# Apixaban Drug · id `cardio:apixaban` · Cardiovascular Atlas · release `f6f6f1b6f50379ed` (public) > General information from published sources, not medical advice, and not reviewed by clinicians. Check the cited source before relying on anything here. The atlas's own text and curation may be reused under Creative Commons Attribution-NonCommercial 4.0 International (CC BY-NC 4.0, https://creativecommons.org/licenses/by-nc/4.0/): credit the atlas, and do not use it commercially. See the atlas About page. Text quoted from a source stays under that source's own terms, given as the source's reuse\_basis. The atlas's reuse terms do not cover it. The downloads list each quotation with its source in third\_party\_quotations. Browse, condition area: Stroke; Heart rhythm problems ## In plain language The medicine inside Eliquis. It is a blood thinner taken by mouth. In the ARISTOTLE trial it was compared with warfarin in people with atrial fibrillation at higher risk of stroke, and the authors report it was superior to warfarin for stroke or clots elsewhere in the body, caused less major bleeding and was linked with lower death from any cause. ## Technical summary RxNorm ingredient 1364430. A factor Xa inhibitor (ARISTOTLE abstract). Tested against warfarin in ARISTOTLE (claim cardio:claim-aristotle-apixaban-vs-warfarin); brand name Eliquis in the US regulator's record (NDA 202155). The numbers are on the claim. ## Claims, with the population each applies to ## Context: Adults with atrial fibrillation and at least one additional risk factor for stroke (ARISTOTLE) Recipient: Adult; Population: Patients aged 18 or older with atrial fibrillation and at least one additional risk factor for stroke: age 75 or older, previous stroke, transient ischemic attack or systemic embolism, symptomatic heart failure or reduced left ventricular function, or diabetes or hypertension requiring drug treatment (registry wording).; Care setting: Not stated in the abstract or the registry record; Geography: International (the registry lists sites in many countries; they are recorded on the study); Life stage: Adults aged 18 or older (registry inclusion text); Follow-up: Median follow-up of 1.8 years (abstract). ### In ARISTOTLE, a randomized, double-blind trial, apixaban (5 mg twice daily) was compared with warfarin (target international normalized ratio 2.0 to 3.0) in 18,201 patients with atrial fibrillation and at least one additional risk factor for stroke, with a median follow-up of 1.8 years. The primary outcome, ischemic or hemorrhagic stroke or systemic embolism, occurred at 1.27% per year with apixaban and 1.60% per year with warfarin (hazard ratio 0.79, 95% confidence interval 0.66 to 0.95; P<0.001 for noninferiority, P=0.01 for superiority). Major bleeding occurred at 2.13% per year with apixaban and 3.09% per year with warfarin (hazard ratio 0.69, 95% CI 0.60 to 0.80; P<0.001). The rates of death from any cause were 3.52% with apixaban and 3.94% with warfarin (hazard ratio 0.89, 95% CI 0.80 to 0.99; P=0.047). Hemorrhagic stroke occurred at 0.24% per year with apixaban and 0.47% per year with warfarin (hazard ratio 0.51, 95% CI 0.35 to 0.75; P<0.001). Ischemic or uncertain-type stroke occurred at 0.97% per year with apixaban and 1.05% per year with warfarin (hazard ratio 0.92, 95% CI 0.74 to 1.13; P=0.42), a difference that was not statistically significant. - Category: Effect - Evidence stage: Interventional - Certainty: Certainty not assessed - Applies to: Recipient: Adult; Population: Patients aged 18 or older with atrial fibrillation and at least one additional risk factor for stroke: age 75 or older, previous stroke, transient ischemic attack or systemic embolism, symptomatic heart failure or reduced left ventricular function, or diabetes