Cardiovascular Atlas
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Apixaban

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.

  • Drug
  • In this atlas

Overview

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 FDA record (NDA 202155). The numbers are on the claim.

About this drug

Level
Substance
Mechanism
An oral direct factor Xa inhibitor (ARISTOTLE abstract).

Claims and evidence

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).
Eligibility: 2 inclusion criteria; 1 exclusion criterion
Included
  • Aged 18 years or older, with atrial fibrillation
  • At least one more stroke risk factor: age 75 or older, previous stroke, transient ischemic attack or systemic embolism, symptomatic heart failure or left ventricular ejection fraction of 40% or less, or diabetes or hypertension requiring drug treatment
Excluded
  • Not stated in the registry record

  • Effect Interventional Certainty not assessed

    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.

    Applies to Adult
    • 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).
    • Not stated in the abstract or the registry record
    • International (the registry lists sites in many countries; they are recorded on the study)
    • Adults aged 18 or older (registry inclusion text)
    Follow-up Median follow-up of 1.8 years (abstract).
    Certainty method
    Not assessed
    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
    Next evidence check due
    Not scheduled
    Sources and citations (19)

    1. Supports Apixaban versus warfarin in patients with atrial fibrillation

      Publication · Journal record via PubMed (N Engl J Med 2011;365(11):981-92) · 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. · Published 2011-09-15 · DOI: 10.1056/NEJMoa1107039 · PMID: 21870978

      Locator
      Abstract, METHODS, sentence 1, fragment 1
      How it applies
      Design and doses (first fragment).
      Retrieved
      Source effective date
      Not reported
      Source state
      Current
      Snapshot hash
      070808b131231dc9141645fc51ed733ed3f8db0ad34099cce02d8c66b19843ba
      Reuse basis
      PubMed record fetched through NCBI E-utilities (label cf-pubmed-21870978.xml). Only the hash of the bytes is kept, because publisher copyright may apply to the abstract (https://pubmed.ncbi.nlm.nih.gov/disclaimer/). Short factual quotations under 25 words, with the citation.

    2. Supports Apixaban versus warfarin in patients with atrial fibrillation

      Publication · Journal record via PubMed (N Engl J Med 2011;365(11):981-92) · 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. · Published 2011-09-15 · DOI: 10.1056/NEJMoa1107039 · PMID: 21870978

      Locator
      Abstract, METHODS, sentence 1, fragment 2
      How it applies
      Warfarin target, patient count and population (second fragment).
      Retrieved
      Source effective date
      Not reported
      Source state
      Current
      Snapshot hash
      070808b131231dc9141645fc51ed733ed3f8db0ad34099cce02d8c66b19843ba
      Reuse basis
      PubMed record fetched through NCBI E-utilities (label cf-pubmed-21870978.xml). Only the hash of the bytes is kept, because publisher copyright may apply to the abstract (https://pubmed.ncbi.nlm.nih.gov/disclaimer/). Short factual quotations under 25 words, with the citation.

    3. Supports Apixaban versus warfarin in patients with atrial fibrillation

      Publication · Journal record via PubMed (N Engl J Med 2011;365(11):981-92) · 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. · Published 2011-09-15 · DOI: 10.1056/NEJMoa1107039 · PMID: 21870978

      Locator
      Abstract, METHODS, sentence 2
      How it applies
      Primary outcome.
      Retrieved
      Source effective date
      Not reported
      Source state
      Current
      Snapshot hash
      070808b131231dc9141645fc51ed733ed3f8db0ad34099cce02d8c66b19843ba
      Reuse basis
      PubMed record fetched through NCBI E-utilities (label cf-pubmed-21870978.xml). Only the hash of the bytes is kept, because publisher copyright may apply to the abstract (https://pubmed.ncbi.nlm.nih.gov/disclaimer/). Short factual quotations under 25 words, with the citation.

    4. Supports Apixaban versus warfarin in patients with atrial fibrillation

      Publication · Journal record via PubMed (N Engl J Med 2011;365(11):981-92) · 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. · Published 2011-09-15 · DOI: 10.1056/NEJMoa1107039 · PMID: 21870978

      Locator
      Abstract, RESULTS, sentence 1
      How it applies
      Median follow-up.
      Retrieved
      Source effective date
      Not reported
      Source state
      Current
      Snapshot hash
      070808b131231dc9141645fc51ed733ed3f8db0ad34099cce02d8c66b19843ba
      Reuse basis
      PubMed record fetched through NCBI E-utilities (label cf-pubmed-21870978.xml). Only the hash of the bytes is kept, because publisher copyright may apply to the abstract (https://pubmed.ncbi.nlm.nih.gov/disclaimer/). Short factual quotations under 25 words, with the citation.

