Trial of Apixaban vs Warfarin in Reducing Rate of Cognitive Decline, Silent Cerebral Infarcts and Cerebral Microbleeds in Patients With Atrial Fibrillation

Inclusion Criteria:

- Non-valvular Atrial Fibrillation

- CHA2DS2-VASc Score > or = to 2

- Never been treated with Apixaban (Eliquis) or prior treatment of < 1 month

- Candidate for oral anticoagulation as assessed by a treating physician

Exclusion Criteria:

- Valvular Atrial Fibrillation (Rheumatic valve disease,Moderate or greater mitral
stenosis,Mechanical cardiac valve)

- Active Bleeding

- Prior treatment with Apixaban >1 month

- Recent stroke within 7 days

- Dementia

- Implanted devices not compatible with MRI/any cardiac implanted device

- Claustrophobia

- Active alcohol/drug abuse

- Life expectancy < 1 year

- Taking asprin with >100mg doses

- Known hypersensitivity to warfarin or Apixaban

- Severe renal insufficiency

- Prior severe bleeding (Intracranial bleeding (subdural, subarachnoid, intraparenchymal
bleeding),GI bleed requiring transfusion,Bleeding from other sites requiring
transfusion)

- Psychosocial reasons that make study participation impractical

- Currently enrolled in another IND or IDE trial that has not completed the primary
endpoint or that clinically interferes with the current study endpoints

- Co-morbid condition(s) that could limit the subject's ability to participate in the
trial or to comply with follow-up requirements, or that could impact the scientific
integrity of the study.

- Prisoners or subjects who are involuntarily incarcerated

- Subjects who are compulsorily detained for treatment of either psychiatric or physical
illness

- Current or expected systemic treatment with strong dual inhibitors of CYP3A4 and P-gp
(Any one of rifampin, carbamazepine, phenytoin, St. John's Wort, ketoconazole,
itraconazole, ritonavir, clarithromycin)

- Need for dual anti-platelet therapy with aspirin and another agent such as
thienopyridine