or hypertension requiring drug treatment (registry wording).; Care setting: Not stated in the abstract or the registry record; Geography: International (the registry lists sites in many countries; they are recorded on the study); Life stage: Adults aged 18 or older (registry inclusion text); Follow-up: Median follow-up of 1.8 years (abstract). - Limitations: Abstract of the main report; the full text, the supplement and the registry results tables were not read. The paper and the registry give different participant counts: the abstract says 18,201 patients and the registry enrollment is 20976, and the difference is not explained or reconciled here. The abstract names the 5 mg twice-daily dose; the registry lists 5.0 mg or 2.5 mg twice daily. The trial population had at least one additional stroke risk factor, so results do not apply to every person with atrial fibrillation. The conclusion in the abstract is the authors' reading, with funding by Bristol-Myers Squibb and Pfizer. - Last checked: 2026-10-14 - Sources: 1. Supports: Apixaban versus warfarin in patients with atrial fibrillation (Publication, edition PubMed record (abstract and bibliographic data) fetched 2026-10-14 through NCBI E-utilities. No PMC copy is listed. The full text and the version of record were not fetched.) Locator: Abstract, METHODS, sentence 1, fragment 1. Retrieved 2026-10-14T18:18:38Z. Source state: Current. Snapshot hash: 070808b131231dc9141645fc51ed733ed3f8db0ad34099cce02d8c66b19843ba. How it applies: Design and doses (first fragment). 2. Supports: Apixaban versus warfarin in patients with atrial fibrillation (Publication, edition PubMed record (abstract and bibliographic data) fetched 2026-10-14 through NCBI E-utilities. No PMC copy is listed. The full text and the version of record were not fetched.) Locator: Abstract, METHODS, sentence 1, fragment 2. Retrieved 2026-10-14T18:18:38Z. Source state: Current. Snapshot hash: 070808b131231dc9141645fc51ed733ed3f8db0ad34099cce02d8c66b19843ba. How it applies: Warfarin target, patient count and population (second fragment). 3. Supports: Apixaban versus warfarin in patients with atrial fibrillation (Publication, edition PubMed record (abstract and bibliographic data) fetched 2026-10-14 through NCBI E-utilities. No PMC copy is listed. The full text and the version of record were not fetched.) Locator: Abstract, METHODS, sentence 2. Retrieved 2026-10-14T18:18:38Z. Source state: Current. Snapshot hash: 070808b131231dc9141645fc51ed733ed3f8db0ad34099cce02d8c66b19843ba. How it applies: Primary outcome. 4. Supports: Apixaban versus warfarin in patients with atrial fibrillation (Publication, edition PubMed record (abstract and bibliographic data) fetched 2026-10-14 through NCBI E-utilities. No PMC copy is listed. The full text and the version of record were not fetched.) Locator: Abstract, RESULTS, sentence 1. Retrieved 2026-10-14T18:18:38Z. Source state: Current. Snapshot hash: 070808b131231dc9141645fc51ed733ed3f8db0ad34099cce02d8c66b19843ba. How it applies: Median follow-up. 5. Supports: Apixaban versus warfarin in patients with atrial fibrillation (Publication, edition PubMed record (abstract and bibliographic data) fetched 2026-10-14 through NCBI E-utilities. No PMC copy is listed. The full text and the version of record were not fetched.) Locator: Abstract, RESULTS, sentence 2, fragment 1. Retrieved 2026-10-14T18:18:38Z. Source state: Current. Snapshot hash: 070808b131231dc9141645fc51ed733ed3f8db0ad34099cce02d8c66b19843ba. How it applies: Primary outcome rate with apixaban. 