    5. Supports Apixaban versus warfarin in patients with atrial fibrillation

      Publication · Journal record via PubMed (N Engl J Med 2011;365(11):981-92) · 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. · Published 2011-09-15 · DOI: 10.1056/NEJMoa1107039 · PMID: 21870978

      Locator
      Abstract, RESULTS, sentence 2, fragment 1
      How it applies
      Primary outcome rate with apixaban.
      Retrieved
      Source effective date
      Not reported
      Source state
      Current
      Snapshot hash
      070808b131231dc9141645fc51ed733ed3f8db0ad34099cce02d8c66b19843ba
      Reuse basis
      PubMed record fetched through NCBI E-utilities (label cf-pubmed-21870978.xml). Only the hash of the bytes is kept, because publisher copyright may apply to the abstract (https://pubmed.ncbi.nlm.nih.gov/disclaimer/). Short factual quotations under 25 words, with the citation.

    6. Supports Apixaban versus warfarin in patients with atrial fibrillation

      Publication · Journal record via PubMed (N Engl J Med 2011;365(11):981-92) · 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. · Published 2011-09-15 · DOI: 10.1056/NEJMoa1107039 · PMID: 21870978

      Locator
      Abstract, RESULTS, sentence 2, fragment 2
      How it applies
      Primary outcome rate with warfarin and hazard ratio.
      Retrieved
      Source effective date
      Not reported
      Source state
      Current
      Snapshot hash
      070808b131231dc9141645fc51ed733ed3f8db0ad34099cce02d8c66b19843ba
      Reuse basis
      PubMed record fetched through NCBI E-utilities (label cf-pubmed-21870978.xml). Only the hash of the bytes is kept, because publisher copyright may apply to the abstract (https://pubmed.ncbi.nlm.nih.gov/disclaimer/). Short factual quotations under 25 words, with the citation.

    7. Supports Apixaban versus warfarin in patients with atrial fibrillation

      Publication · Journal record via PubMed (N Engl J Med 2011;365(11):981-92) · 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. · Published 2011-09-15 · DOI: 10.1056/NEJMoa1107039 · PMID: 21870978

      Locator
      Abstract, RESULTS, sentence 2, fragment 3
      How it applies
      P values for noninferiority and superiority.
      Retrieved
      Source effective date
      Not reported
      Source state
      Current
      Snapshot hash
      070808b131231dc9141645fc51ed733ed3f8db0ad34099cce02d8c66b19843ba
      Reuse basis
      PubMed record fetched through NCBI E-utilities (label cf-pubmed-21870978.xml). Only the hash of the bytes is kept, because publisher copyright may apply to the abstract (https://pubmed.ncbi.nlm.nih.gov/disclaimer/). Short factual quotations under 25 words, with the citation.

    8. Supports Apixaban versus warfarin in patients with atrial fibrillation

      Publication · Journal record via PubMed (N Engl J Med 2011;365(11):981-92) · 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. · Published 2011-09-15 · DOI: 10.1056/NEJMoa1107039 · PMID: 21870978

      Locator
      Abstract, RESULTS, sentence 3, fragment 1
      How it applies
      Major bleeding with apixaban.
      Retrieved
      Source effective date
      Not reported
      Source state
      Current
      Snapshot hash
      070808b131231dc9141645fc51ed733ed3f8db0ad34099cce02d8c66b19843ba
      Reuse basis
      PubMed record fetched through NCBI E-utilities (label cf-pubmed-21870978.xml). Only the hash of the bytes is kept, because publisher copyright may apply to the abstract (https://pubmed.ncbi.nlm.nih.gov/disclaimer/). Short factual quotations under 25 words, with the citation.

    9. Supports Apixaban versus warfarin in patients with atrial fibrillation

      Publication · Journal record via PubMed (N Engl J Med 2011;365(11):981-92) · 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. · Published 2011-09-15 · DOI: 10.1056/NEJMoa1107039 · PMID: 21870978

      Locator
      Abstract, RESULTS, sentence 3, fragment 2
      How it applies
      Major bleeding with warfarin.
      Retrieved
      Source effective date
      Not reported
      Source state
      Current
      Snapshot hash
      070808b131231dc9141645fc51ed733ed3f8db0ad34099cce02d8c66b19843ba
      Reuse basis
      PubMed record fetched through NCBI E-utilities (label cf-pubmed-21870978.xml). Only the hash of the bytes is kept, because publisher copyright may apply to the abstract (https://pubmed.ncbi.nlm.nih.gov/disclaimer/). Short factual quotations under 25 words, with the citation.

