Sub-Clinical Atrial Fibrillation Biomarker Study

You may not qualify if:

• Clinical atrial fibrillation documented by surface ECG (12 lead ECG, Telemetry, Holter) lasting ≥ 6 minutes, with or without clinical symptoms
• Mechanical valve prosthesis, recent (within past 6 months) deep vein thrombosis or pulmonary embolism or other condition requiring treatment with an anticoagulant
• Allergy to aspirin or apixaban
• Severe renal insufficiency (serum creatinine \> 2.5 mg/dL \[221 μmol/L\] or a calculated creatinine clearance \< 25 ml/min)
• Serious bleeding in the last 6 months or at high risk of bleeding (this includes, but is not limited to: prior intracranial hemorrhage, active peptic ulcer disease, clinically significant thrombocytopenia or anemia, recent stroke within past 10 days, documented hemorrhagic tendencies or blood dyscrasias)
• Moderate to severe hepatic impairment
• Ongoing need for combination therapy with aspirin and clopidogrel (or other combination of two platelet inhibitors)
• Meets criteria for requiring lower dose of apixaban AND also has ongoing need for strong inhibitors of both CYP3A4 and P-glycoprotein (e.g., ketoconazole, itraconazole, ritonavir or clarithromycin)
• Ongoing need for strong inducers of both CYP3A4 and P-glycoprotein (e.g., rifampin, carbamazepine, phenytoin, St. John's wort)
• Received an investigational drug in the past 30 days
• Participants considered by the investigator to be unsuitable for the study for any of the following reasons:
• Not agreeable for treatment with either aspirin or apixaban or anticipated to have poor compliance on study drug treatment
• Unwilling to attend study follow-up visits
• Life expectancy less than 2 years due to concomitant disease
• Women who are pregnant, breast-feeding or of child-bearing potential without an acceptable form of contraception in place (sterilization, abstinence or other method with less than 1% failure rate)