Shinya Goto,1 Jun Zhu,2 Liu Lisheng,2 Byung-Hee Oh,3 Daniel M. Wojdyla,4 Michael Hanna,5 John D. Horowitz,6 Lars Wallentin,7 Denis Xavier,8 John H. Alexander4 1Hospital, Beijing, China; 3Chinese Academy of Medical Sciences, Beijing, China; 4Duke Clinical Research Institute, Duke University Medical Center, Durham, NC, USA; 5Bristol-Myers Squibb, Princeton, NJ, USA;6University of Adelaide, Adelaide, Australia; 7Uppsala Clinical Research Center, Uppsala, Sweden; 8St. John’s Medical College and Research Institute, Bangalore, India Sponsored by Bristol-Myers Squibb and Pfizer Efficacy and Safety of Apixaban Compared with Warfarin for Stroke Prevention in Atrial Fibrillation in East Asia with Atrial Fibrillation

1993 patients were recruited from East Asian countries including China (n=843), Japan (n=336), South Korea (n=310), Philippines (n=205), Malaysia (n=126), Hong Kong (n=76), and Singapore (n=40).

Primary Efficacy Endpoint

Primary Safety Endpoint

Conclusion- East Asia vs Non East Asia The ARISTOTLE trial enrolled over 1900 patients from East Asian countries. These patients were of lower body weight and tended to have poorer INR control with warfarin. Despite similar CHADS2 scores, the overall rate of stroke was higher in East Asian than non-East Asian patients. Apixaban had consistent benefits when compared with warfarin on stroke or systemic embolism in East Asian and non-East Asian patients. A tendency toward a greater reduction in bleeding was seen with apixaban compared with warfarin in East Asian compared with non- East Asian patients. Rates of intracranial bleeding on warfarin were higher in East Asian than non-East Asian patients. These data support that apixaban is an attractive alternative to warfarin among East Asian as well as non-East Asian patients with nonvalvular AF.