{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,21]],"date-time":"2026-08-21T12:53:36Z","timestamp":1787316816726,"version":"build-2736575974"},"reference-count":29,"publisher":"Elsevier BV","license":[{"start":{"date-parts":[[2022,1,1]],"date-time":"2022-01-01T00:00:00Z","timestamp":1640995200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2022,1,1]],"date-time":"2022-01-01T00:00:00Z","timestamp":1640995200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"},{"start":{"date-parts":[[2022,1,1]],"date-time":"2022-01-01T00:00:00Z","timestamp":1640995200000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-017"},{"start":{"date-parts":[[2022,1,1]],"date-time":"2022-01-01T00:00:00Z","timestamp":1640995200000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-037"},{"start":{"date-parts":[[2022,1,1]],"date-time":"2022-01-01T00:00:00Z","timestamp":1640995200000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-012"},{"start":{"date-parts":[[2022,1,1]],"date-time":"2022-01-01T00:00:00Z","timestamp":1640995200000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-029"},{"start":{"date-parts":[[2022,1,1]],"date-time":"2022-01-01T00:00:00Z","timestamp":1640995200000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-004"}],"funder":[{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["KL2TR000450"],"award-info":[{"award-number":["KL2TR000450"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["TL1TR000449"],"award-info":[{"award-number":["TL1TR000449"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["UL1TR000448"],"award-info":[{"award-number":["UL1TR000448"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000054","name":"National Cancer Institute","doi-asserted-by":"publisher","award":["1KM1CA156708-01"],"award-info":[{"award-number":["1KM1CA156708-01"]}],"id":[{"id":"10.13039\/100000054","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000133","name":"Agency for Healthcare Research and Quality","doi-asserted-by":"publisher","award":["R18HS0224181-01A1"],"award-info":[{"award-number":["R18HS0224181-01A1"]}],"id":[{"id":"10.13039\/100000133","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100006108","name":"National Center for Advancing Translational Sciences","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100006108","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["clinicalkey.com","clinicalkey.com.au","clinicalkey.es","clinicalkey.fr","clinicalkey.jp","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["American Heart Journal"],"published-print":{"date-parts":[[2022,1]]},"DOI":"10.1016\/j.ahj.2021.08.021","type":"journal-article","created":{"date-parts":[[2021,9,19]],"date-time":"2021-09-19T21:51:04Z","timestamp":1632088264000},"page":"221-231","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":4,"special_numbering":"C","title":["The bleeding risk treatment paradox at the physician and hospital level: Implications for reducing bleeding in patients undergoing percutaneous coronary intervention"],"prefix":"10.1016","volume":"243","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6007-0519","authenticated-orcid":false,"given":"Amit P.","family":"Amin","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nathan","family":"Frogge","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6950-3341","authenticated-orcid":false,"given":"Hemant","family":"Kulkarni","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gene","family":"Ridolfi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6213-5758","authenticated-orcid":false,"given":"Gregory","family":"Ewald","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0122-7154","authenticated-orcid":false,"given":"Rachel","family":"Miller","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bruce","family":"Hall","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susan","family":"Rogers","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7187-6822","authenticated-orcid":false,"given":"Ty","family":"Gluckman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeptha","family":"Curtis","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5681-6709","authenticated-orcid":false,"given":"Frederick A.","family":"Masoudi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2914-0894","authenticated-orcid":false,"given":"Sunil V.","family":"Rao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"78","reference":[{"key":"10.1016\/j.ahj.2021.08.021_bib0001","first-page":"897","article-title":"an updated bleeding model to predict the risk of post-procedure bleeding among patients undergoing Percutaneous Coronary Intervention: a report using an expanded bleeding definition from the National Cardiovascular Data Registry CathPCI Registry","volume":"6","author":"Rao","year":"2013","journal-title":"JACC: Cardiovasc Interv"},{"key":"10.1016\/j.ahj.2021.08.021_bib0002","doi-asserted-by":"crossref","first-page":"2156","DOI":"10.1001\/jama.2010.708","article-title":"Association between use of bleeding avoidance strategies and risk of periprocedural bleeding among patients undergoing Percutaneous Coronary