Atrial FibrillationPhase 3ARISTOTLENCT00412984
Apixaban for the Prevention of Stroke in Subjects With Atrial Fibrillation
A Phase 3 study testing warfarin and apixaban in people with Atrial Fibrillation and Atrial Flutter, run by Bristol-Myers Squibb at 1,111 sites in 41 countries.
Trial summary
The trial seeks to determine if apixaban, an investigational anticoagulant (blood-thinner) is as effective as standard therapy (warfarin) in preventing stroke and systemic embolism in subjects with atrial fibrillation and risk factors for stroke. Read more about this study
- Who is it for?
- Any age
- Conditions the study is for
- Atrial Fibrillation, Atrial Flutter
- What is being tested?
- warfarin and apixaban
- Type of treatment
- Pill or oral medicine
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 20,976 participants
- Where
- 1,111 sitesin 41 countries
- Study dates
- 31 Dec 2006to 25 May 2011
- Phase
- Phase 3
- Are there results?
- Yes, posted in the registrySummary in the doctors' view
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages Any age
- All sexes
- No healthy volunteers
- Child, Adult, Older adult
Who may be able to join
- Males and females ≥ 18 yrs with atrial fibrillation (AF) and one or more of the following risk factors for stroke:
- Age ≥ 75, previous stroke
- transient ischemic attack (TIA) or Systemic Embolism (SE)
- Symptomatic congestive heart failure or left ventricular dysfunction with left ventricular ejection fraction (LVEF) ≤ 40%
- Diabetes mellitus or hypertension requiring pharmacological treatment
Who cannot join
None listed.
Trial locations and contacts
1,111 sites in 41 countries.
1111 sites in 41 countries
United States284 sites
Abington Medical Specialists
Abington, Pennsylvania, 19001
Akron Cardiology Consultants
Akron, Ohio, 44304
Albany Assoc. In Cardiology
Albany, New York, 12205
Albany Associates In Cardiology
Albany, New York, 12205
Abq Health Partners, Llc
Albuquerque, New Mexico, 87012
University Of New Mexico/University Hospital
Albuquerque, New Mexico, 87131-0001
University Of New Mexico/University Hospital
Albuquerque, New Mexico, 87131
Alexandria Cardiology Clinic
Alexandria, Louisiana, 71301
Great Lakes Heart Center Of Alpena
Alpena, Michigan, 49707
Blair Medical Associates, Inc.
Altoona, Pennsylvania, 16602
Amarillo Heart Clinical Research Institute Inc.
Amarillo, Texas, 79106
Mcfarland Clinic Pc
Ames, Iowa, 50010
Advanced Clinical Reserach Institute
Anaheim, California, 92801
Alaska Heart Institute
Anchorage, Alaska, 99508
Community Clinical Research Center
Anderson, Indiana, 46011
Southeastern Research Associates, Inc
Anderson, South Carolina, 29621
Asheville Cardiology Associates
Asheville, North Carolina, 28803
Cardiovascular Specialits, Pc
Atlanta, Georgia, 30342
Medical Specialist Of The Palm Beach
Atlantis, Florida, 33462
Augusta Cardiology Clinic, P.C.
Augusta, Georgia, 30901
Fox Valley Clinical Research Center, Llc
Aurora, Illinois, 60504
Miami International Cardiology Consultants
Aventura, Florida, 33180
Midatlantic Cardiovascular Associates, P.A.
Baltimore, Maryland, 21204
Midatlantic Cardiovascular Associates, Pa
Baltimore, Maryland, 21208
Midatlantic Cardiovascular Associates, P.A.
Baltimore, Maryland, 21218
Johns Hopkins Bayview Medical Center
Baltimore, Maryland, 21224-2735
Johns Hopkins Bayview Medical Center
Baltimore, Maryland, 21224
Franklin Square Hospital
Baltimore, Maryland, 21237
Midatlantic Cardiovascular Associates, P.A.
Baltimore, Maryland, 21237
Midatlantic Cardiovascular Associates, Pa
Baltimore, Maryland, 21237
Lowcountry Medical Group, Llc
Beaufort, South Carolina, 29906
Lowcountry Medical Group
Beaufort, South Carolina, 29906
Midatlantic Cardiovascular Associates, Pa
Bel Air, Maryland, 21014
St. Charles Health System, Inc.
Bend, Oregon, 97701
St. Charles Health System, Inc
Bend, Oregon, 97701
Comprehensive Clinical Research
Berlin, New Jersey, 08009
Act/Cardiovascular Research Institute
Beverly Hills, California, 90210
Burlington Medical Associates
Billerica, Massachusetts, 01821
Cardiology Associates, Pc
Binghamton, New York, 13905
Cardiovascular Associates, Pc
Birmingham, Alabama, 35209
Alabama Internal Medicine Pc
Birmingham, Alabama, 35235
Birmingham Heart Clinic P.C.
Birmingham, Alabama, 35235
Premier Healthcare, Llc
Bloomington, Indiana, 47403
David Charles Mishkel, Md, Pa
Boca Raton, Florida, 33431
Caritas St. Elizabeth'S Medical Center
Boston, Massachusetts, 02135
Connecticut Clinical Research, Llc
Bridgeport, Connecticut, 06606
Bridgeport Hospital
Bridgeport, Connecticut, 06610
Holston Medical Group
Bristol, Tennessee, 37620
Christopher M. Johnson, D.O.
Bucyrus, Ohio, 44820
Christopher M. Johnson, D.O.
Bucyrus, Ohio, OHIO
Buffalo Heart Group, Llp
Buffalo, New York, 14215-1145
Bruce L. Platt Md, Pc
Buffalo, New York, 14215
Bruce L. Platt, Md
Buffalo, New York, 14215
Buffalo Heart Group, Llp
Buffalo, New York, 14215
Daniel W. Gottlieb, Md, Ps
Burien, Washington, 98166
Daniel William Gottlieb, Md
Burien, Washington, 98166
Lahey Clinic Medical Center
Burlington, Massachusetts, 01805
Kernodle Clinic, Inc.
Burlington, North Carolina, 27215
Heritage Cardiology Assoc.
Camp Hill, Pennsylvania, 17011
Community Health Care, Inc.
Canal Fulton, Ohio, 44614
Cardiology Associates
Canton, Ohio, 44710
Capitol Interventional Cardiology
Carmichael, California, 95608
Medical University Of South Carolina
Charleston, South Carolina, 29425
Nmff
Chicago, Illinois, 60611
The Carl & Edyth Lindner Center For R&E At The Christ Hosp
Cincinnati, Ohio, 45219
The Heart & Vascular Institute Of Florida
Clearwater, Florida, 33756
The Heart And Vascular Institute Of Florida
Clearwater, Florida, 33756
Electrophysiology Associates, Pc
Colorado Springs, Colorado, 80910
Cardiovascular Specialists Of Central Maryland, P.A.
Columbia, Maryland, 21044
University Of Missouri
Columbia, Missouri, 65212
Columbia Heart Clinic
Columbia, South Carolina, 29203
Columbus Cardiology Associates Pc
Columbus, Georgia, 31909
Columbus Cardiology Associates,Pc
Columbus, Georgia, 31909
Corsicana Medical Research, Pllc
Corsicana, Texas, 75110
Georgia Heart Specialists, L.L.C.
Covington, Georgia, 30014
Soltero Cardiovascular Research Center
Dallas, Texas, 75226
Heartplace
Dallas, Texas, 75230
Cardiovascular Specialist Of South Florida
Davie, Florida, 33324
Daytona Heart Group
Daytona Beach, Florida, 32114
Atlanta Institute For Medical Research, Inc
Decatur, Georgia, 30030
Aurora Denver Cardiology Associates, P.C.
Denver, Colorado, 80218
Denver Va Medical Center
Denver, Colorado, 80220
Henry Ford Hospital
Detroit, Michigan, 48202
Central Bucks Cardiology
Doylestown, Pennsylvania, 18901
Heart Care Center, P.C.
East Syracuse, New York, 13057
Central Cardiology Assoc.
Elizabethtown, Kentucky, 42701
Elkhart Clinic, Llc
Elkhart, Indiana, 46514
Cardiovascular Associates Of The Delware Valley, P.A.
Elmer, New Jersey, 08318
Internal Medicine And Lipid Mgmt.
Erie, Pennsylvania, 16509
Escondido Cardiology Associates, Inc.
Escondido, California, 92025
Oregon Medical Group - Clinical Research
Eugene, Oregon, 97401
Neccr Internal Medicine & Cardiology Associates,Llc
Fall River, Massachusetts, 02720
Lillestol Research Llc
Fargo, North Dakota, 58103
Cardiology Associates Of Fort Lauderdale, P.A.
Fort Lauderdale, Florida, 33308
Broward General Medical Center
Fort Lauderdale, Florida, 33316
Florida Heart Associates
Fort Myers, Florida, 33907
Lutheran Medical Group, Llc
Fort Wayne, Indiana, 46804
Fort Wayne Cardiology
Fort Wayne, Indiana, 46805
Heart Center Of North Texas
Fort Worth, Texas, 76104
Florida Research Network, Llc
Gainesville, Florida, 32605
Northeast Georgia Heart Center, Pc
Gainesville, Georgia, 30501
New West Physicians Clinical Research
Golden, Colorado, 80401
Internal Medical Associates of Grand Island, P.C
Grand Island, Nebraska, 68803-4311
Internal Medical Associates Of Grand Island, P.C
Grand Island, Nebraska, 68803
Cardiology Associates Of Green Bay Ltd-Bellin Hospital
Green Bay, Wisconsin, 54301
Upstate Cardiology
Greenville, South Carolina, 29607
Internal Medicine Of Greer
Greer, South Carolina, 29650
Cardiology Associates Of New Haven,Pc
Guilford, Connecticut, 06437
Clinical Investigation Specialists, Inc
Gurnee, Illinois, 60031
Cardiovascular Associates Of The Delaware Valley, P.A.
Haddon Heights, New Jersey, 08035
Kandra, Fierer, Kuskin Associates
Harrisburg, Pennsylvania, 17112
Nebraska Heart Institute
Hastings, Nebraska, 68901
Pivotal Clinical Research, Llc
Hatfield, Pennsylvania, 19440
Pentucket Medical Associates
Haverhill, Massachusetts, 01830-6278
Pentucket Medical Associates
Haverhill, Massachusetts, 01830
William D. Bowden, D.O.
Healdsburg, California, 95448
Carolina Cardiology Associates, Pa
High Point, North Carolina, 27262
Hillsboro Cardiology Pc
Hillsboro, Oregon, 97123
Healthworx
Hollywood, Florida, 33021
Luis Tami, Md
Hollywood, Florida, 33021
Dr. Rajesh Shroff
Hot Springs, Arkansas, 71913
Cardiovascular Institute Of The South
Houma, Louisiana, 70360
Center For Atrial Fibrillation
Houston, Texas, 77030
The Methodist Hospital Neurology Institute
Houston, Texas, 77030
The Methodist Hospital
Houston, Texas, 77030
The University Of Texas Md Anderson Cancer Center
Houston, Texas, 77030
Northwest Houston Cardiology, Pa
Houston, Texas, 77065
Northwest Houston Cardiology, Pa
Houston, Texas, 77070
Francisco R. Maislos
Houston, Texas, 77074
Woodlands North Houston Heart Center
Houston, Texas, 77090
Regional Medical Center And Diagnostic Clinics
Humble, Texas, 77338
Huntington Hospital
Huntington, New York, 11743
Heart Center, Inc.
Huntsville, Alabama, 35801
St Francis Medical Group - Indiana Heart Physicians
Indianapolis, Indiana, 46237
The Care Group, Llc.
Indianapolis, Indiana, 46290
The Care Group, Llc
Indianapolis, Indiana, 46290
Nature Coast Clinical Research
Inverness, Florida, 34452
St. Vincent'S Ambulatory Care, Inc
Jacksonville, Florida, 32204
Jacksonville Heart Center, Pa
Jacksonville, Florida, 32207
Jacksonville Cardiovascular Center
Jacksonville, Florida, 32216
Jacksonville Center For Clinical Research
Jacksonville, Florida, 32216
St. Luke'S Cardiology
Jacksonville, Florida, 32216
Jacksonville Heart Center, Pa
Jacksonville, Florida, 32258
Jacksonville Heart Center, P.A.
