Problem Atrial fibrilation
Format Double-blinded double-dummy multi-center RCT
Treatment Apixaban
Control Warfarin
Population 18,201 patients
Inclusion criteria Atrial fibrillation or flutter at enrollment or two or more episodes of atrial fibrillation or flutter, as documented by electrocardiography, at least 2 weeks apart in the 12 months before enrollment.

In addition, at least one of the following risk factors for stroke was required:
-Age of at least 75 years
-Previous stroke, transient ischemic attack, or systemic embolism
-Symptomatic heart failure within the previous 3 months or left ventricular ejection fraction of no more than 40%
-Diabetes mellitus
-Hypertension requiring pharmacologic treatment.
Exclusion criteria Atrial fibrillation due to a reversible cause
Moderate or severe mitral stenosis
Conditions other than atrial fibrillation that required anticoagulation (e.g., a prosthetic heart valve)
Stroke within the previous 7 days
Need for aspirin at a dose of >165 mg a day or for both aspirin and clopidogrel
Severe renal insufficiency (serum creatinine level of >2.5 mg per deciliter [221 Î_mol per liter] or calculated creatinine clearance of <25 ml per minute).
Follow-up Median 1.8 years
Primary endpoint Ischemic or hemorrhagic stroke or systemic embolism
Secondary endpoint(s) Death from any cause

Primary safety outcome: major bleeding, according to the criteria of the International Society on Thrombosis and Haemostasis (ISTH)
Details .
Brief summary: Apixiban improved mortality, bleeding and stroke rates
PAPER: Apixaban versus warfarin in patients with atrial fibrillation.
Date 15 Sep 2011
Journal N Engl J Med. 2011 Sep 15;365(11):981-92.
Information Apixaban (vs Warfarin)
-Lower rates of stroke or systemic embolism
-Less bleeding
-Lower mortality