    10. Supports Apixaban versus warfarin in patients with atrial fibrillation

      Publication · Journal record via PubMed (N Engl J Med 2011;365(11):981-92) · 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. · Published 2011-09-15 · DOI: 10.1056/NEJMoa1107039 · PMID: 21870978

      Locator
      Abstract, RESULTS, sentence 3, fragment 3
      How it applies
      Death from any cause.
      Retrieved
      Source effective date
      Not reported
      Source state
      Current
      Snapshot hash
      070808b131231dc9141645fc51ed733ed3f8db0ad34099cce02d8c66b19843ba
      Reuse basis
      PubMed record fetched through NCBI E-utilities (label cf-pubmed-21870978.xml). Only the hash of the bytes is kept, because publisher copyright may apply to the abstract (https://pubmed.ncbi.nlm.nih.gov/disclaimer/). Short factual quotations under 25 words, with the citation.

    11. Supports Apixaban versus warfarin in patients with atrial fibrillation

      Publication · Journal record via PubMed (N Engl J Med 2011;365(11):981-92) · 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. · Published 2011-09-15 · DOI: 10.1056/NEJMoa1107039 · PMID: 21870978

      Locator
      Abstract, RESULTS, sentence 4, fragment 1
      How it applies
      Hemorrhagic stroke with apixaban.
      Retrieved
      Source effective date
      Not reported
      Source state
      Current
      Snapshot hash
      070808b131231dc9141645fc51ed733ed3f8db0ad34099cce02d8c66b19843ba
      Reuse basis
      PubMed record fetched through NCBI E-utilities (label cf-pubmed-21870978.xml). Only the hash of the bytes is kept, because publisher copyright may apply to the abstract (https://pubmed.ncbi.nlm.nih.gov/disclaimer/). Short factual quotations under 25 words, with the citation.

    12. Supports Apixaban versus warfarin in patients with atrial fibrillation

      Publication · Journal record via PubMed (N Engl J Med 2011;365(11):981-92) · 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. · Published 2011-09-15 · DOI: 10.1056/NEJMoa1107039 · PMID: 21870978

      Locator
      Abstract, RESULTS, sentence 4, fragment 2
      How it applies
      Hemorrhagic stroke with warfarin.
      Retrieved
      Source effective date
      Not reported
      Source state
      Current
      Snapshot hash
      070808b131231dc9141645fc51ed733ed3f8db0ad34099cce02d8c66b19843ba
      Reuse basis
      PubMed record fetched through NCBI E-utilities (label cf-pubmed-21870978.xml). Only the hash of the bytes is kept, because publisher copyright may apply to the abstract (https://pubmed.ncbi.nlm.nih.gov/disclaimer/). Short factual quotations under 25 words, with the citation.

    13. Supports Apixaban versus warfarin in patients with atrial fibrillation

      Publication · Journal record via PubMed (N Engl J Med 2011;365(11):981-92) · 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. · Published 2011-09-15 · DOI: 10.1056/NEJMoa1107039 · PMID: 21870978

      Locator
      Abstract, RESULTS, sentence 4, fragment 3
      How it applies
      Ischemic or uncertain-type stroke rates.
      Retrieved
      Source effective date
      Not reported
      Source state
      Current
      Snapshot hash
      070808b131231dc9141645fc51ed733ed3f8db0ad34099cce02d8c66b19843ba
      Reuse basis
      PubMed record fetched through NCBI E-utilities (label cf-pubmed-21870978.xml). Only the hash of the bytes is kept, because publisher copyright may apply to the abstract (https://pubmed.ncbi.nlm.nih.gov/disclaimer/). Short factual quotations under 25 words, with the citation.

    14. Supports Apixaban versus warfarin in patients with atrial fibrillation

      Publication · Journal record via PubMed (N Engl J Med 2011;365(11):981-92) · 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. · Published 2011-09-15 · DOI: 10.1056/NEJMoa1107039 · PMID: 21870978

      Locator
      Abstract, RESULTS, sentence 4, fragment 4
      How it applies
      Ischemic or uncertain-type stroke hazard ratio.
      Retrieved
      Source effective date
      Not reported
      Source state
      Current
      Snapshot hash
      070808b131231dc9141645fc51ed733ed3f8db0ad34099cce02d8c66b19843ba
      Reuse basis
      PubMed record fetched through NCBI E-utilities (label cf-pubmed-21870978.xml). Only the hash of the bytes is kept, because publisher copyright may apply to the abstract (https://pubmed.ncbi.nlm.nih.gov/disclaimer/). Short factual quotations under 25 words, with the citation.