Jacksonville Beach, Florida, 32250
Lycoming Internal Medicine Inc.
Jersey Shore, Pennsylvania, 17740
Cvms Research Institute, Llc
Jupiter, Florida, 33458
Ricardo Bedoya, M.D.
Jupiter, Florida, 33458
Truman Medical Center
Kansas City, Missouri, 64108
Saint Luke'S Lipid And Diabetes Research Center
Kansas City, Missouri, 64111
Holston Medical Group
Kingsport, Tennessee, 37660
Knoxville Heart Group
Knoxville, Tennessee, 37916
Volunteer Research Group
Knoxville, Tennessee, 37920-1502
Volunteer Research Group
Knoxville, Tennessee, 37920
La Mesa Cardiac Center, A Medical Group
La Mesa, California, 91942
Wilford Hall Medical Center
Lackland Air Force Base, Texas, 78236-9908
Wilford Hall Medical Center
Lackland Air Force Base, Texas, 78236
Smith, Patel & Amkieh, Llc
Lacombe, Louisiana, 70445
Imperial Calcasieu Medical Group, Llp
Lake Charles, Louisiana, 70601
Thoracic And Cardiovascular Healthcare Foundation
Lansing, Michigan, 48910
Va Southern Nevada Healthcare System
Las Vegas, Nevada, 89106
Utah Cardiology P.C
Layton, Utah, 84041
Lynn N. Smith, Md
Lewisburg, West Virginia, 24901
Central Maine Heart & Vascular Institute
Lewiston, Maine, 04240
New Lexington Clinic, P.S.C.
Lexington, Kentucky, 40504
Mary K. Richards, Md Pa
Little Rock, Arkansas, 72204
South Denver Cardiology Associates Pc
Littleton, Colorado, 80120
Sjh Cardiology Associates
Liverpool, New York, 13088
Advanced Cardiovascular Health Specialists, Pc
Livonia, Michigan, 48154
Dcol Center For Clinical Research
Longview, Texas, 75605
Va Greater Los Angeles Healthcare System
Los Angeles, California, 90073
Va Medical Center
Louisville, Kentucky, 40202
Norton Cardiovascular Associates
Louisville, Kentucky, 40205
St. Mary'S Hospital
Madison, Wisconsin, 53715
St.Mary'S Hospital
Madison, Wisconsin, 53715
Wellstar Cardiovascular Medicine, Pc
Marietta, Georgia, 30060
Cardiology Center, Llc
Marrero, Louisiana, 70072
Loyola University Medical Center
Maywood, Illinois, 60153
North Dallas Research Associates
McKinney, Texas, 75069
Rogue Valley Physicians - Clinical Research Group
Medford, Oregon, 97504
Melbourne Internal Medicine Associates
Melbourne, Florida, 32901
Miami International Cardiology Consultants
Miami, Florida, 33137-3732
Miami International Cardiology Consultants
Miami, Florida, 33137
Dali, Sammi
Michigan City, Indiana, 46360
Aurora Health Care
Milwaukee, Wisconsin, 53215
Medical College Of Wisconsin
Milwaukee, Wisconsin, 53226
Long Island Heart Associates
Mineola, New York, 11501
Minneapolis Va Medical Center
Minneapolis, Minnesota, 55417
University Of Minnesota
Minneapolis, Minnesota, 55455
Coastal Cardiology
Mission Viejo, California, 92691
Mobile Heart Specialists, Pc
Mobile, Alabama, 36608
Clara V. Massey, Md
Mobile, Alabama, 36617
Jack C. Va Medical Center
Muskogee, Oklahoma, 74401
Physicians Regional Medical Group
Naples, Florida, 34119
Charles River Medical Associates
Natick, Massachusetts, 01760
Alfieri Cardiology
Newark, Delaware, 19713
Sentara York Clinical Research
Norfolk, Virginia, 23510
Illinois Heart & Lung Research Center, Sc
Normal, Illinois, 61761
Cpt. James A Lovell Federal Health Care Center
North Chicago, Illinois, 60064
The William W. Backus Hospital
Norwich, Connecticut, 06360
William W Backus Hospital
Norwich, Connecticut, 06360
Kenneth W. Carr Md
Oceanside, California, 92056
Cor Clinical Research, Llc
Oklahoma City, Oklahoma, 73103
University Of Oklahoma Health Sciences Center
Oklahoma City, Oklahoma, 73104
Plaza Medical Group, Pc
Oklahoma City, Oklahoma, 73112
Oklahoma Heart Hospital Physicians
Oklahoma City, Oklahoma, 73120
South Oklahoma Heart Research
Oklahoma City, Oklahoma, 73135
Eminence Research, Llc
Oklahoma City, Oklahoma, 73139
Olive Branch Family Medical Center
Olive Branch, Mississippi, 38654
Palmetto Nephrology Pa
Orangeburg, South Carolina, 29118
Florida Heart Group
Orlando, Florida, 32803
Midwest Cardiology Associates , P.C.
Overland Park, Kansas, 66209
Alpha Medical Research
Oviedo, Florida, 32765
Owensboro Heart & Vascular
Owensboro, Kentucky, 42303
Desert Med Grp Inc, Dba Desert Oasis Healthcare Med Group
Palm Springs, California, 92262
Cardiology Consultants
Pensacola, Florida, 32501
Michigan Heart And Vascular Specialists
Petoskey, Michigan, 49770
Internal Medicine Physicians Associates, P.C.
Phoenix, Arizona, 85006
Avera Medical Associates Clinic
Pierre, South Dakota, 57501
Pinehurst Medical Center, Inc
Pinehurst, North Carolina, 28374
Legacy Heart Center
Plano, Texas, 75024
North Texas Medical Research
Plano, Texas, 75093
Princeton Medical Institute
Princeton, New Jersey, 08540
Rhode Island Hospital
Providence, Rhode Island, 02903
Desert Cardiology Consultants Medical Group, Inc
Rancho Mirage, California, 92270
Clinical Associates Research
Reisterstown, Maryland, 21136
Medical Research Initiatives
Richmond, Virginia, 23220
Roanoke Heart Institute, Plc
Roanoke, Virginia, 24014
North Memorial Health Care
Robbinsdale, Minnesota, 55422
William Beaumont Hospital
Royal Oak, Michigan, 48073
Regional Cardiolody Associates
Sacramento, California, 95819
Northern California Research
Sacramento, California, 95821
Sacramento Heart And Vascular Medical Associates
Sacramento, California, 95825
Bhs Specialty Network, Inc
San Antonio, Texas, 78217
Covenant Clinical Research, Pa
San Antonio, Texas, 78229
Star Clinical Trails
San Antonio, Texas, 78229
Arrhythmia Consultants Of The Central Coast Medical Group
Santa Barbara, California, 93105
Northern California Medical Associates
Santa Rosa, California, 95403
Niranjan Seshadri, Md
Sarasota, Florida, 34232
Heart & Vascular Center Research, Inc.
Sarasota, Florida, 34239
Saratoga Cardiology Associates, Pc
Saratoga Springs, New York, 12866
Guthrie Clinic Ltd.
Sayre, Pennsylvania, 18840
Guthrie Medical Group, P.C.
Sayre, Pennsylvania, 18840
Edward Balli, Md, Pa
Seguin, Texas, 78155
Cardio Assoc Of Del Val, P.A.
Sewell, New Jersey, 08080
Cardiology Associates
Shreveport, Louisiana, 71105
Louisiana Heart Center
Slidell, Louisiana, 70458
Medical Research Inst, Inc
Slidell, Louisiana, 70458
Medical Research Institute, Inc
Slidell, Louisiana, 70458
Cardiology Associates, Inc.
South Bend, Indiana, 46601
Central New Jersey Cardiology
South Plainfield, New Jersey, 07080
S. Carolina Pharmaceutical Research
Spartanburg, South Carolina, 29303
Rockwood Clinic Research Cent.
Spokane, Washington, 99202
The Heart And Vascular Institute Of Florida
St. Petersburg, Florida, 33709
Stamford Therapeutics Consortium
Stamford, Connecticut, 06905
Toledo Cardiology Consultants
Toledo, Ohio, 43608
Northwest Heart Center
Tomball, Texas, 77375
Southwest Heart
Tucson, Arizona, 85710
Southern Arizona Va Health Care System
Tucson, Arizona, 85723
Pima Research Foundation
Tucson, Arizona, 85745
Tennessee Center For Clinical Trials
Tullahoma, Tennessee, 37388
Castlerock Clinical Research Consultants, Llc
Tulsa, Oklahoma, 74136
Tupelo Neurology Clinic, Pa
Tupelo, Mississippi, 38801
Tyler Cardiovascular Consultants
Tyler, Texas, 75701
The Univ. Of Texas Health Science Ctr. At Tyler
Tyler, Texas, 75708
University Of Texas Health Science Center At Tyler
Tyler, Texas, 75708
Preferred Primary Care Physicians
Uniontown, Pennsylvania, 15401
Ventura Cardio. Cond. Med. Group, Inc.
Ventura, Louisiana, 93003
Research, Inc.
Vero Beach, Florida, 32960
Cardiovascular Associates
Virginia Beach, Virginia, 23454
Progressive Clinical Research
Vista, California, 92083
Family Practice Center Of Wadsworth, Inc.
Wadsworth, Ohio, 44281
Walla Walla Clinic
Walla Walla, Washington, 99362
Cardivasclular Consultants Medical Group
Walnut Creek, California, 94598
George Washington University Medical Faculty Associates
Washington D.C., District of Columbia, 20037
Washington Va Medical Center
Washington D.C., District of Columbia, 20422
Chase Medical Research, Llc
Waterbury, Connecticut, 06708
Cardiology Assc. Of Waukesha
Waukesha, Wisconsin, 53188
West Chester Cardiology, Pc
West Chester, Pennsylvania, 19380
Midatlantic Cardiovascular Associates, Pa
Westminster, Maryland, 21157
Shiva Heart Center Medical Group
Wildomar, California, 92595
Office Of Dr. Kozinn
Williamsville, New York, 14221
Suburban Cardiology
Williamsville, New York, 14221
Cardiology Consultants Of Philadelphia
Yardley, Pennsylvania, 19067
Michigan Heart, P.C.