6. Supports: Apixaban versus warfarin in patients with atrial fibrillation (Publication, edition PubMed record (abstract and bibliographic data) fetched 2026-10-14 through NCBI E-utilities. No PMC copy is listed. The full text and the version of record were not fetched.) Locator: Abstract, RESULTS, sentence 2, fragment 2. Retrieved 2026-10-14T18:18:38Z. Source state: Current. Snapshot hash: 070808b131231dc9141645fc51ed733ed3f8db0ad34099cce02d8c66b19843ba. How it applies: Primary outcome rate with warfarin and hazard ratio. 7. Supports: Apixaban versus warfarin in patients with atrial fibrillation (Publication, edition PubMed record (abstract and bibliographic data) fetched 2026-10-14 through NCBI E-utilities. No PMC copy is listed. The full text and the version of record were not fetched.) Locator: Abstract, RESULTS, sentence 2, fragment 3. Retrieved 2026-10-14T18:18:38Z. Source state: Current. Snapshot hash: 070808b131231dc9141645fc51ed733ed3f8db0ad34099cce02d8c66b19843ba. How it applies: P values for noninferiority and superiority. 8. Supports: Apixaban versus warfarin in patients with atrial fibrillation (Publication, edition PubMed record (abstract and bibliographic data) fetched 2026-10-14 through NCBI E-utilities. No PMC copy is listed. The full text and the version of record were not fetched.) Locator: Abstract, RESULTS, sentence 3, fragment 1. Retrieved 2026-10-14T18:18:38Z. Source state: Current. Snapshot hash: 070808b131231dc9141645fc51ed733ed3f8db0ad34099cce02d8c66b19843ba. How it applies: Major bleeding with apixaban. 9. Supports: Apixaban versus warfarin in patients with atrial fibrillation (Publication, edition PubMed record (abstract and bibliographic data) fetched 2026-10-14 through NCBI E-utilities. No PMC copy is listed. The full text and the version of record were not fetched.) Locator: Abstract, RESULTS, sentence 3, fragment 2. Retrieved 2026-10-14T18:18:38Z. Source state: Current. Snapshot hash: 070808b131231dc9141645fc51ed733ed3f8db0ad34099cce02d8c66b19843ba. How it applies: Major bleeding with warfarin. 10. Supports: Apixaban versus warfarin in patients with atrial fibrillation (Publication, edition PubMed record (abstract and bibliographic data) fetched 2026-10-14 through NCBI E-utilities. No PMC copy is listed. The full text and the version of record were not fetched.) Locator: Abstract, RESULTS, sentence 3, fragment 3. Retrieved 2026-10-14T18:18:38Z. Source state: Current. Snapshot hash: 070808b131231dc9141645fc51ed733ed3f8db0ad34099cce02d8c66b19843ba. How it applies: Death from any cause. 11. Supports: Apixaban versus warfarin in patients with atrial fibrillation (Publication, edition PubMed record (abstract and bibliographic data) fetched 2026-10-14 through NCBI E-utilities. No PMC copy is listed. The full text and the version of record were not fetched.) Locator: Abstract, RESULTS, sentence 4, fragment 1. Retrieved 2026-10-14T18:18:38Z. Source state: Current. Snapshot hash: 070808b131231dc9141645fc51ed733ed3f8db0ad34099cce02d8c66b19843ba. How it applies: Hemorrhagic stroke with apixaban. 12. Supports: Apixaban versus warfarin in patients with atrial fibrillation (Publication, edition PubMed record (abstract and bibliographic data) fetched 2026-10-14 through NCBI E-utilities. No PMC copy is listed. The full text and the version of record were not fetched.) Locator: Abstract, RESULTS, sentence 4, fragment 2. Retrieved 2026-10-14T18:18:38Z. Source state: Current. Snapshot hash: 070808b131231dc9141645fc51ed733ed3f8db0ad34099cce02d8c66b19843ba. How it applies: Hemorrhagic stroke with warfarin. 13. Supports: Apixaban versus warfarin in patients with atrial fibrillation (Publication, edition PubMed record (abstract and bibliographic data) fetched 2026-10-14 through NCBI E-utilities. No PMC copy is listed. The full text and the version of record were not fetched.) Locator: Abstract, RESULTS, sentence 4, fragment 3. Retrieved 2026-10-14T18:18:38Z. Source state: Current. Snapshot hash: 070808b131231dc9141645fc51ed733ed3f8db0ad34099cce02d8c66b19843ba. How it applies: Ischemic or uncertain-type stroke rates. 