0
Poland
State/province [380] 0 0
Lubin
Country [381] 0 0
Poland
State/province [381] 0 0
Lublin
Country [382] 0 0
Poland
State/province [382] 0 0
Myslenice
Country [383] 0 0
Poland
State/province [383] 0 0
Nowy Sacz
Country [384] 0 0
Poland
State/province [384] 0 0
Olawa
Country [385] 0 0
Poland
State/province [385] 0 0
Piotrkow Trybunalski
Country [386] 0 0
Poland
State/province [386] 0 0
Pulawy
Country [387] 0 0
Poland
State/province [387] 0 0
Ruda Slaska
Country [388] 0 0
Poland
State/province [388] 0 0
Skierniewice
Country [389] 0 0
Poland
State/province [389] 0 0
Szczecin
Country [390] 0 0
Poland
State/province [390] 0 0
Walbrzych
Country [391] 0 0
Poland
State/province [391] 0 0
Warsaw
Country [392] 0 0
Poland
State/province [392] 0 0
Wejherowo
Country [393] 0 0
Poland
State/province [393] 0 0
Wroclaw
Country [394] 0 0
Portugal
State/province [394] 0 0
Aveiro
Country [395] 0 0
Portugal
State/province [395] 0 0
Carnaxide
Country [396] 0 0
Portugal
State/province [396] 0 0
Coimbra
Country [397] 0 0
Portugal
State/province [397] 0 0
Leiria
Country [398] 0 0
Portugal
State/province [398] 0 0
Ponta Delgada
Country [399] 0 0
Portugal
State/province [399] 0 0
Santarem
Country [400] 0 0
Portugal
State/province [400] 0 0
Setubal
Country [401] 0 0
Portugal
State/province [401] 0 0
Vila Franca De Xira
Country [402] 0 0
Puerto Rico
State/province [402] 0 0
Caguas
Country [403] 0 0
Puerto Rico
State/province [403] 0 0
Mayaguez
Country [404] 0 0
Puerto Rico
State/province [404] 0 0
San Juan
Country [405] 0 0
Romania
State/province [405] 0 0
Bacau
Country [406] 0 0
Romania
State/province [406] 0 0
Baia Mare
Country [407] 0 0
Romania
State/province [407] 0 0
Braila
Country [408] 0 0
Romania
State/province [408] 0 0
Brasov
Country [409] 0 0
Romania
State/province [409] 0 0
Bucharest
Country [410] 0 0
Romania
State/province [410] 0 0
Buzau
Country [411] 0 0
Romania
State/province [411] 0 0
Cluj-Napoca
Country [412] 0 0
Romania
State/province [412] 0 0
Focsani
Country [413] 0 0
Romania
State/province [413] 0 0
Pitesti
Country [414] 0 0
Romania
State/province [414] 0 0
Suceava
Country [415] 0 0
Romania
State/province [415] 0 0
Targoviste
Country [416] 0 0
Russian Federation
State/province [416] 0 0
Arkhangelsk
Country [417] 0 0
Russian Federation
State/province [417] 0 0
Gatchina
Country [418] 0 0
Russian Federation
State/province [418] 0 0
Kazan
Country [419] 0 0
Russian Federation
State/province [419] 0 0
Kemerovo
Country [420] 0 0
Russian Federation
State/province [420] 0 0
Krasnoyarsk
Country [421] 0 0
Russian Federation
State/province [421] 0 0
Moscow
Country [422] 0 0
Russian Federation
State/province [422] 0 0
Nizhny Novgorod
Country [423] 0 0
Russian Federation
State/province [423] 0 0
Novokuznetsk
Country [424] 0 0
Russian Federation
State/province [424] 0 0
Novosibirsk
Country [425] 0 0
Russian Federation
State/province [425] 0 0
Omsk
Country [426] 0 0
Russian Federation
State/province [426] 0 0
Rostov-On-Don
Country [427] 0 0
Russian Federation
State/province [427] 0 0
Saint Petersburg
Country [428] 0 0
Russian Federation
State/province [428] 0 0
Saratov
Country [429] 0 0
Russian Federation
State/province [429] 0 0
Tomsk
Country [430] 0 0
Russian Federation
State/province [430] 0 0
Tyumen
Country [431] 0 0
Serbia
State/province [431] 0 0
Belgrade
Country [432] 0 0
Serbia
State/province [432] 0 0
Kragujevac
Country [433] 0 0
Serbia
State/province [433] 0 0
Niska Banja
Country [434] 0 0
Serbia
State/province [434] 0 0
Nis
Country [435] 0 0
Serbia
State/province [435] 0 0
Zemun
Country [436] 0 0
Singapore
State/province [436] 0 0
Singapore
Country [437] 0 0
Slovakia
State/province [437] 0 0
Bratislava
Country [438] 0 0
Slovakia
State/province [438] 0 0
Levice
Country [439] 0 0
Slovakia
State/province [439] 0 0
Martin
Country [440] 0 0
Slovakia
State/province [440] 0 0
Nitra
Country [441] 0 0
Slovakia
State/province [441] 0 0
Nove Zamky
Country [442] 0 0
Slovakia
State/province [442] 0 0
Presov
Country [443] 0 0
Slovakia
State/province [443] 0 0
Ruzomberok
Country [444] 0 0
Slovakia
State/province [444] 0 0
Zilina
Country [445] 0 0
South Africa
State/province [445] 0 0
Alberton
Country [446