Ypsilanti, Michigan, 48197
Brazil74 sites
Local Institution
Belém, Pará, 66087-660
Local Institution
Belém, Pará, 66087
Local Institution
Belo Horzonte, Minas Gerais, 30150-221
Local Institution
Belo Horzonte, Minas Gerais, 30150
Local Institution
Blumenau, Santa Catarina, 89010-500
Local Institution
Blumenau, Santa Catarina, 89010
Local Institution
Botucatu, São Paulo, 18618-000
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Botucatu, São Paulo, 18618
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Campina Grande do Sul, Paraná, 83430-000
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Campina Grande do Sul, Paraná, 83430
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Campinas, São Paulo, 13059-740
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Campinas, São Paulo, 13059
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Curitiba, Paraná, 80010-030
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Curitiba, Paraná, 80010
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Curitiba, Paraná, 80730-150
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Curitiba, Paraná, 80730
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Juiz de Fora, Minas Gerais, 36021-630
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Juiz de Fora, Minas Gerais, 36021
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Londrina, Paraná, 86010-450
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Londrina, Paraná, 86010
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Marília, São Paulo, 17515-000
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Marília, São Paulo, 17515-460
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Marília, São Paulo, 17515
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Marília, São Paulo, 17519-000
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Marília, São Paulo, 17519
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Natal, Rio Grande do Norte, 59020-100
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Natal, Rio Grande do Norte, 59020
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Porte Alegre, Rio Grande do Sul, 90610-000
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Porte Alegre, Rio Grande do Sul, 90610
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Porte Alegre, Rio Grande do Sul, 90880-480
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Porte Alegre, Rio Grande do Sul, 90880480
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Porto Alegre, Rio Grande do Sul, 90020-090
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Porto Alegre, Rio Grande do Sul, 90020
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Porto Alegre, Rio Grande do Sul, 90035-903
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Porto Alegre, Rio Grande do Sul, 90035
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Porto Alegre, Rio Grande do Sul, 90620-001
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Porto Alegre, Rio Grande do Sul, 90620
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Porto Alegre, Rio Grande do Sul, 91350-280
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Porto Alegre, Rio Grande do Sul, 91350
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Rio de Janeiro, 20551-030
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Rio de Janeiro, 20551
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Rio de Janeiro, 22251-030
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Rio de Janeiro, 22251
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Salvador, Estado de Bahia, 40144-900
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Salvador, Estado de Bahia, 40144
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Salvador, Estado de Bahia, 41810-010
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Salvador, Estado de Bahia, 41810
Local Institution
San Jose Do Rio Preto, São Paulo, 15090-000
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San Jose Do Rio Preto, São Paulo, 15090
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Santo André, São Paulo, 09190-610
Local Institution
Santo André, São Paulo, 09190
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São José, Santa Catarina, 88103-450
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São José, Santa Catarina, 88103
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São José do Rio Preto, São Paulo, 15015-210
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São José do Rio Preto, São Paulo, 15015-750
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São José do Rio Preto, São Paulo, 15015
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São Paulo, 01221-900
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São Paulo, 01221
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São Paulo, 01322-001
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São Paulo, 01322
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São Paulo, 01323-001
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São Paulo, 01323-010
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São Paulo, 01323
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São Paulo, 04012-180
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São Paulo, 04012
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São Paulo, 04024-002
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São Paulo, 04024
Local Institution
São Paulo, 04038-031
Local Institution
São Paulo, 04038
Local Institution
São Paulo, 08270-070
Local Institution
São Paulo, 08270
Local Institution
Uberaba, Minas Gerais, 38056 055
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Uberlândia, Minas Gerais, 38400-299
Local Institution
Uberlândia, Minas Gerais, 38400
Russia62 sites
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Chelyabinsk, 454136
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Chita, 672090
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Dzerzhinskiy, 140091
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Kazan', 420012
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Kemerovo, 650002
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Kirovsk, 187342
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Krasnodar, 350042
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Moscow, 105229
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Moscow, 109240
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Moscow, 111020
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Moscow, 111539
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Moscow, 115093
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Moscow, 115487
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Moscow, 117556
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Moscow, 117593
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Moscow, 119048
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Moscow, 119121
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Moscow, 119992
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Moscow, 121356
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Moscow, 121552
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Moscow, 123182
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Moscow, 125206
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Moscow, 125284
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Moscow, 125367
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Moscow, 125424
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Moscow, 127018
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Moscow, 129090
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Nizhny Novgorod, 603003
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Nizhny Novgorod, 603005
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Novosibirsk, 630008
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Novosibirsk, 630054
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Odintsovo, 143000
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Penza, 440026
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Perm, 614097
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Rostov-on-Don, 344022
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Ryazan, 390026
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Saint Petersburg, 190103
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Saint Petersburg, 191025
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Saint Petersburg, 192288
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Saint Petersburg, 193144
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Saint Petersburg, 193163
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Saint Petersburg, 193312
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Saint Petersburg, 194354
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Saint Petersburg, 195271
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Saint Petersburg, 196601
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Saint Petersburg, 197110
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Saint Petersburg, 197341
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Saint Petersburg, 198013
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Saint Petersburg, 199106
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Samara, 443070
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Saratov, 410002
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Tomsk, 634012
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Tver', 170036
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Tyumen, 625023
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Voronezh, 394065
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Voronezh, 394066
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Yaroslavl, 150002
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Yaroslavl, 150003
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Yaroslavl, 150030
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Zheleznodorozhniy, 143920
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Zhukovsky, 140160
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Zhukovsky, 140180
Canada59 sites
Local Institution
Bathurst, New Brunswick, E2A 4X7
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Brampton, Ontario, L6Z 4N5
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Burlington, Ontario, L7M 4Y1
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Burnaby, British Columbia, V5G 1T4
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Calgary, Alberta, T2E 7C5
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Cambridge, Ontario, N1R 6V6
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Cambridge, Ontario, N1R 7R1
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Charlottetown, Prince Edward Island, C1A 5Y9
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Drummondville, Quebec, J2B 7T1
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Edmonton, Alberta, T56-3NJ
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Edmonton, Alberta, T5X 3N5
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Edmonton, Alberta, T6G 2B7
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Edmonton, Alberta, TSA 4L8
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Greater Sudbury, Ontario, P3C 5K7
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Greater Sudbury, Ontario, P3C5K7
Local Institution
Greater Sudbury, Ontario, P3E 2N8
Local Institution
Greater Sudbury, Ontario, P3E 3B8
Local Institution
Greenfield Park, Quebec, J4V 2G8
Local Institution
Hamilton, Ontario, L8L 2X2
Local Institution
Lachine, Quebec, H8S 2E4
Local Institution
Lévis, Quebec, G6V 4Z5
Local Institution
London, Ontario, N6G 2V2
Local Institution
Longueuil, Quebec, J4K 1C8
Local Institution
Longueuil, Quebec, J4N 0C9
Local Institution
Longueuil, Quebec, J4N 1C2
Local Institution
Mississauga, Ontario, L5B 4A2
Local Institution
Montreal, Quebec, H1T 1C8
Local Institution
Montreal, Quebec, H2W 1T8
Local Institution
Montreal, Quebec, H3A 1A1
Local Institution
Montreal, Quebec, H3T 1E2
Local Institution
Montreal, Quebec, W3R-153
Local Institution
Mount Pearl, Newfoundland and Labrador, A1N 1W7
Local Institution
Nanaimo, British Columbia, V9R 3G9
Local Institution
New Westminster, British Columbia, V3L 3W4
Local Institution
Newmarket, Ontario, L3Y 5G8
Local Institution
Newmarket, Ontario, L3Y 8C3
Local Institution
Niagara Falls, Ontario, L2E 7H1
Local Institution
Niagara Falls, Ontario, L2E7H1
Local Institution
North Bay, Ontario, P1B 2H3
Local Institution
North Vancouver, British Columbia, V7N 4M2
Local Institution
Oshawa, Ontario, L1J 2J9
Local Institution
Oshawa, Ontario, L1J 2K1
Local Institution
Ottawa, Ontario, K1Y 4E9
Local Institution
Ottawa, Ontario, K1Y 4W7
Local Institution
Pointe-Claire, Quebec, H9R 3J1
Local Institution
Québec, Quebec, G1J 1Z6
Local Institution
Saint-Lambert, Quebec, J4P 2H4
Local Institution
Sarnia, Ontario, N7T 4X3
Local Institution
Saskatoon, Saskatchewan, S7L OY7
Local Institution
Scarborough Village, Ontario, M1B 5N1
Local Institution
St. John's, Newfoundland and Labrador, A1A 3R5
Local Institution
St. John's, Newfoundland and Labrador, A1B 3V6
Local Institution
St. John's, Newfoundland and Labrador, A1E 2C2
Local Institution
Ste-Foy, Quebec, G1W 4R4
Local Institution
Toronto, Ontario, M5B 1W8
Local Institution
Toronto, Ontario, M9W 4L6
Local Institution
Victoria, British Columbia, V8R 4R2
Local Institution
Weston, Ontario, M9N 1W4
Local Institution
Winnipeg, Manitoba, R2V 4W3
Argentina49 sites
Local Institution
Adrogué, Buenos Aires, 1846
Local Institution
Bahía Blanca, Buenos Aires, B8000FTD
Local Institution
Buenos Aires, 1119
Local Institution
Buenos Aires, 1181
Local Institution
Buenos Aires, 1280
Local Institution
Buenos Aires, C1280AEB
Local Institution
Buenos Aires, C1426ANZ
Local Institution
Cipolletti, Río Negro Province, 8324
Local Institution
Ciudad Autonoma, Buenos Aires, 1128AAD
Local Institution
Ciudad Autonoma, Buenos Aires, 1128
Local Institution
Ciudad Autonoma, Buenos Aires, 1426 EGR
Local Institution
Ciudad Autonoma, Buenos Aires, C1426 EGR
Local Institution
Ciudad Autonoma, Buenos Aires, CP1425A WC
Local Institution
Ciudad Autonoma, Buenos Aires, CP1425AWC
Local Institution
Ciudad Autonoma de, Buenos Aires, 1180
Local Institution
Ciudad Autonoma de Buenos Aire, Buenos Aires, CI094AAD
Local Institution
Córdoba, Córdoba Province, 5000
Local Institution
Córdoba, 5000
Local Institution
Córdoba, X5000EPU
Local Institution
Córdoba, X5003DCE
Local Institution
Córdoba, X5008KKF
Local Institution
Coronel Suárez, Buenos Aires, B7540GHD