14. Supports: Apixaban versus warfarin in patients with atrial fibrillation (Publication, edition PubMed record (abstract and bibliographic data) fetched 2026-10-14 through NCBI E-utilities. No PMC copy is listed. The full text and the version of record were not fetched.) Locator: Abstract, RESULTS, sentence 4, fragment 4. Retrieved 2026-10-14T18:18:38Z. Source state: Current. Snapshot hash: 070808b131231dc9141645fc51ed733ed3f8db0ad34099cce02d8c66b19843ba. How it applies: Ischemic or uncertain-type stroke hazard ratio. 15. Background: Apixaban versus warfarin in patients with atrial fibrillation (Publication, edition PubMed record (abstract and bibliographic data) fetched 2026-10-14 through NCBI E-utilities. No PMC copy is listed. The full text and the version of record were not fetched.) Locator: Abstract, CONCLUSIONS, sentence 1. Retrieved 2026-10-14T18:18:38Z. Source state: Current. Snapshot hash: 070808b131231dc9141645fc51ed733ed3f8db0ad34099cce02d8c66b19843ba. How it applies: The authors' conclusion. 16. Background: Apixaban versus warfarin in patients with atrial fibrillation (Publication, edition PubMed record (abstract and bibliographic data) fetched 2026-10-14 through NCBI E-utilities. No PMC copy is listed. The full text and the version of record were not fetched.) Locator: Abstract, CONCLUSIONS, sentence 2. Retrieved 2026-10-14T18:18:38Z. Source state: Current. Snapshot hash: 070808b131231dc9141645fc51ed733ed3f8db0ad34099cce02d8c66b19843ba. How it applies: Funding and registry number. 17. Background: Apixaban versus warfarin in patients with atrial fibrillation (Publication, edition PubMed record (abstract and bibliographic data) fetched 2026-10-14 through NCBI E-utilities. No PMC copy is listed. The full text and the version of record were not fetched.) Locator: Abstract, BACKGROUND, sentence 2, fragment 1. Retrieved 2026-10-14T18:18:38Z. Source state: Current. Snapshot hash: 070808b131231dc9141645fc51ed733ed3f8db0ad34099cce02d8c66b19843ba. How it applies: Apixaban is a factor Xa inhibitor. 18. Background: Apixaban for the Prevention of Stroke in Subjects With Atrial Fibrillation (ARISTOTLE) (Registry, edition ClinicalTrials.gov API v2 record fetched 2026-10-14. Last update posted 2018-07-03.) Locator: protocolSection.armsInterventionsModule.interventions\[1\].description. Retrieved 2026-10-14T18:18:33Z. Source state: Current. Snapshot hash: e9c077ce4717632f4d86664bb4c91b18b90ec4aa54e6b1934507084c1727f0ab. How it applies: Registry dose description, which differs from the abstract. 19. Background: Apixaban for the Prevention of Stroke in Subjects With Atrial Fibrillation (ARISTOTLE) (Registry, edition ClinicalTrials.gov API v2 record fetched 2026-10-14. Last update posted 2018-07-03.) Locator: protocolSection.designModule.enrollmentInfo.count. Retrieved 2026-10-14T18:18:33Z. Source state: Current. Snapshot hash: e9c077ce4717632f4d86664bb4c91b18b90ec4aa54e6b1934507084c1727f0ab. How it applies: Registry enrollment count, which differs from the abstract. ## Connected pages - Compared with warfarin in ARISTOTLE: Atrial fibrillation (AF) (`cardio:atrial-fibrillation`) [a claim, not a settled fact; see claim `cardio:claim-aristotle-apixaban-vs-warfarin` and its context] - A direct oral anticoagulant used for this strategy: Blood thinners (oral anticoagulants) to prevent stroke in AF (`cardio:oral-anticoagulation`) - Filed under this front: Medicines (`cardio:front-medicines`) - Contained in: Apixaban (Eliquis) (`cardio:eliquis`) - Investigated in: ARISTOTLE (`cardio:aristotle`) ## Provenance Content hash: ecb59c5099d85b5169fc795b69526e7b2bbb8138cf32f1b30c99f65df47c4c2f Last substantive edit: 2026-10-15 Evidence last checked: 2026-10-14