 Given the central role of thrombosis in the pathobiology of acute ischemic heart disease, injectable intravenous or subcutaneous anticoagulants have become the foundation of medical treatment for patients presenting with acute coronary syndromes unstable angina and myocardial infarction; ACS and for those undergoing coronary revascularization procedures, either percutaneously or surgically Harrington et al., 2004; Popma et al., 2004. Currently available anticoagulants include unfractionated heparin UFH, the low molecular weight heparins LMWH, and the direct thrombin inhibitors DTI e.g., recombinant hirudin, bivalirudin, and argatroban. The present paradigm both for anticoagulant use and for continued antithrombotic drug development is to establish a balance between efficacy reducing the risk of ischemic events and safety minimizing the risk of bleeding Harrington et al., 2004. Each of the available agents carries an increased risk of bleeding relative to placebo. 