Local Institution
Haedo, Buenos Aires, B1706AJU
Local Institution
Junín, Buenos Aires, 6000
Local Institution
La Plata, Buenos Aires, 1900
Local Institution
La Plata, Buenos Aires, 1902
Local Institution
La Plata, Buenos Aires, B1900AXI
Local Institution
Mar del Plata, Buenos Aires, 7600
Local Institution
Merlo, Buenos Aires, 1722
Local Institution
Merlo, Buenos Aires, B1722COV
Local Institution
Olivos, Buenos Aires, 1602
Local Institution
Quilmes, Buenos Aires, 1878
Local Institution
Ramos Mejía, Buenos Aires, 1706
Local Institution
Ramos Mejía, Buenos Aires, B1704ESN
Local Institution
Ramos Mejía, Buenos Aires, B1704ETD
Local Institution
Rosario, Santa Fe Province, 2000
Local Institution
Rosario, Santa Fe Province, S2000 CVD
Local Institution
Rosario, Santa Fe Province, S2000CVB
Local Institution
Rosario, Santa Fe Province, S2000CVD
Local Institution
Rosario, Santa Fe Province, S2001ODA
Local Institution
Salta, 4400
Local Institution
San Justo, Buenos Aires, 1754
Local Institution
San Martín, Buenos Aires, 1650
Local Institution
San Miguel de Tucumán, T4000NIL
Local Institution
San Miquel de Tucuman, Tucumán Province, 4000
Local Institution
San Nicolás de los Arroyos, Buenos Aires, 2900
Local Institution
Santa Fe, 3000
Local Institution
Zárate, Buenos Aires, 2800
Local Institution
Zárate, Buenos Aires, B2800DGH
Japan47 sites
Local Institution
Asahikawa-Shi, Hokkaido, 0788214
Local Institution
Fukui, 9100067
Local Institution
Isehara, Kanagawa, 2591193
Local Institution
Itoshima, Fukuoka, 819-1104
Local Institution
Iwakuni, Yamaguchi, 7400021
Local Institution
Izumi, Kagoshima-ken, 8990131
Local Institution
Izumi, Osaka, 594-0071
Local Institution
Kagoshima, 8920822
Local Institution
Kasukabe-shi, Saitama, 3440035
Local Institution
Kasukabe-Shi, Saitama, 344-0035
Local Institution
Katou-gun, Hokkaido, 080111
Local Institution
Katou-Gun, Hokkaido, 0800111
Local Institution
Kobe, Hyōgo, 6540026
Local Institution
Kurume, Fukuoka, 8390863
Local Institution
Kyoto, 6168152
Local Institution
Meguro-ku, Tokyo, 1538515
Local Institution
Meguro-Ku, Tokyo, 153-8515
Local Institution
Nagasaki, 852-8102
Local Institution
Nara, Nara, 630-8305
Local Institution
Ohkawa-City, Fukuoka, 8310016
Local Institution
Ōita, 8700033
Local Institution
Osaka, Osaka, 5330022
Local Institution
Osaka, Osaka, 540-0006
Local Institution
Osaka, Osaka, 5400006
Local Institution
Osaka, 551-0032
Local Institution
Osaka, 5510032
Local Institution
Osaka, 558-8558
Local Institution
Saga, Saga-ken, 840-8571
Local Institution
Saga, Saga-ken, 849-8501
Local Institution
Saga, 8490917
Local Institution
Sapporo, Hokkaido, 0028043
Local Institution
Sendai, Miyagi, 983-8520
Local Institution
Shinagawa-Ku, Tokyo, 1428666
Local Institution
Shirakawa, Fukushima, 961-0005
Local Institution
Suita, Osaka, 5658565
Local Institution
tabashi City, Tokyo, 173-0015
Local Institution
tabashi City, Tokyo, 1730015
Local Institution
Takasaki, Gunma, 3700829
Local Institution
Takatsuki, Osaka, 5690852
Local Institution
Tomakomai-shi, Hokkaido, 0028043
Local Institution
Tomakomai-Shi, Hokkaido, 002-8043
Local Institution
Toyama, Toyama, 9308550
Local Institution
Yao, Osaka, 5810036
Local Institution
Yokohama, Kanagawa, 2278501
Local Institution
Yokohama, Kanagawa, 2458575
Local Institution
Yokosuka, Kanagawa, 2388567
Local Institution
Yūbari, Hokkaido, 0680402
Germany43 sites
Local Institution
Aachen, 52074
Local Institution
Bad Krozingen, 79189
Local Institution
Bad Neustadt/ Salle, 97616
Local Institution
Bad Oeynhausen, 32545
Local Institution
Berlin, 10787
Local Institution
Berlin, 10789
Local Institution
Berlin, 12043
Local Institution
Berlin, 13353
Local Institution
Berlin, 14050
Local Institution
Betzdorf, 57518
Local Institution
Bochum, 44789
Local Institution
Bochum, 44791
Local Institution
Bonn, 53127
Local Institution
Coburg, 96450
Local Institution
Dillingen, 66763
Local Institution
Dresden, 01099
Local Institution
Duisburg, 47139
Local Institution
Essen, 45122
Local Institution
Frankfurt am Main, 60594
Local Institution
Göttingen, 37075
Local Institution
Halle, 06120
Local Institution
Hanover, 30625
Local Institution
Heidelberg, 69115
Local Institution
Heidelberg, 69120
Local Institution
Kassel, 34121
Local Institution
Köpenick, 12559
Local Institution
Lahr, 77933
Local Institution
Ludwigshafen, 67063
Local Institution
Ludwigshafen, 67073
Local Institution
Mannheim, 68167
Local Institution
Marburg, 35043
Local Institution
München, 80636
Local Institution
München, 81545
Local Institution
München, 81675
Local Institution
Osnabrück, 49076
Local Institution
Regensburg, 93053
Local Institution
Riesa, D-01587
Local Institution
Rostiock, 18057
Local Institution
Trier, 54292
Local Institution
Waren, 17192
Local Institution
Witten, 58455
Local Institution
Wolmirstedt, 39326
Local Institution
Worms, 67550
United Kingdom43 sites
Local Institution
Aberdeen, Aberdeenshire, AB25 2ZN
Local Institution
Antrim, BT41 2RL
Local Institution
Barnet, Hertfordshire, EN5 3DJ
Local Institution
Barnsley, South Yorkshire, S75 2EP
Local Institution
Belfast, Antrim, BT14 6AB
Local Institution
Birmingham, WEST Midlands, B18 7QH
Local Institution
Blackpool, FY3 8NR
Local Institution
Bournemouth, Dorset, BH7 7DW
Local Institution
Bury St Edmunds, Suffolk, IP30 9QU
Local Institution
Bury St Edmunds, Suffolk, IP31 2HD
Local Institution
Bury St Edmunds, Suffolk, IP33 2QZ
Local Institution
Cambridge, Cambridgeshire, CB2 2QQ
Local Institution
Cardiff, MID Glamorgan, CF14 4XW
Local Institution
Chesterfield, Derbyshire, S40 4TF
Local Institution
Chesterfield, Derbyshire, S44 5BL
Local Institution
Chichester, EAST Sussex, PO19 6SE
Local Institution
Colchester, Essex, C03 4LN
Local Institution
Craigavon, Armagh, BT63 5QQ
Local Institution
Denmark Hill, Greater London, SE5 9RS
Local Institution
Doncaster, South Yorkshire, DN2 5LT
Local Institution
Glasgow, Aberdeenshire, G11 6NT
Local Institution
Glasgow, Dumbartonshire, G11 6NT
Local Institution
Glasgow, Strathclyde, G51 4TF
Local Institution
Glasgow, G21 3UW
Local Institution
Harrow, Middlesex, HA1 3UJ
Local Institution
Ipswich, Suffolk, IP14 2PU
Local Institution
Ipswich, Suffolk, IP7 5DN
Local Institution
Livingston, WEST Lothian, EH54 6PP
Local Institution
Llandough, MID Glamorgan, CF64 2XX
Local Institution
London, Greater London, SW17 0RE
Local Institution
Newcastle upon Tyne, TYNE and WEAR, NE1 4LP
Local Institution
Newport, Gwent, NP20 2UB
Local Institution
Nottingham, Nottinghamshire, NG5 1PB
Local Institution
Paisley, Renfrewshire, PA2 9PN
Local Institution
Peterborough, Cambridgeshire, PE2 5GP
Local Institution
Romford, Essex, RH7 0AG
Local Institution
Stirling, Stirlingshire, FK8 2AU
Local Institution
Swansea, WEST Glamorgan, SA6 6NL
Local Institution
Westbury, Wiltshire, BA 13 3JD
Local Institution
Westbury, Wiltshire, BA13 3JD
Local Institution
Worksop, Nottinghamshire, S81 OBD
Local Institution
York, Yorkshire, YO31 8HE
Local Institution
York, Yorkshire, YO31 HE
India39 sites
Local Institution
Ahmedabad, Gujarat, 380060
Local Institution
Ahmedabad, 380014
Local Institution
Annāmalainagar, 608002
Local Institution
Bangalore, Karnataka, 5600034
Local Institution
Bangalore, Karnataka, 560054
Local Institution
Bangalore, Karnataka, 560094
Local Institution
Bangalore, 560052
Local Institution
Bikaner, Rajasthan, 334001
Local Institution
Bikaner, Rajasthan, 334003
Local Institution
Calicut, Kerala, 673 004
Local Institution
Chennai, 600006
Local Institution
Hyderabad, Andhra Pradesh, 500004
Local Institution
Hyderabad, 500001
Local Institution
Hyderabad, 500044
Local Institution
Indore, 452001
Local Institution
Indore, 452014
Local Institution
Jalandhar, Punjab, 144008
Local Institution
Kolkata, 700054
Local Institution
Kottayam, 686016
Local Institution
Lucknow, Uttar Pradesh, 226003
Local Institution
Lucknow, 226003
Local Institution
Mumbai Naka, 422005
Local Institution
Mysore, Karnataka, 570004
Local Institution
Nagpur, Maharashtra, 440010
Local Institution
Nagpur, Maharashtra, 440012
Local Institution
Nashik, 422002
Local Institution
New Delhi, 110025
Local Institution
New Delhi, 110060
Local Institution
New Delhi, 116025
Local Institution
Pune, Maharashta, 411011
Local Institution
Pune, Maharashtra, 411001
Local Institution
Pune, Maharashtra, 421006
Local Institution
Pune, 411001
Local Institution
Pune, 411004
Local Institution
Thrissur, 680002
Local Institution
Vadodara, Gujarat, 390007
Local Institution
Vijayawada, 520008
Local Institution
Visakhapatnam, Andhra Pradesh, 530003
Local Institution
Visakhapatnam, Andhrapradesh, 530002
China37 sites
Local Institution
Beijing, Beijing Municipality, 100001
Local Institution
Beijing, Beijing Municipality, 100020
Local Institution
Beijing, Beijing Municipality, 100050
Local Institution
Beijing, Beijing Municipality, 100088
Local Institution
Beijing, Beijing Municipality, 100101
Local Institution
Beijing, Beijing Municipality, 100853
Local Institution
Changsha, Hunan, 410000
Local Institution
Chengdu, Sichuan, 610041
Local Institution
Chongqing, Sichuan, 400010
Local Institution
Dalian, Liaoning, 116011
Local Institution
Dalian, Liaoning, 116021
Local Institution
Dalian, Liaoning, 116027
Local Institution
Daqing, Heilongjiang, 163001
Local Institution
Guangzhou, Guangdong, 510080
Local Institution
Guangzhou, Guangdong, 510120
Local Institution
Haerbin, Heilongjiang, 150001
Local Institution
Haerbin, Heilongjiang, 150086
Local Institution
Hangzhou, Jiangsu, 310009
Local Institution
Hangzhou, Zhejiang, 310009
Local Institution
Jinan, Shandong, 250012
Local Institution
Jinan, Shandong, 250033
Local Institution
Lanzhou, Gansu, 730000
Local Institution
Lanzhou, Gansu, 730030
Local Institution
Nanjing, Jiangsu, 210029
Local Institution
Qingdao, Shandong, 266011
Local Institution
Shanghai, Shanghai Municipality, 100037
Local Institution
Shanghai, Shanghai Municipality, 200003
Local Institution
Shanghai, Shanghai Municipality, 200011
Local Institution
Shanghai, Shanghai Municipality, 200025
Local Institution
Shanghai, Shanghai Municipality, 200031
Local Institution
Shanghai, Shanghai Municipality, 200080
Local Institution
Shanghai, Shanghai Municipality, 200233
Local Institution
Shanghai, Shanghai Municipality, 200433
Local Institution
Shenyang, Liaoning, 110003
Local Institution
Shenyang, Liaoning, 110016
Local Institution
Shijiazhuang, Hebei, 050000
Local Institution
Wuhan, Hubei, 430060
Ukraine36 sites
Local Institution
Chernivtsy, 58013
Local Institution
Dnipropetrovsk, 49006
Local Institution
Dnipropetrovsk, 49060
Local Institution
Donetsk, 83003
Local Institution
Donetsk, 83045
Local Institution
Donetsk, 83114
Local Institution
Ivano-Frankivsk, 76025
Local Institution
Kharkiv, 61002
Local Institution
Kharkiv, 61018
Local Institution
Kharkiv, 61039
Local Institution
Kharkiv, 61115
Local Institution
Kharkiv, 61178
Local Institution
Kiev, 01032
Local Institution
Kyiv, 01023
Local Institution
Kyiv, 01103
Local Institution
Kyiv, 02091
Local Institution
Kyiv, 02660
Local Institution
Kyiv, 03049
Local Institution
Kyiv, 03115
Local Institution
Kyiv, 03680
Local Institution
Kyiv, 04050
Local Institution
Kyiv, 04107
Local Institution
Luhansk, 91011
Local Institution
Luhansk, 91016
Local Institution
Lutsk, 43024
Local Institution
Lviv, 79013
Local Institution
Lviv, 79015
Local Institution
Mykolayiv, 54003
Local Institution
Odesa, 65009
Local Institution
Odesa, 65025
Local Institution
Odesa, 65039
Local Institution
Odesa, 65114
Local Institution
Uzhhorod, 88000
Local Institution
Vinnitsa, 21029
Local Institution
Zaporizhzhya, 69035
Local Institution
Zhytomyr, 10002
Poland27 sites
Local Institution
Gdynia, 81-423
Local Institution
Gdynia, 81-472
Local Institution
Gdynia, 81-519
Local Institution
Grodzisk Mazowiecki, 05-825
Local Institution
Inowrocław, 88-100
Local Institution
Kielce, 25-736
Local Institution
Kielce, 25-763
Local Institution
Krakow, 30-092
Local Institution
Krakow, 31-135
Local Institution
Krakow, 31-202
Local Institution
Lodz, 91-347
Local Institution
Lodz, 91347
Local Institution
Piotrkow Trybunalski, 97-300
Local Institution
Płock, 09-400
Local Institution
Płock, 09-402
Local Institution
Płońsk, 09-100
Local Institution
Poznan, 60-531
Local Institution
Poznan, 60479
Local Institution
Ruda Śląska, 41-703
Local Institution
Skierniewice, 96-100
Local Institution
Słupsk, 76-200
Local Institution
Torun, 87100
Local Institution
Warsaw, 01-138
Local Institution
Warsaw, 04-073
Local Institution
Warsaw, 04-628
Local Institution
Warsaw, 04-749
Local Institution
Węgrów, 07100
Australia21 sites
Local Institution
Adelaide, South Australia, SA 5000
Local Institution
Ashford, South Australia, 5035
Local Institution
Auchenflower, Queensland, 4066
Local Institution
Bedford Park, South Australia, 5042
Local Institution
Box Hill, Victoria, 3128
Local Institution
Brisbane, Queensland, 4032
Local Institution
Caboolture, Queensland, 4510
Local Institution
Coffs Harbour, New South Wales, 2450
Local Institution
Concord, New South Wales, 2139
Local Institution
Dandenong, Victoria, 3175
Local Institution
Fremantle, Western Australia, 6160
Local Institution
Geelong, Victoria, 3220
Local Institution
Gosford, New South Wales, 2250
Local Institution
Herston, Queensland, 4029
Local Institution
Joondalup, Western Australia, 6027
Local Institution
Kippa-Ring, Queensland, 4021
Local Institution
Kogarah, New South Wales, 2217
Local Institution
Miranda, New South Wales, 2228
Local Institution
Nambour, Queensland, 4560
Local Institution
Sherwood, Queensland, 4075
Local Institution
Woodville, South Australia, 5011
Belgium19 sites
Local Institution
Aalst, 9300
Local Institution
Antwerp, 2020
Local Institution
Antwerp, 2060
Local Institution
Arlon, 6700
Local Institution
Bruges, 8000
Local Institution
Brussels, 1090
Local Institution
Dillingen, 66763
Local Institution
Genk, 3600
Local Institution
Ghent, 9000
Local Institution
Gilly, 6060
Local Institution
Hasselt, 3500
Local Institution
Huy, 4500
Local Institution
Kortrijk, 8500
Local Institution
Menen, 8930
Local Institution
Mol, 2400
Local Institution
Montegnée, 4420
Local Institution
Verviers, 4800
Local Institution
Woluwe-Saint-Lambert, 1200
Local Institution
Yvoir, 5530
Hungary19 sites
Local Institution
Budapest, 1023
Local Institution
Budapest, 1032
Local Institution
Budapest, 1085
Local Institution
Budapest, 1096
Local Institution
Budapest, 1125
Local Institution
Debrecen, 4032
Local Institution
Dunaújváros, 2400
Local Institution
Győr, 9023
Local Institution
Gyula, 5700
Local Institution
Hódmezővásárhely, 6800
Local Institution
Komárom, 2921
Local Institution
Mosonmagyaróvár, 9200
Local Institution