Intervention","volume":"303","author":"Marso","year":"2010","journal-title":"JAMA"},{"key":"10.1016\/j.ahj.2021.08.021_bib0003","doi-asserted-by":"crossref","DOI":"10.1161\/JAHA.118.008551","article-title":"Reversing the \u201cRisk-Treatment Paradox\u201d of bleeding in patients undergoing Percutaneous Coronary Intervention: risk-concordant use of bleeding avoidance strategies is associated with reduced bleeding and lower costs","volume":"7","author":"Amin","year":"2018","journal-title":"J Am Heart Assoc"},{"key":"10.1016\/j.ahj.2021.08.021_bib0004","doi-asserted-by":"crossref","first-page":"790","DOI":"10.1016\/j.jcin.2013.03.020","article-title":"Enhanced mortality risk prediction with a focus on high-risk percutaneous coronary intervention: results from 1,208,137 procedures in the NCDR (National Cardiovascular Data Registry)","volume":"6","author":"Brennan","year":"2013","journal-title":"JACC Cardiovasc Interv"},{"key":"10.1016\/j.ahj.2021.08.021_bib0005","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.jacc.2011.02.039","article-title":"Bleeding avoidance strategies. Consensus and controversy","volume":"58","author":"Dauerman","year":"2011","journal-title":"J Am Coll Cardiol"},{"key":"10.1016\/j.ahj.2021.08.021_bib0006","doi-asserted-by":"crossref","first-page":"2225","DOI":"10.1016\/j.jacc.2015.03.567","article-title":"Bleeding avoidance strategies during percutaneous coronary interventions","volume":"65","author":"Singh","year":"2015","journal-title":"J Am Coll Cardiol"},{"key":"10.1016\/j.ahj.2021.08.021_bib0007","doi-asserted-by":"crossref","DOI":"10.1161\/JAHA.113.000174","article-title":"Risk-treatment paradox in the selection of transradial access for percutaneous coronary intervention","volume":"2","author":"Wimmer","year":"2013","journal-title":"J Am Heart Assoc"},{"key":"10.1016\/j.ahj.2021.08.021_bib0008","doi-asserted-by":"crossref","first-page":"1847","DOI":"10.1016\/j.jacc.2013.02.017","article-title":"Pre-procedural estimate of individualized bleeding risk impacts physicians' utilization of bivalirudin during percutaneous coronary intervention","volume":"61","author":"Rao","year":"2013","journal-title":"J Am Coll Cardiol"},{"key":"10.1016\/j.ahj.2021.08.021_bib0009","doi-asserted-by":"crossref","first-page":"h1302","DOI":"10.1136\/bmj.h1302","article-title":"Precision medicine to improve use of bleeding avoidance strategies and reduce bleeding in patients undergoing percutaneous coronary intervention: prospective cohort study before and after implementation of personalized bleeding risks","volume":"350","author":"Spertus","year":"2015","journal-title":"BMJ"},{"key":"10.1016\/j.ahj.2021.08.021_bib0010","doi-asserted-by":"crossref","first-page":"297","DOI":"10.1136\/heartjnl-2012-303379","article-title":"The NCDR CathPCI Registry: a US national perspective on care and outcomes for percutaneous coronary intervention","volume":"99","author":"Moussa","year":"2013","journal-title":"Heart"},{"key":"10.1016\/j.ahj.2021.08.021_bib0011","doi-asserted-by":"crossref","first-page":"81","DOI":"10.1093\/aje\/kwi017","article-title":"Appropriate assessment of neighborhood effects on individual health: integrating random and fixed effects in multilevel logistic regression","volume":"161","author":"Larsen","year":"2005","journal-title":"Am J Epidemiol"},{"key":"10.1016\/j.ahj.2021.08.021_bib0012","series-title":"Applied multivariate data analysis","author":"Everitt","year":"1991"},{"key":"10.1016\/j.ahj.2021.08.021_bib0013","series-title":"Data analysis and statistics for nursing research","author":"Polit","year":"1996"},{"key":"10.1016\/j.ahj.2021.08.021_bib0014","doi-asserted-by":"crossref","first-page":"2247","DOI":"10.1016\/j.jcin.2019.05.051","article-title":"Primary and secondary vascular access site complications associated with Percutaneous Coronary Intervention: insights from the BMC2 Registry","volume":"12","author":"Kopin","year":"2019","journal-title":"JACC Cardiovasc Interv"},{"key":"10.1016\/j.ahj.2021.08.021_bib0015","doi-asserted-by":"crossref","first-page":"2913","DOI":"10.1016\/j.jacc.2017.04.032","article-title":"Outcomes of PCI in relation to procedural characteristics and operator volumes in the United States","volume":"69","author":"Fanaroff","year":"2017","journal-title":"J Am Coll Cardiol"},{"key":"10.1016\/j.ahj.2021.08.021_bib0016","first-page":"347","article-title":"Comparison of Bivalirudin and Radial access across a spectrum of preprocedural risk of bleeding in Percutaneous Coronary Intervention","volume":"6","author":"Baklanov","year":"2013","journal-title":"Circulation: Cardiovasc Interv"},{"key":"10.1016\/j.ahj.2021.08.021_bib0017","doi-asserted-by":"crossref","first-page":"206","DOI":"10.4244\/EIJV6I2A33","article-title":"The impact of bivalirudin on percutaneous coronary intervention-related bleeding","volume":"6","author":"Lindsey","year":"2010","journal-title":"EuroIntervention"},{"key":"10.1016\/j.ahj.2021.08.021_bib0018","doi-asserted-by":"crossref","first-page":"518","DOI":"10.1016\/j.ahj.2009.12.027","article-title":"Meta-analysis of randomized trials on the efficacy of vascular closure devices