Study to Gather Information About the Proper Dosing of the Oral FXIa Inhibitor BAY 2433334 and to Compare the Safety of the Study Drug to Apixaban, a Non-vitamin K Oral Anticoagulant (NOAC) in Patients With Irregular Heartbeat (Atrial Fibrillation) That Can Lead to Heart-related Complications.
Condition: Atrial Fibrillation (AF)
MeSH terms: Atrial Fibrillation
Intervention: BAY2433334; Apixaban; BAY2433334 matching placebo; Apixaban matching placebo
Intervention description: Tablet, taken orally once a day.; Capsule, taken orally twice a day.; Tablet, taken orally once a day.; Capsule, taken orally twice a day.
Intervention MeSH terms: Apixaban
Phase: Phase 2
Study type: Interventional
Primary purpose: Treatment
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Quadruple (Participant, Care Provider, Investigator, Outcomes Assessor)
Enrollment: 755.0
Sex: All
Minimum age: 45 Years
Healthy volunteers: No

Summary:

      The purpose of this study is to try to find the best dose of the new drug BAY 2433334 to give
      to participants and to look at how well BAY 2433334 works in patients with irregular
      heartbeat (atrial fibrillation) that can lead to blood clots, stroke and other heart-related
      complications. In addition researchers want to compare the safety of the study drug to
      apixaban, a non-vitamin K oral anticoagulant (NOAC) in patients with atrial fibrillation.
      This study is also done to learn how the drug in this study moves into, through and out of
      the body. BAY 2433334, works by blocking a step of the blood clotting process in our body and
      thins the blood and is a so called oral FXIa inhibitor.

      Apixaban, works by reducing the production of blood clotting factors in our body and thins
      the blood and is a so called non-vitamin K oral anticoagulant (NOAC). Thinning the blood can
      prevent you from blood clots which can cause a stroke.
    

Eligibility criteria:

        Inclusion Criteria:

          -  Participant must be 45 years of age or older at the time of signing the informed
             consent.

          -  Participant with AF documented by ECG evidence with

               -  CHA2DS2-VASc score ≥ 2 if male or CHA2DS2-VASc score ≥ 3 if female

               -  Indication for treatment with an oral anticoagulant in

                    -  any participant currently not treated with an oral anticoagulant (e.g.
                       treatment naïve) or alternatively,

                    -  participant on a NOAC in case of at least one bleeding risk feature (history
                       of a prior bleed within the last 12 months requiring medical attention and /
                       or moderate renal dysfunction with eGFR 30-50 ml/min and / or current
                       clinically indicated antiplatelet therapy with Acetylsalicylic acid(ASA) ≤
                       100 mg)

          -  Written informed consent

        Exclusion Criteria:

          -  Mechanical heart valve prosthesis

          -  Any degree of rheumatic mitral stenosis or moderate-to-severe, non-rheumatic mitral
             stenosis

          -  Atrial fibrillation due to a reversible cause, participants in sinus rhythm after
             successful ablation, or plan for cardioversion or ablation during study conduct

          -  Requirement for chronic anticoagulation (for a different indication than AF) or
             antiplatelet therapy (up to 100 mg ASA is allowed). Anticipated need for chronic
             therapy with Nonsteroidal anti-inflammatory drugs (NSAIDs)

          -  Treated with a Vitamin K antagonist in the 30 days prior to screening