Orosháza, 5900
Local Institution
Pécs, 7624
Local Institution
Siófok, 8600
Local Institution
Siófok, 8601
Local Institution
Sopron, 9400
Local Institution
Szentes, 6600
Local Institution
Zalaegerszeg, 8900
Mexico18 sites
Local Institution
Col. Toriello Guerra, Mexico City, CP 14050
Local Institution
Culiacán, Sinaloa, 80020
Local Institution
Guadalajara, Jalisco, 44200
Local Institution
Guadalajara, Jalisco, 44600
Local Institution
Guadalajara, Jalisco, 44656
Local Institution
Jalapa, Veracruz, 91020
Local Institution
Mexico City, Mexico City, 06070
Local Institution
Mexico City, Mexico City, 06726
Local Institution
Mexico City, Mexico City, 07760
Local Institution
Mexico City, Mexico City, 10700
Local Institution
Mexico City, Mexico City, 14080
Local Institution
Monterrey, Nuevo León, 64000
Local Institution
Monterrey, Nuevo León, 64700
Local Institution
Monterrey, Nuevo León, 64710
Local Institution
Morelia, Michoacán, 58000
Local Institution
Puebla City, 11490
Local Institution
Querétaro, 76000
Local Institution
Tijuana, Estado de Baja California, 22500
Spain18 sites
Local Institution
Albacete, 02006
Local Institution
Barcelona, 08003
Local Institution
Barcelona, 08035
Local Institution
Elda, 03600
Local Institution
Figueres, 17600
Local Institution
Girona, 17007
Local Institution
La Cañada, Almeria, 04120
Local Institution
Las Palmas, 35010
Local Institution
Lugo, Galicia, 27003
Local Institution
Madrid, 28006
Local Institution
Madrid, 28040
Local Institution
Madrid, 28046
Local Institution
Palma de Mallorca, 07010
Local Institution
San Juan, Alicante, 03550
Local Institution
San Sebastián de los Reyes, 28703
Local Institution
Tarragona, 43007
Local Institution
Torrevieja, Alicante, 03186
Local Institution
Viladecans, 08840
Denmark17 sites
Local Institution
Arhus C, 8000
Local Institution
Copenhagen, 2100
Local Institution
Esbjerg, 6700
Local Institution
Frederiksberg, 2000
Local Institution
Frederikssund, 3600
Local Institution
Gentofte Municipality, 2900
Local Institution
Haderslev, 6100
Local Institution
Hellerup, 2900
Local Institution
Herlev, 2730
Local Institution
Herning, 7400
Local Institution
Hillerød, 3400
Local Institution
Hvidovre, 2650
Local Institution
Kolding, 6000
Local Institution
Odense, 5000
Local Institution
Silkeborg, 8600
Local Institution
Slagelse, 4200
Local Institution
Svendborg, 5700
Italy17 sites
Local Institution
Ascoli Piceno, 63100
Local Institution
Campobasso, 86100
Local Institution
Chieti, 66013
Local Institution
Cremona, 26100
Local Institution
Fidenza (Pr), 43036
Local Institution
Genova, 16132
Local Institution
Isernia, 86170
Local Institution
Lido di Camaiore, Lucca, 55043
Local Institution
Livorno, 57100
Local Institution
Milan, 20132
Local Institution
Naples, 80131
Local Institution
Palermo, 90127
Local Institution
Reggio Emilia, 42100
Local Institution
Roma, 00168
Local Institution
San Daniele de Friuli, 33038
Local Institution
Torino, 10153
Local Institution
Vittorio Veneto (Tv), 31029
Israel15 sites
Local Institution
Afula, 18101
Local Institution
Ashkelon, 78306
Local Institution
Giv‘atayim, 53583
Local Institution
Hadera, 38100
Local Institution
Haifa, 31096
Local Institution
Haifa, 34362
Local Institution
Holon, 58100
Local Institution
Jerusalem, 91120
Local Institution
Jerusalem, 91240
Local Institution
Kfar Saba, 44281
Local Institution
Nazareth, 16000
Local Institution
Nazareth, 16100
Local Institution
Petah Tikva, 49100
Local Institution
Safed, 13100
Local Institution
Tel Aviv, 64239
Romania15 sites
Local Institution
Baia Mare, 430031
Local Institution
Bucharest, 011192
Local Institution
Bucharest, 020125
Local Institution
Bucharest, 021659
Local Institution
Bucharest, 030572
Local Institution
Bucharest, 050098
Local Institution
Cluj-Napoca, 400001
Local Institution
Cluj-Napoca, 400347
Local Institution
Iași, 700503
Local Institution
Oradea, 410169
Local Institution
Sibiu, 550245
Local Institution
Târgu Mureş, 540103
Local Institution
Târgu Mureş, 540136
Local Institution
Timișoara, 300024
Local Institution
Timișoara, 300320
South Korea15 sites
Local Institution
Anyang-si, Gyeonggi-do, 431-070
Local Institution
Busan, 602-702
Local Institution
Daegu, 700-712
Local Institution
Daegu, 705-717
Local Institution
Daejeon, 302-718
Local Institution
Goyang, 411-706
Local Institution
Gwangju, 501-757
Local Institution
Gyeonggi-do, 463-707
Local Institution
Incheon, Korea, 400-711
Local Institution
Pusan, 602-739
Local Institution
Scongnam-Si, 463-712
Local Institution
Seoul, 110-744
Local Institution
Seoul, 130-709
Local Institution
Seoul, 143-729
Local Institution
Suwon, 443-721
Netherlands14 sites
Local Institution
's-Hertogenbosch, 5211 NL
Local Institution
Breda, 4818 CK
Local Institution
Deventer, 7416 SE
Local Institution
Eindhoven, 5623 EJ
Local Institution
Eindhoven, 5623EJ
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Enschede, 7513 ER
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Hardenberg, 7772 SE
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Hilversum, 1213 XZ
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Nijmegen, 6525 GA
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Oss, 5342 BT
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Rotterdam, 3045 PM
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Tiel, 4002 WP
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Utrecht, 3582 KE
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Velp, 6883 AZ
Sweden14 sites
Local Institution
Goteberg, 413 45
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Helsingborg, 251 87
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Linköping, 581 85
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Lund, 222 21
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Örebro, 701 85
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Örebro, 70185
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Skellefteå, 931 86
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Stockholm, 111 35
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Stockholm, 111 57
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Stockholm, 118 83
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Stockholm, 141 86
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Stockholm, 171 76
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Uppsala, 751 85
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Vaxjo, 351 85
Czechia12 sites
Local Institution
Boskovice, 680 21
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Brno, 625 00
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Brno-Malomerice, 614 00
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Ivančice, 664 91
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Kladno, 272 59
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Litomyšl, 570 14
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Městec Králové, 289 03
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Ostrava, 70852
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Prague, 128 08
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Prague, 158 00
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Příbram, 261 01
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Ústí nad Orlicí, 562 18
Norway12 sites
Local Institution
Ålesund, 6003
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Bergen, 5021
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Bergen, N-5021
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Elverum, 2408
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Flekkefjord, 4400
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Nesttun, 5221
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Oslo, 0407
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Skien, 3710
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Stavanger, 4064
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Straume, 5353
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Tønsberg, 3116
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Tromsø, 9038
Peru11 sites
Local Institution
Bellavista, Provincia Constitucional del Callao, 2176
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Bellavista, Provincia Constitucional del Callao, CALLAO 2
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Chiclayo, Lambayeque, CIX
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Jesus Maria, Lima region, 11
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Jesus Maria, Lima region, LIMA 11
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Lima, LIMA 01
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Lima, LIMA 1
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Lima, LIMA 33
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Miraflores, Lima region, LIMA 18
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San Borja, Lima region, LIMA 41
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San Martín de Porres, Lima region, LIMA 31
South Africa10 sites
Local Institution
Bellville Cape Town, Western Cape, 7530
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George, Western Cape, 6529
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Observatory, CAPE TOWN, 7925
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Parow, Western Cape, 7505
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Pretoria, Gauteng, 0084
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Pretoria, Gauteng, 0132
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Richards Bay, KwaZulu-Natal, 3900
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Somerset West, Western Cape, 7130
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Westdene, Bloemfontein, 9301
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Worcester, Western Cape, 6850
Chile9 sites
Local Institution
Osorno, Los Lagos Region, 5311089
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Osorno, Los Lagos Region, 5311523
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Santiago, Santiago Metropolitan, 7500520
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Santiago, Santiago Metropolitan, 7500922
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Santiago, Santiago Metropolitan, 8330074
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Temuco, Araucania, 4781156
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Temuco, Araucania, 4781176
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Temuco, Valparaiso, 4781173
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Viña del Mar, Valparaiso, 2570017
Finland8 sites
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Helsinki, 00280
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Helsinki, FI-00280
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Hus, 00029
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Jyväskylä, 40100
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Kemi, 94100
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Oulu, 90100
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Pori, 28120
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Tampere, 33100
Philippines8 sites
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Laoag, Ilocos Norte, 2900
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Manila, 1000
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Manila, 1008
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Naga, 4400
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Pasig, 1600
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Quezon, 1100
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Quezon City, 1102
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San Juan City, 1100
Colombia7 sites
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Barranquilla, XXXXX
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Barranquilla
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Bogotá, 000
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Bogotá
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Cali
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Medellín, Antioquia
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Medellín
France7 sites
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Amiens, 80054
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Bordeaux, 33075
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Brest, 29609
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Grenoble, 38043
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La Seyne-sur-Mer, 83500
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Paris, 75018
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Six-Fours-les-Plages, 83140
Taiwan6 sites
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Taipei, 100
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Taipei, 10449
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Taipei, 104
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Taipei, 111
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Taipei, 112
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Taipei, 220
Malaysia5 sites
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Batu Caves, Selangor, 68100
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Kota Samarahan, Sarawak, 94300
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Kuala Lumpur, 56000
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Kuala Lumpur, 59100
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Kubang Kerian, Kelantan, 16150
Austria3 sites
Local Institution
Graz, 8036
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Oberpullendorf, 7350
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Vienna, 1160
Puerto Rico3 sites
Local Institution
Cayey, 00736
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Cidra, 00739
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Ponce, 00717
Turkey (Türkiye)3 sites
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Ankara, 06100
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Eskişehir, 26480
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Izmir, 35100
Switzerland2 sites
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Baden, 5404
Local Institution
Bern, 3010
About this study
Official title: A Phase 3, Active (Warfarin) Controlled, Randomized, Double-Blind, Parallel Arm Study to Evaluate Efficacy and Safety of Apixaban in Preventing Stroke and Systemic Embolism in Subjects With Nonvalvular Atrial Fibrillation
The trial seeks to determine if apixaban, an investigational anticoagulant (blood-thinner) is as effective as standard therapy (warfarin) in preventing stroke and systemic embolism in subjects with atrial fibrillation and risk factors for stroke.
