re pradaxa in ACS
the knock on the thrombin inhibitors in ACS is stent thrombosis, so even if pradaxa has outcomes that are superior to heparins on composite endpoints (much like angiomax) that would make it approvable in ACS, if M188 can be titrated in such a way to minimize bleeding risk (the knock on heparin in ACS) it has a real chance of being a best in class
big IFs, of course, but i can see a pharma taking a chance on this drug
edit: obviously i am talking about the PCI setting, although since every pt with ACS is a possible PCI in waiting TOC for PCI would often translate to the larger ACS population as a whole as long as the drug can reasonably be given in the inpatient setting throughout the hospital course for anticoagulation even if that pt does not ultimately undergo PCI
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