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People with dangerously irregular heart rhythms given Eliquis were 21 percent less likely to suffer strokes than those on decades-old warfarin, a problematic drug first developed as rat poison that requires regular blood tests.

It also produced a 31 percent relative reduction in the risk of major bleeding -- especially bleeding in the brain -- and an 11 percent reduction in risk of death from any cause, results from a 18,000-patient study lasting nearly two years showed.

The mortality benefit only just reached statistical significance but the finding puts Eliquis ahead of its two key rivals by demonstrating superiority to warfarin on all three counts of effectiveness, safety and saving lives.

In particular, he is concerned about adherence to medical treatment among elderly patients, as doctors may be less able to ensure they are taking drugs correctly once they do not need regular blood tests. For such patients, once-daily Xarelto may be a better bet than twice-daily Eliquis or Pradaxa, providing a niche market opportunity for Bayer and J&J.