- Conditions
- Atrial Fibrillation, Atrial Flutter
- Medical subject headings
- Atrial Fibrillation, Atrial Flutter
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
warfarinDrug
Also called Coumadin, BMS-565793
Oral tablets, 2.0 mg, adjusted to an INR of 2.5 (range 2.0 to 3.0)
apixabanDrug
Also called BMS-562247
Oral tablets, 5.0 mg or 2.5 mg, twice daily
| Study group | Role | What they receive |
|---|---|---|
| 1 | Active comparator | Not described Receives: Drug: warfarin |
| 2 | Experimental | Not described Receives: Drug: apixaban |
What is being measured
The primary outcome is the main question the study is designed to answer.
Number of Participants With First Event of Ischemic/Unspecified Stroke, Hemorrhagic Stroke, or Systemic Embolism (SE) During the Intended Treatment Period
All suspected efficacy events were adjudicated by the Central Events Committee (CEC). Diagnosis of stroke=the nontraumatic focal neurological deficit lasting at least 24 hours, and includes ischemic stroke, hemorrhagic stroke, ischemic stroke with hemorrhagic conversion, stroke of uncertain type, and retinal ischemic event (embolism, infarction). Diagnosis of SE=clinical history consistent with an acute loss of blood flow to a peripheral artery (or arteries), supported by evidence of embolism from surgical specimens, autopsy, angiography, vascular imaging, or other objective testing.
Measured: Time to first event in "Intended Treatment Period": started on day of randomization, ended at efficacy cut-off date (date target number of primary efficacy events [448] was expected to have occurred; set to 30-Jan-2011, prior to unblinding).
Rate of Adjudicated Stroke or Systemic Embolism (SE) During the Intended Treatment Period
Rate=Number of adjudicated stroke or SE events per 100 patient years. Diagnosis of stroke=the nontraumatic focal neurological deficit lasting at least 24 hours, and includes ischemic stroke, hemorrhagic stroke, ischemic stroke with hemorrhagic conversion, stroke of uncertain type, and retinal ischemic event (embolism, infarction). Diagnosis of SE=clinical history consistent with an acute loss of blood flow to a peripheral artery (or arteries), supported by evidence of embolism from surgical specimens, autopsy, angiography, vascular imaging, or other objective testing.
Measured: "Intended Treatment Period" started on the day of randomization and ended at the efficacy cut-off date (date on which it was expected that the target number of primary efficacy events [448] would have occurred; set to 30-Jan-2011, prior to unblinding).
Secondary outcomes (12)
Number of Participants With Event of Major (International Society on Thrombosis and Hemostasis [ISTH]) Bleeding During Treatment Period
ISTH Bleeding Criteria: Major bleeding=a bleeding event that was: clinically overt bleeding accompanied by a decrease in hemoglobin (Hgb) of 2 g/dL or more, and/or a transfusion of 2 or more units of packed red blood cells; bleeding that occurred in at least 1 of the following critical sites: intracranial, intraspinal, intraocular (within the corpus of the eye; a conjunctival bleed is not an intraocular bleed), pericardial, intra-articular, intramuscular with compartment syndrome, and retroperitoneal; bleeding that was fatal.
Measured: "Treatment Period" started with first dose of blinded study drug and ended 2 days after the last dose of blinded study drug. Mean duration of exposure to double-blind study drug was 1.7 years in each treatment group.
Rate of Adjudicated Major (ISTH) Bleed Events During Treatment Period
Rate=number of adjudicated major (ISTH) bleed events per 100 patient years. ISTH Bleeding Criteria: Major bleeding=a bleeding event that was: clinically overt bleeding accompanied by a decrease in hemoglobin (Hgb) of 2 g/dL or more and/or a transfusion of 2 or more units of packed red blood cells; bleeding that occurred in at least 1 of the following sites: intracranial, intraspinal, intraocular (within the corpus of the eye; a conjunctival bleed is not an intraocular bleed), pericardial, intra-articular, intramuscular with compartment syndrome, and retroperitoneal; bleeding that was fatal.
Measured: "Treatment Period" started with first dose of blinded study drug and ended 2 days after the last dose of blinded study drug. Mean duration of exposure to double-blind study drug was 1.7 years in each treatment group.
Number of Participants With Events of All-Cause Death During the Intended Treatment Period
Death was defined as all-cause mortality. All unobserved deaths were assumed to be cardiovascular in nature unless a non-cardiovascular cause could be clearly provided. Cardiovascular=deaths due to ischemic and hemorrhagic stroke, SE, myocardial infarction (MI), sudden death, heart failure, other cardiovascular, and unobserved deaths. Non-cardiovascular=all deaths due to a clearly documented non-cardiovascular cause (further classified into the categories: bleeding, study drug toxicity other than bleeding, malignancy, infection, trauma, and pulmonary causes of death).
Measured: "Intended Treatment Period" started on the day of randomization and ended at the efficacy cut-off date (date on which it was expected that the target number of primary efficacy events [448] would have occurred; set to 30-Jan-2011, prior to unblinding).
Rate of Adjudicated All-Cause Death During the Intended Treatment Period
All unobserved deaths were assumed to be cardiovascular in nature unless a non-cardiovascular cause could be clearly provided. Cardiovascular=deaths due to ischemic and hemorrhagic stroke, SE, MI, sudden death, heart failure, other cardiovascular, and unobserved deaths. Non-cardiovascular=all deaths due to a clearly documented non-cardiovascular cause (further classified into the categories: bleeding, study drug toxicity other than bleeding, malignancy, infection, trauma, and pulmonary causes of death).
Measured: "Intended Treatment Period" started on the day of randomization and ended at the efficacy cut-off date (date on which it was expected that the target number of primary efficacy events [448] would have occurred; set to 30-Jan-2011, prior to unblinding).
Rate of Ischemic or Unspecified Stroke, Hemorrhagic Stroke, Systemic Embolism (SE), and Myocardial Infarction (MI) (as Individual Endpoints) During the Intended Treatment Period
Diagnosis for an acute or evolving MI=elevation of creatine kinase-MB isoenzyme (CK-MB) or Troponin T or I ≥ 2 × the upper limit of normal (ULN), or if no CK-MB or troponin values are available, a total CK ≥ 2×ULN, or new, significant (≥0.04 s) Q waves in ≥2 contiguous leads. For descriptions of Stroke and SE, see Outcome Measure 1.
Measured: "Intended Treatment Period" started on the day of randomization and ended at the efficacy cut-off date (date on which it was expected that the target number of primary efficacy events [448] would have occurred; set to 30-Jan-2011, prior to unblinding).
Rate of Ischemic or Unspecified Stroke, Hemorrhagic Stroke, Systemic Embolism (SE), Myocardial Infarction (MI) and All-Cause Death (ACD) (as Composite Endpoints) During the Intended Treatment Period
Diagnosis for an acute or evolving MI=elevation of CK-MB or Troponin T or I ≥ 2 × the ULN, or if no CK-MB or troponin values are available, a total CK ≥ 2×ULN, or new, significant (≥0.04 s) Q waves in ≥2 contiguous leads. For descriptions of Stroke and SE, see Outcome Measure 1. For description of ACD, see Outcome Measure 5.
Measured: "Intended Treatment Period" started on the day of randomization and ended at the efficacy cut-off date (date on which it was expected that the target number of primary efficacy events [448] would have occurred; set to 30-Jan-2011, prior to unblinding).
Number of Warfarin/Vitamin K Antagonist (VKA) Naive Participants With Composite Stroke / Systemic Embolism (SE) / Major Bleeding During the Intended Treatment Period
For descriptions of Stroke and SE, see Outcome Measure 1. For description of Major bleeding, see Outcome Measure 3.
Measured: "Intended Treatment Period" started on the day of randomization and ended at the efficacy cut-off date (date on which it was expected that the target number of primary efficacy events [448] would have occurred; set to 30-Jan-2011, prior to unblinding).
Rate of Composite Stroke / Systemic Embolism / Major Bleeding in Warfarin/Vitamin K Antagonist (VKA) Naive Participants During the Intended Treatment Period
Measured: "Intended Treatment Period" started on the day of randomization and ended at the efficacy cut-off date (date on which it was expected that the target number of primary efficacy events [448] would have occurred; set to 30-Jan-2011, prior to unblinding).
Number of Participants With Events of Major or Clinically Relevant Nonmajor (CRNM) Bleed During Treatment Period
Major bleeding=bleeding that is clinically overt and that either resulted in a decrease in hemoglobin of 2 g/dL or more over a 24-hour period, led to a transfusion of 2 or more units of packed red blood cells, occurred in a critical site, or led to death. CRNM bleeding=bleeding that is clinically overt, that satisfies none of the additional criteria required for the event to be adjudicated as a major bleeding event, that led to either hospital admission for bleeding, physician-guided medical or surgical treatment for bleeding, or a change in antithrombotic therapy.
Measured: "Treatment Period" started with first dose of blinded study drug and ended 2 days after the last dose of blinded study drug. Mean duration of exposure to double-blind study drug was 1.7 years in each treatment group.
Rate of Events of Major or Clinically Relevant Non-Major (CRNM) Bleed During Treatment Period
Rate=number of major or CRNM bleed events per 100 patient years. Major=clinically overt and either 1) resulted in a decrease in hemoglobin of 2 g/dL or more, or 2) led to a transfusion of 2 or more units of packed red blood cells, or 3) occurred in a critical site, or 4) led to death. CRNM bleeding=clinically overt, but satisfied no additional criteria required to be adjudicated as a major bleeding event, and led to either 1) hospital admission for bleeding or 2) physician guided medical or surgical treatment for bleeding or 3) a change in antithrombotic therapy.
Measured: "Treatment Period" started with first dose of blinded study drug and ended 2 days after the last dose of blinded study drug. Mean duration of exposure to double-blind study drug was 1.7 years in each treatment group.
Number of Participants With All Bleeding Events During Treatment Period
All bleeding events include major bleeding, CRNM bleeding (see Outcome Measure 12 Description for definitions), plus events of minor bleeding and fatal bleeding. Minor bleeding: All acute clinically overt bleeding events not meeting the criteria for either major bleeding or clinically relevant non-major bleeding will be classified as minor bleeding. Fatal bleeding is defined as a bleeding event that the Clinical Events Committee determines is the primary cause of death or contributes directly to death.
Measured: "Treatment Period" started with first dose of blinded study drug and ended 2 days after the last dose of blinded study drug. Mean duration of exposure to double-blind study drug was 1.7 years in each treatment group.
Rate of All Bleeding Events During Treatment Period
Rate=number of all bleeding events per 100 patient years. "All bleeding events" include major bleeding, CRNM bleeding (see Outcome Measure 12 Description for definitions), plus events of minor bleeding and fatal bleeding. Minor bleeding: All acute clinically overt bleeding events not meeting the criteria for either major bleeding or clinically relevant non-major bleeding will be classified as minor bleeding. Fatal bleeding is defined as a bleeding event that the Clinical Events Committee determines is the primary cause of death or contributes directly to death.
