All the blood-thinner action at the European Society of Cardiology meeting has heads spinning. And no one’s heads are spinning faster than those at Eli Lilly. The company finally ushered its new anti-clotting med Effient onto the market last month. It’s hoping to turn that clot-buster into a blockbuster. But now that AstraZeneca’s experimental drug Brilinta showed so much promise–and old standby Plavix performed well , too–market observers are expecting Effient to have a tougher time of it than they originally thought. As you know, Effient came onto the scene with a caveat: a risk of excessive bleeding. So far, Brilinta hasn’t shown that weakness. And with a new data analysis showing high Plavix doses working well in certain elderly patients, docs may be pressing the soon-to-be-cheap-generic into greater service. In fact, Seamus Fernandez at Leerink Swann has slashed his forecast for Effient sales, CNBC ‘s Mike Huckman reports. By 2015, Fernandez expects the drug to be bringing in $900 million annually, down a full $1 billion from previous estimates. And he’s calling for a “major restructuring or a major acquisition” or both.