    15. Background Apixaban versus warfarin in patients with atrial fibrillation

      Publication · Journal record via PubMed (N Engl J Med 2011;365(11):981-92) · 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. · Published 2011-09-15 · DOI: 10.1056/NEJMoa1107039 · PMID: 21870978

      Locator
      Abstract, CONCLUSIONS, sentence 1
      How it applies
      The authors' conclusion.
      Retrieved
      Source effective date
      Not reported
      Source state
      Current
      Snapshot hash
      070808b131231dc9141645fc51ed733ed3f8db0ad34099cce02d8c66b19843ba
      Reuse basis
      PubMed record fetched through NCBI E-utilities (label cf-pubmed-21870978.xml). Only the hash of the bytes is kept, because publisher copyright may apply to the abstract (https://pubmed.ncbi.nlm.nih.gov/disclaimer/). Short factual quotations under 25 words, with the citation.

    16. Background Apixaban versus warfarin in patients with atrial fibrillation

      Publication · Journal record via PubMed (N Engl J Med 2011;365(11):981-92) · 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. · Published 2011-09-15 · DOI: 10.1056/NEJMoa1107039 · PMID: 21870978

      Locator
      Abstract, CONCLUSIONS, sentence 2
      How it applies
      Funding and registry number.
      Retrieved
      Source effective date
      Not reported
      Source state
      Current
      Snapshot hash
      070808b131231dc9141645fc51ed733ed3f8db0ad34099cce02d8c66b19843ba
      Reuse basis
      PubMed record fetched through NCBI E-utilities (label cf-pubmed-21870978.xml). Only the hash of the bytes is kept, because publisher copyright may apply to the abstract (https://pubmed.ncbi.nlm.nih.gov/disclaimer/). Short factual quotations under 25 words, with the citation.

    17. Background Apixaban versus warfarin in patients with atrial fibrillation

      Publication · Journal record via PubMed (N Engl J Med 2011;365(11):981-92) · 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. · Published 2011-09-15 · DOI: 10.1056/NEJMoa1107039 · PMID: 21870978

      Locator
      Abstract, BACKGROUND, sentence 2, fragment 1
      How it applies
      Apixaban is a factor Xa inhibitor.
      Retrieved
      Source effective date
      Not reported
      Source state
      Current
      Snapshot hash
      070808b131231dc9141645fc51ed733ed3f8db0ad34099cce02d8c66b19843ba
      Reuse basis
      PubMed record fetched through NCBI E-utilities (label cf-pubmed-21870978.xml). Only the hash of the bytes is kept, because publisher copyright may apply to the abstract (https://pubmed.ncbi.nlm.nih.gov/disclaimer/). Short factual quotations under 25 words, with the citation.

    18. Background Apixaban for the Prevention of Stroke in Subjects With Atrial Fibrillation (ARISTOTLE)

      Registry · U.S. National Library of Medicine (ClinicalTrials.gov) · Edition ClinicalTrials.gov API v2 record fetched 2026-10-14. Last update posted 2018-07-03. · NCT: NCT00412984

      Locator
      protocolSection.armsInterventionsModule.interventions[1].description
      How it applies
      Registry dose description, which differs from the abstract.
      Retrieved
      Source effective date
      2018-07-03
      Source state
      Current
      Snapshot hash
      e9c077ce4717632f4d86664bb4c91b18b90ec4aa54e6b1934507084c1727f0ab
      Reuse basis
      Registry record. The raw API JSON is committed at research/snapshots/cf-ctgov-NCT00412984.json. The ClinicalTrials.gov terms page is rendered by JavaScript and its text was not read, so the redistribution basis is unverified. Public text is quote, following Ben's decision of 2026-10-13 (medical-atlas-core issue 2) that registries allow short quotations with attribution. Any quotation stays short.

    19. Background Apixaban for the Prevention of Stroke in Subjects With Atrial Fibrillation (ARISTOTLE)

      Registry · U.S. National Library of Medicine (ClinicalTrials.gov) · Edition ClinicalTrials.gov API v2 record fetched 2026-10-14. Last update posted 2018-07-03. · NCT: NCT00412984

      Locator
      protocolSection.designModule.enrollmentInfo.count
      How it applies
      Registry enrollment count, which differs from the abstract.
      Retrieved
      Source effective date
      2018-07-03
      Source state
      Current
      Snapshot hash
      e9c077ce4717632f4d86664bb4c91b18b90ec4aa54e6b1934507084c1727f0ab
      Reuse basis
      Registry record. The raw API JSON is committed at research/snapshots/cf-ctgov-NCT00412984.json. The ClinicalTrials.gov terms page is rendered by JavaScript and its text was not read, so the redistribution basis is unverified. Public text is quote, following Ben's decision of 2026-10-13 (medical-atlas-core issue 2) that registries allow short quotations with attribution. Any quotation stays short.

Clinical links

Each link reports what one cited claim says about one population. "Evaluated for" means studied, not shown to work. These links do not show that anything is effective or right for you.

Record details

Record id
cardio:apixaban
Content hash
f100595f5855e0643dfd37e9ff91bd79bd96d9fcd6aea570500b8f59ac3a0d56