Measured: "Treatment Period" started with first dose of blinded study drug and ended 2 days after the last dose of blinded study drug. Mean duration of exposure to double-blind study drug was 1.7 years in each treatment group.
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted19 Dec 2006 (estimated)
- Study start31 Dec 2006
- Primary completion25 May 2011
- Study completion25 May 2011
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Posted resultsParticipant flow, outcome measures and adverse events reported by the sponsor.
- Publications (60)Papers the sponsor has linked to this study.
- Other trials for Atrial FibrillationStudies of the same condition, open and under way.
- More trials run by Bristol-Myers SquibbThe sponsor's other registered studies.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase 3
- Primary purpose
- Prevention
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Double blind
- Who is masked
- Participant, Investigator
- Enrolment
- 20,976 participants (actual)
Sponsor and investigators
- Lead sponsor
- Bristol-Myers Squibb
- Sponsor type
- Industry (pharma, biotech, devices)
- Responsible party
- Sponsor
- Investigators
- Bristol-Myers Squibb, Study director, Bristol-Myers Squibb
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT00412984
- Sponsor's protocol ID
- CV185-030
- Acronym
- ARISTOTLE
- Status last verified
- May 2018
- First submitted
- 18 Dec 2006
- Last updated
- 3 Jul 2018
- Results posted
- Yes, on ClinicalTrials.gov
- Data monitoring committee
- Yes
Publications
Vinereanu D, Wojdyla DM, Alexander JH, Lopes RD, Al-Khatib SM, Gersh BJ, Bahit MC, Hohnloser SH, Flaker GC, Rosenquist M, Hijazi Z, Wallentin L, Granger CB. Heart rate and death and hospitalization for heart failure in patients with persistent or permanent atrial fibrillation: Insights from the ARISTOTLE trial. Am Heart J. 2023 Nov;265:132-136. doi: 10.1016/j.ahj.2023.07.006. Epub 2023 Jul 26.
PubMed 37506747Hijazi Z, Lindback J, Oldgren J, Benz AP, Alexander JH, Connolly SJ, Eikelboom JW, Granger CB, Lopes RD, Siegbahn A, Wallentin L. Individual net clinical outcome with oral anticoagulation in atrial fibrillation using the ABC-AF risk scores. Am Heart J. 2023 Jul;261:55-63. doi: 10.1016/j.ahj.2023.03.012. Epub 2023 Mar 27.
PubMed 36990261Jamieson MJ, Byon W, Dettloff RW, Crawford M, Gargalovic PS, Merali SJ, Onorato J, Quintero AJ, Russ C. Apixaban Use in Obese Patients: A Review of the Pharmacokinetic, Interventional, and Observational Study Data. Am J Cardiovasc Drugs. 2022 Nov;22(6):615-631. doi: 10.1007/s40256-022-00524-x. Epub 2022 May 16.
PubMed 35570249Pol T, Hijazi Z, Lindback J, Oldgren J, Alexander JH, Connolly SJ, Eikelboom JW, Ezekowitz MD, Granger CB, Lopes RD, Yusuf S, Siegbahn A, Wallentin L. Using multimarker screening to identify biomarkers associated with cardiovascular death in patients with atrial fibrillation. Cardiovasc Res. 2022 Jul 20;118(9):2112-2123. doi: 10.1093/cvr/cvab262.
PubMed 34358298Pol T, Hijazi Z, Lindback J, Alexander JH, Bahit MC, De Caterina R, Eikelboom JW, Ezekowitz MD, Gersh BJ, Granger CB, Hylek EM, Lopes R, Siegbahn A, Wallentin L. Evaluation of the prognostic value of GDF-15, ABC-AF-bleeding score and ABC-AF-death score in patients with atrial fibrillation across different geographical areas. Open Heart. 2021 Mar;8(1):e001471. doi: 10.1136/openhrt-2020-001471.
PubMed 33741689Hijazi Z, Wallentin L, Lindback J, Alexander JH, Connolly SJ, Eikelboom JW, Ezekowitz MD, Granger CB, Lopes RD, Pol T, Yusuf S, Oldgren J, Siegbahn A. Screening of Multiple Biomarkers Associated With Ischemic Stroke in Atrial Fibrillation. J Am Heart Assoc. 2020 Dec 15;9(24):e018984. doi: 10.1161/JAHA.120.018984. Epub 2020 Dec 9.
PubMed 33292046Wallentin L, Lindback J, Eriksson N, Hijazi Z, Eikelboom JW, Ezekowitz MD, Granger CB, Lopes RD, Yusuf S, Oldgren J, Siegbahn A. Angiotensin-converting enzyme 2 (ACE2) levels in relation to risk factors for COVID-19 in two large cohorts of patients with atrial fibrillation. Eur Heart J. 2020 Nov 1;41(41):4037-4046. doi: 10.1093/eurheartj/ehaa697.
PubMed 32984892Hijazi Z, Granger CB, Hohnloser SH, Westerbergh J, Lindback J, Alexander JH, Keltai M, Parkhomenko A, Lopez-Sendon JL, Lopes RD, Siegbahn A, Wallentin L. Association of Different Estimates of Renal Function With Cardiovascular Mortality and Bleeding in Atrial Fibrillation. J Am Heart Assoc. 2020 Sep 15;9(18):e017155. doi: 10.1161/JAHA.120.017155. Epub 2020 Aug 31.
PubMed 32865097Zeitouni M, Giczewska A, Alexander JH. Reply: Specifics of Dose Modification in ARISTOTLE. J Am Coll Cardiol. 2020 Jul 7;76(1):128-129. doi: 10.1016/j.jacc.2020.05.013. No abstract available.
PubMed 32616154Rosjo H, Hijazi Z, Omland T, Westerbergh J, Lyngbakken MN, Alexander JH, Gersh BJ, Granger CB, Hylek EM, Lopes RD, Siegbahn A, Wallentin L. Cardiac troponin is associated with cardiac outcomes in men and women with atrial fibrillation, insights from the ARISTOTLE trial. J Intern Med. 2020 Aug;288(2):248-259. doi: 10.1111/joim.13072. Epub 2020 May 18.
PubMed 32350915Zeitouni M, Giczewska A, Lopes RD, Wojdyla DM, Christersson C, Siegbahn A, De Caterina R, Steg PG, Granger CB, Wallentin L, Alexander JH; ARISTOTLE Investigators. Clinical and Pharmacological Effects of Apixaban Dose Adjustment in the ARISTOTLE Trial. J Am Coll Cardiol. 2020 Mar 17;75(10):1145-1155. doi: 10.1016/j.jacc.2019.12.060.
PubMed 32164888Stanifer JW, Pokorney SD, Chertow GM, Hohnloser SH, Wojdyla DM, Garonzik S, Byon W, Hijazi Z, Lopes RD, Alexander JH, Wallentin L, Granger CB. Apixaban Versus Warfarin in Patients With Atrial Fibrillation and Advanced Chronic Kidney Disease. Circulation. 2020 Apr 28;141(17):1384-1392. doi: 10.1161/CIRCULATIONAHA.119.044059. Epub 2020 Mar 12.
PubMed 32160801Garcia DA, Fisher DA, Mulder H, Wruck L, De Caterina R, Halvorsen S, Granger CB, Held C, Wallentin L, Alexander JH, Lopes RD. Gastrointestinal bleeding in patients with atrial fibrillation treated with Apixaban or warfarin: Insights from the Apixaban for Reduction in Stroke and Other Thromboembolic Events in Atrial Fibrillation (ARISTOTLE) trial. Am Heart J. 2020 Mar;221:1-8. doi: 10.1016/j.ahj.2019.10.013. Epub 2019 Oct 31.
PubMed 31896036Dalgaard F, Mulder H, Wojdyla DM, Lopes RD, Held C, Alexander JH, De Caterina R, Washam JB, Hylek EM, Garcia DA, Gersh BJ, Wallentin L, Granger CB, Al-Khatib SM. Patients With Atrial Fibrillation Taking Nonsteroidal Anti-Inflammatory Drugs and Oral Anticoagulants in the ARISTOTLE Trial. Circulation. 2020 Jan 7;141(1):10-20. doi: 10.1161/CIRCULATIONAHA.119.041296. Epub 2019 Nov 21.
PubMed 31747786Goldstein SA, Green J, Huber K, Wojdyla DM, Lopes RD, Alexander JH, Vinereanu D, Wallentin L, Granger CB, Al-Khatib SM. Characteristics and Outcomes of Atrial Fibrillation in Patients With Thyroid Disease (from the ARISTOTLE Trial). Am J Cardiol. 2019 Nov 1;124(9):1406-1412. doi: 10.1016/j.amjcard.2019.07.046. Epub 2019 Aug 7.
PubMed 31474328
Study at a glance
From the registry record, last updated by the sponsor on 3 Jul 2018. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- A Phase 3, Active (Warfarin) Controlled, Randomized, Double-Blind, Parallel Arm Study to Evaluate Efficacy and Safety of Apixaban in Preventing Stroke and Systemic Embolism in Subjects With Nonvalvular Atrial Fibrillation
- ClinicalTrials.gov ID
- NCT00412984
- Acronym / sponsor ID
- ARISTOTLE / CV185-030
- Conditions
- Atrial Fibrillation, Atrial Flutter
- Phase
- Phase 3
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 20,976 participants (actual)
- Lead sponsor
- Bristol-Myers SquibbIndustry (pharma, biotech, devices)
- Study start
- 31 Dec 2006 (actual)
- Primary completion
- 25 May 2011 (actual)
- Study completion
- 25 May 2011 (actual)
- First posted
- 19 Dec 2006 (estimated)
- Results
- Posted 29 Apr 2013
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
The trial seeks to determine if apixaban, an investigational anticoagulant (blood-thinner) is as effective as standard therapy (warfarin) in preventing stroke and systemic embolism in subjects with atrial fibrillation and risk factors for stroke.
Study design
- Primary purpose
- Prevention
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Double blind (participant, investigator)
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| 1 | Active comparator | Drug: warfarin |
| 2 | Experimental | Drug: apixaban |
Who may qualify
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Child, Adult, Older adult
Key inclusion criteria (5 listed)
- Males and females ≥ 18 yrs with atrial fibrillation (AF) and one or more of the following risk factors for stroke:
- Age ≥ 75, previous stroke
- transient ischemic attack (TIA) or Systemic Embolism (SE)
- Symptomatic congestive heart failure or left ventricular dysfunction with left ventricular ejection fraction (LVEF) ≤ 40%
- Diabetes mellitus or hypertension requiring pharmacological treatment
Key exclusion criteria (0 listed)
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| warfarinAlso: Coumadin, BMS-565793Oral tablets, 2.0 mg, adjusted to an INR of 2.5 (range 2.0 to 3.0) | Drug | 1 |
| apixabanAlso: BMS-562247Oral tablets, 5.0 mg or 2.5 mg, twice daily | Drug | 2 |
Primary outcome
Number of Participants With First Event of Ischemic/Unspecified Stroke, Hemorrhagic Stroke, or Systemic Embolism (SE) During the Intended Treatment Period
Time frame: Time to first event in "Intended Treatment Period": started on day of randomization, ended at efficacy cut-off date (date target number of primary efficacy events [448] was expected to have occurred; set to 30-Jan-2011, prior to unblinding).
All suspected efficacy events were adjudicated by the Central Events Committee (CEC). Diagnosis of stroke=the nontraumatic focal neurological deficit lasting at least 24 hours, and includes ischemic stroke, hemorrhagic stroke, ischemic stroke with hemorrhagic conversion, stroke of uncertain type, and retinal ischemic event (embolism, infarction). Diagnosis of SE=clinical history consistent with an acute loss of blood flow to a peripheral artery (or arteries), supported by evidence of embolism from surgical specimens, autopsy, angiography, vascular imaging, or other objective testing.