after diagnostic angiography and angioplasty","volume":"159","author":"Biancari","year":"2010","journal-title":"Am Heart J"},{"key":"10.1016\/j.ahj.2021.08.021_bib0019","first-page":"32","article-title":"Systematic review of randomized controlled trials comparing manual compression to vascular closure devices for diagnostic and therapeutic arterial procedures","volume":"27","author":"Cox","year":"2015","journal-title":"Surg Technol Int"},{"key":"10.1016\/j.ahj.2021.08.021_bib0020","doi-asserted-by":"crossref","first-page":"13761","DOI":"10.1038\/srep13761","article-title":"Network meta-analysis of randomized trials on the safety of vascular closure devices for femoral arterial puncture site haemostasis","volume":"5","author":"Jiang","year":"2015","journal-title":"Sci Rep"},{"key":"10.1016\/j.ahj.2021.08.021_bib0021","doi-asserted-by":"crossref","first-page":"1256","DOI":"10.1016\/j.amjcard.2016.01.015","article-title":"Meta-analysis of effects of Bivalirudin versus Heparin on Myocardial Ischemic and bleeding outcomes after Percutaneous Coronary Intervention","volume":"117","author":"Barria","year":"2016","journal-title":"Am J Cardiol"},{"key":"10.1016\/j.ahj.2021.08.021_bib0022","doi-asserted-by":"crossref","first-page":"14","DOI":"10.1016\/j.ahj.2015.10.006","article-title":"An updated comprehensive meta-analysis of bivalirudin vs heparin use in primary percutaneous coronary intervention","volume":"171","author":"Shah","year":"2016","journal-title":"Am Heart J"},{"key":"10.1016\/j.ahj.2021.08.021_bib0023","doi-asserted-by":"crossref","first-page":"1132","DOI":"10.1056\/NEJMoa1706443","article-title":"Bivalirudin versus Heparin Monotherapy in Myocardial Infarction","volume":"377","author":"Erlinge","year":"2017","journal-title":"N Engl J Med"},{"key":"10.1016\/j.ahj.2021.08.021_bib0024","doi-asserted-by":"crossref","first-page":"1849","DOI":"10.1016\/S0140-6736(14)60924-7","article-title":"Unfractionated Heparin versus Bivalirudin in Primary Percutaneous Coronary Intervention (HEAT-PPCI): an open-label, single centre, randomised controlled trial","volume":"384","author":"Shahzad","year":"2014","journal-title":"The Lancet"},{"key":"10.1016\/j.ahj.2021.08.021_bib0025","first-page":"E192","article-title":"Ultrasound guidance in femoral artery catheterization: a systematic review and a meta-analysis of randomized controlled trials","volume":"31","author":"Rashid","year":"2019","journal-title":"J Invasive Cardiol"},{"key":"10.1016\/j.ahj.2021.08.021_bib0026","doi-asserted-by":"crossref","first-page":"1107","DOI":"10.1016\/S0140-6736(12)62177-1","article-title":"Use of clopidogrel with or without aspirin in patients taking oral anticoagulant therapy and undergoing percutaneous coronary intervention: an open-label, randomised, controlled trial","volume":"381","author":"Dewilde","year":"2013","journal-title":"Lancet"},{"key":"10.1016\/j.ahj.2021.08.021_bib0027","doi-asserted-by":"crossref","first-page":"1509","DOI":"10.1056\/NEJMoa1817083","article-title":"Antithrombotic therapy after acute coronary syndrome or PCI in atrial fibrillation","volume":"380","author":"Lopes","year":"2019","journal-title":"N Engl J Med"},{"key":"10.1016\/j.ahj.2021.08.021_bib0028","doi-asserted-by":"crossref","first-page":"21","DOI":"10.1001\/jama.2016.8019","article-title":"Changing physician behavior is harder than we thought","volume":"316","author":"Wilensky","year":"2016","journal-title":"JAMA"},{"key":"10.1016\/j.ahj.2021.08.021_bib0029","doi-asserted-by":"crossref","first-page":"190","DOI":"10.1016\/j.ahj.2016.03.027","article-title":"Understanding physician-level barriers to the use of individualized risk estimates in percutaneous coronary intervention","volume":"178","author":"Decker","year":"2016","journal-title":"Am Heart J"}],"container-title":["American Heart Journal"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S0002870321002271?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S0002870321002271?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2025,11,2]],"date-time":"2025-11-02T09:58:38Z","timestamp":1762077518000},"score":1,"resource":{"primary":{"URL":"https:\/\/linkinghub.elsevier.com\/retrieve\/pii\/S0002870321002271"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,1]]},"references-count":29,"alternative-id":["S0002870321002271"],"URL":"https:\/\/doi.org\/10.1016\/j.ahj.2021.08.021","relation":{},"ISSN":["0002-8703"],"issn-type":[{"value":"0002-8703","type":"print"}],"subject":[],"published":{"date-parts":[[2022,1]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"The bleeding risk treatment paradox at the physician and hospital level: Implications for reducing bleeding in patients undergoing percutaneous coronary intervention","name":"articletitle","label":"Article Title"},{"value":"American Heart Journal","name":"journaltitle","label":"Journal Title"},{"value":"https:\/\/doi.org\/10.1016\/j.ahj.2021.08.021","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"article","name":"content_type","label":"Content Type"},{"value":"\u00a9 2021 Published by Elsevier Inc.","name":"copyright","label":"Copyright"}]}}