Rate of Adjudicated Stroke or Systemic Embolism (SE) During the Intended Treatment Period
Time frame: "Intended Treatment Period" started on the day of randomization and ended at the efficacy cut-off date (date on which it was expected that the target number of primary efficacy events [448] would have occurred; set to 30-Jan-2011, prior to unblinding).
Rate=Number of adjudicated stroke or SE events per 100 patient years. Diagnosis of stroke=the nontraumatic focal neurological deficit lasting at least 24 hours, and includes ischemic stroke, hemorrhagic stroke, ischemic stroke with hemorrhagic conversion, stroke of uncertain type, and retinal ischemic event (embolism, infarction). Diagnosis of SE=clinical history consistent with an acute loss of blood flow to a peripheral artery (or arteries), supported by evidence of embolism from surgical specimens, autopsy, angiography, vascular imaging, or other objective testing.
12 secondary outcomes
Number of Participants With Event of Major (International Society on Thrombosis and Hemostasis [ISTH]) Bleeding During Treatment Period
Time frame: "Treatment Period" started with first dose of blinded study drug and ended 2 days after the last dose of blinded study drug. Mean duration of exposure to double-blind study drug was 1.7 years in each treatment group.
Rate of Adjudicated Major (ISTH) Bleed Events During Treatment Period
Time frame: "Treatment Period" started with first dose of blinded study drug and ended 2 days after the last dose of blinded study drug. Mean duration of exposure to double-blind study drug was 1.7 years in each treatment group.
Number of Participants With Events of All-Cause Death During the Intended Treatment Period
Time frame: "Intended Treatment Period" started on the day of randomization and ended at the efficacy cut-off date (date on which it was expected that the target number of primary efficacy events [448] would have occurred; set to 30-Jan-2011, prior to unblinding).
Rate of Adjudicated All-Cause Death During the Intended Treatment Period
Time frame: "Intended Treatment Period" started on the day of randomization and ended at the efficacy cut-off date (date on which it was expected that the target number of primary efficacy events [448] would have occurred; set to 30-Jan-2011, prior to unblinding).
Rate of Ischemic or Unspecified Stroke, Hemorrhagic Stroke, Systemic Embolism (SE), and Myocardial Infarction (MI) (as Individual Endpoints) During the Intended Treatment Period
Time frame: "Intended Treatment Period" started on the day of randomization and ended at the efficacy cut-off date (date on which it was expected that the target number of primary efficacy events [448] would have occurred; set to 30-Jan-2011, prior to unblinding).
Rate of Ischemic or Unspecified Stroke, Hemorrhagic Stroke, Systemic Embolism (SE), Myocardial Infarction (MI) and All-Cause Death (ACD) (as Composite Endpoints) During the Intended Treatment Period
Time frame: "Intended Treatment Period" started on the day of randomization and ended at the efficacy cut-off date (date on which it was expected that the target number of primary efficacy events [448] would have occurred; set to 30-Jan-2011, prior to unblinding).
Number of Warfarin/Vitamin K Antagonist (VKA) Naive Participants With Composite Stroke / Systemic Embolism (SE) / Major Bleeding During the Intended Treatment Period
Time frame: "Intended Treatment Period" started on the day of randomization and ended at the efficacy cut-off date (date on which it was expected that the target number of primary efficacy events [448] would have occurred; set to 30-Jan-2011, prior to unblinding).
Rate of Composite Stroke / Systemic Embolism / Major Bleeding in Warfarin/Vitamin K Antagonist (VKA) Naive Participants During the Intended Treatment Period
Time frame: "Intended Treatment Period" started on the day of randomization and ended at the efficacy cut-off date (date on which it was expected that the target number of primary efficacy events [448] would have occurred; set to 30-Jan-2011, prior to unblinding).
Number of Participants With Events of Major or Clinically Relevant Nonmajor (CRNM) Bleed During Treatment Period
Time frame: "Treatment Period" started with first dose of blinded study drug and ended 2 days after the last dose of blinded study drug. Mean duration of exposure to double-blind study drug was 1.7 years in each treatment group.
Rate of Events of Major or Clinically Relevant Non-Major (CRNM) Bleed During Treatment Period
Time frame: "Treatment Period" started with first dose of blinded study drug and ended 2 days after the last dose of blinded study drug. Mean duration of exposure to double-blind study drug was 1.7 years in each treatment group.
Number of Participants With All Bleeding Events During Treatment Period
Time frame: "Treatment Period" started with first dose of blinded study drug and ended 2 days after the last dose of blinded study drug. Mean duration of exposure to double-blind study drug was 1.7 years in each treatment group.
Rate of All Bleeding Events During Treatment Period
Time frame: "Treatment Period" started with first dose of blinded study drug and ended 2 days after the last dose of blinded study drug. Mean duration of exposure to double-blind study drug was 1.7 years in each treatment group.
Results and safety
Loading the posted results from ClinicalTrials.gov…
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 3 Jul 2018.
- Posted resultsParticipant flow, baseline, all outcome measures and adverse events.
- Derived from this study: PubMed 37506747Vinereanu D, Wojdyla DM, Alexander JH, Lopes RD, Al-Khatib SM, Gersh BJ, Bahit MC, Hohnloser SH, Flaker GC, Rosenquist M, Hijazi Z, Wallentin L, Granger CB. Heart rate and death and hospitalization for heart failure in patients with persistent or permanent atrial fibrillation: Insights from the ARISTOTLE trial. Am Heart J. 2023 Nov;265:132-136. doi: 10.1016/j.ahj.2023.07.006. Epub 2023 Jul 26.
- Derived from this study: PubMed 36990261Hijazi Z, Lindback J, Oldgren J, Benz AP, Alexander JH, Connolly SJ, Eikelboom JW, Granger CB, Lopes RD, Siegbahn A, Wallentin L. Individual net clinical outcome with oral anticoagulation in atrial fibrillation using the ABC-AF risk scores. Am Heart J. 2023 Jul;261:55-63. doi: 10.1016/j.ahj.2023.03.012. Epub 2023 Mar 27.
- Derived from this study: PubMed 35570249Jamieson MJ, Byon W, Dettloff RW, Crawford M, Gargalovic PS, Merali SJ, Onorato J, Quintero AJ, Russ C. Apixaban Use in Obese Patients: A Review of the Pharmacokinetic, Interventional, and Observational Study Data. Am J Cardiovasc Drugs. 2022 Nov;22(6):615-631. doi: 10.1007/s40256-022-00524-x. Epub 2022 May 16.
- Derived from this study: PubMed 34358298Pol T, Hijazi Z, Lindback J, Oldgren J, Alexander JH, Connolly SJ, Eikelboom JW, Ezekowitz MD, Granger CB, Lopes RD, Yusuf S, Siegbahn A, Wallentin L. Using multimarker screening to identify biomarkers associated with cardiovascular death in patients with atrial fibrillation. Cardiovasc Res. 2022 Jul 20;118(9):2112-2123. doi: 10.1093/cvr/cvab262.
- Derived from this study: PubMed 33741689Pol T, Hijazi Z, Lindback J, Alexander JH, Bahit MC, De Caterina R, Eikelboom JW, Ezekowitz MD, Gersh BJ, Granger CB, Hylek EM, Lopes R, Siegbahn A, Wallentin L. Evaluation of the prognostic value of GDF-15, ABC-AF-bleeding score and ABC-AF-death score in patients with atrial fibrillation across different geographical areas. Open Heart. 2021 Mar;8(1):e001471. doi: 10.1136/openhrt-2020-001471.
- Derived from this study: PubMed 33292046Hijazi Z, Wallentin L, Lindback J, Alexander JH, Connolly SJ, Eikelboom JW, Ezekowitz MD, Granger CB, Lopes RD, Pol T, Yusuf S, Oldgren J, Siegbahn A. Screening of Multiple Biomarkers Associated With Ischemic Stroke in Atrial Fibrillation. J Am Heart Assoc. 2020 Dec 15;9(24):e018984. doi: 10.1161/JAHA.120.018984. Epub 2020 Dec 9.
- Derived from this study: PubMed 32984892Wallentin L, Lindback J, Eriksson N, Hijazi Z, Eikelboom JW, Ezekowitz MD, Granger CB, Lopes RD, Yusuf S, Oldgren J, Siegbahn A. Angiotensin-converting enzyme 2 (ACE2) levels in relation to risk factors for COVID-19 in two large cohorts of patients with atrial fibrillation. Eur Heart J. 2020 Nov 1;41(41):4037-4046. doi: 10.1093/eurheartj/ehaa697.
- Derived from this study: PubMed 32865097Hijazi Z, Granger CB, Hohnloser SH, Westerbergh J, Lindback J, Alexander JH, Keltai M, Parkhomenko A, Lopez-Sendon JL, Lopes RD, Siegbahn A, Wallentin L. Association of Different Estimates of Renal Function With Cardiovascular Mortality and Bleeding in Atrial Fibrillation. J Am Heart Assoc. 2020 Sep 15;9(18):e017155. doi: 10.1161/JAHA.120.017155. Epub 2020 Aug 31.
- Derived from this study: PubMed 32616154Zeitouni M, Giczewska A, Alexander JH. Reply: Specifics of Dose Modification in ARISTOTLE. J Am Coll Cardiol. 2020 Jul 7;76(1):128-129. doi: 10.1016/j.jacc.2020.05.013. No abstract available.
- Derived from this study: PubMed 32350915Rosjo H, Hijazi Z, Omland T, Westerbergh J, Lyngbakken MN, Alexander JH, Gersh BJ, Granger CB, Hylek EM, Lopes RD, Siegbahn A, Wallentin L. Cardiac troponin is associated with cardiac outcomes in men and women with atrial fibrillation, insights from the ARISTOTLE trial. J Intern Med. 2020 Aug;288(2):248-259. doi: 10.1111/joim.13072. Epub 2020 May 18.
- Derived from this study: PubMed 32164888Zeitouni M, Giczewska A, Lopes RD, Wojdyla DM, Christersson C, Siegbahn A, De Caterina R, Steg PG, Granger CB, Wallentin L, Alexander JH; ARISTOTLE Investigators. Clinical and Pharmacological Effects of Apixaban Dose Adjustment in the ARISTOTLE Trial. J Am Coll Cardiol. 2020 Mar 17;75(10):1145-1155. doi: 10.1016/j.jacc.2019.12.060.
- Derived from this study: PubMed 32160801Stanifer JW, Pokorney SD, Chertow GM, Hohnloser SH, Wojdyla DM, Garonzik S, Byon W, Hijazi Z, Lopes RD, Alexander JH, Wallentin L, Granger CB. Apixaban Versus Warfarin in Patients With Atrial Fibrillation and Advanced Chronic Kidney Disease. Circulation. 2020 Apr 28;141(17):1384-1392. doi: 10.1161/CIRCULATIONAHA.119.044059. Epub 2020 Mar 12.
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
Bristol-Myers Squibb study director
Bristol-Myers Squibb
1,111 sites in 41 countries: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A Phase 3 study testing warfarin and apixaban in people with Atrial Fibrillation and Atrial Flutter, run by Bristol-Myers Squibb at 1,111 sites in 41 countries.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 5 inclusion and 0 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: finished, as of the sponsor's last update on 3 Jul 2018. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1,111 sites in United States, Brazil, Russia, Canada, Argentina and 36 more countries. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
What does this phase mean?
Phase 3 studies compare the treatment with the current standard treatment or a placebo in a large group, to confirm how well it works and watch for side effects.
Not every study follows the same path, and some studies (observational studies, device studies) have no phase.
Are results available for this study?
Yes. Results are posted in the registry (first posted 29 Apr 2013). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Number of Participants With First Event of Ischemic/Unspecified Stroke, Hemorrhagic Stroke, or Systemic Embolism (SE) During the Intended Treatment Period (time frame: Time to first event in "Intended Treatment Period": started on day of randomization, ended at efficacy cut-off date (date target number of primary efficacy events [448] was expected to have occurred; set to 30-Jan-2011, prior to unblinding).). The study lists 2 primary outcomes in all. It is what the study was designed to measure, not a finding.
Where can I read the original study information?
On the ClinicalTrials.gov record for NCT00412984, which also lists 60 linked publications.
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 3 Jul 2018.