{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T11:13:41Z","timestamp":1777374821801,"version":"3.51.4"},"reference-count":67,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2026,4,27]],"date-time":"2026-04-27T00:00:00Z","timestamp":1777248000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCDD"],"abstract":"<jats:p>Bleeding risk assessment is a critical component of the management of patients with ST-segment elevation myocardial infarction (STEMI), yet the optimal approach to risk stratification remains controversial. Although several bleeding risk scores have been developed, their predictive performance in STEMI populations is still evolving. Importantly, bleeding risk in STEMI is dynamic and influenced by clinical status, procedural factors, and antithrombotic strategies, underscoring the need for continuous reassessment throughout hospitalization. Bleeding avoidance measures\u2014including radial access, judicious use of anticoagulation, and individualized antiplatelet therapy\u2014play a pivotal role in reducing complications. Balancing ischemic and hemorrhagic risks is particularly challenging in patients with concomitantly high thrombotic and bleeding risks, requiring tailored management strategies. As bleeding remains a major determinant of prognosis, refining risk stratification tools and integrating evidence-based bleeding prevention strategies into clinical practice are essential. This narrative review summarizes the current evidence regarding the identification of high bleeding risk in hospitalized patients with STEMI and discusses its clinical implications. Also, this review proposes a dynamic, phase-specific framework for in-hospital bleeding risk assessment and management in patients with STEMI.<\/jats:p>","DOI":"10.3390\/jcdd13050183","type":"journal-article","created":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T07:49:36Z","timestamp":1777362576000},"page":"183","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["In Hospital Assessment and Management of High Bleeding Risk in Patients with ST-Elevation Myocardial Infarction (STEMI)"],"prefix":"10.3390","volume":"13","author":[{"given":"Sanghoon","family":"Kim","sequence":"first","affiliation":[{"name":"Department of Cardiology, CHA Bundang Medical Center, CHA University, Seongnam 13497, Republic of Korea"},{"name":"Division of Cardiology, College of Medicine-Jacksonville, University of Florida, Jacksonville, FL 32209, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alberto","family":"Piserra-L\u00f3pez","sequence":"additional","affiliation":[{"name":"\u00c1rea del Coraz\u00f3n, Hospital Universitario Virgen de la Victoria, IBIMA Plataforma BIONAND, 29010 Malaga, Spain"},{"name":"Centro de Investigaci\u00f3n Biom\u00e9dica en Red de Enfermedades Cardiovasculares (CIBERCV), 28029 Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2591-6010","authenticated-orcid":false,"given":"Salvatore","family":"Giordano","sequence":"additional","affiliation":[{"name":"Division of Cardiology, College of Medicine-Jacksonville, University of Florida, Jacksonville, FL 32209, USA"},{"name":"Department of Medical and Surgical Sciences, Division of Cardiology, \u201cMagna Graecia\u201d University, 88100 Catanzaro, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5467-7402","authenticated-orcid":false,"given":"Claudio","family":"Laudani","sequence":"additional","affiliation":[{"name":"Division of Cardiology, College of Medicine-Jacksonville, University of Florida, Jacksonville, FL 32209, USA"},{"name":"Division of Cardiology, Azienda Ospedaliero-Universitaria Policlinico \u201cRodolico-San Marco\u201d, University of Catania, 95123 Catania, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3097-2834","authenticated-orcid":false,"given":"Francesco","family":"Costa","sequence":"additional","affiliation":[{"name":"\u00c1rea del Coraz\u00f3n, Hospital Universitario Virgen de la Victoria, IBIMA Plataforma BIONAND, 29010 Malaga, Spain"},{"name":"Centro de Investigaci\u00f3n Biom\u00e9dica en Red de Enfermedades Cardiovasculares (CIBERCV), 28029 Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9151-5824","authenticated-orcid":false,"given":"Nelsa","family":"Gonz\u00e1lez-Aguado","sequence":"additional","affiliation":[{"name":"\u00c1rea del Coraz\u00f3n, Hospital Universitario Virgen de la Victoria, IBIMA Plataforma BIONAND, 29010 Malaga, Spain"},{"name":"Centro de Investigaci\u00f3n Biom\u00e9dica en Red de Enfermedades Cardiovasculares (CIBERCV), 28029 Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7137-274X","authenticated-orcid":false,"given":"Nicola","family":"Corcione","sequence":"additional","affiliation":[{"name":"Invasive Cardiology Unit, Pineta Grande Hospital, Castel Volturno, 81030 Caserta, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8451-2131","authenticated-orcid":false,"given":"Dominick J.","family":"Angiolillo","sequence":"additional","affiliation":[{"name":"Division of Cardiology, College of Medicine-Jacksonville, University of Florida, Jacksonville, FL 32209, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9567-3253","authenticated-orcid":false,"given":"Luis","family":"Ortega-Paz","sequence":"additional","affiliation":[{"name":"Division of Cardiology, College of Medicine-Jacksonville, University of Florida, Jacksonville, FL 32209, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2026,4,27]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"2135","DOI":"10.1016\/j.jacc.2024.11.009","article-title":"2025 ACC\/AHA\/ACEP\/NAEMSP\/SCAI Guideline for the Management of Patients With Acute Coronary Syndromes: A Report of the American College of Cardiology\/American Heart Association Joint Committee on Clinical Practice Guidelines","volume":"85","author":"Rao","year":"2025","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"e041995","DOI":"10.1161\/JAHA.125.041995","article-title":"Comparative Benefits of Primary Percutaneous Coronary Intervention Versus Onsite Fibrinolytic for Patients With ST-Segment-Elevation Myocardial Infarction: A Quasi-Experimental Study","volume":"14","author":"Zhou","year":"2025","journal-title":"J. Am. Heart Assoc."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1022","DOI":"10.1001\/jama.2013.1556","article-title":"Association between bleeding events and in-hospital mortality after percutaneous coronary intervention","volume":"309","author":"Chhatriwalla","year":"2013","journal-title":"JAMA"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"550","DOI":"10.4244\/EIJ-D-20-01197","article-title":"Mortality after bleeding versus myocardial infarction in coronary artery disease: A systematic review and meta-analysis","volume":"17","author":"Piccolo","year":"2021","journal-title":"EuroIntervention"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"589","DOI":"10.2298\/VSP140223064M","article-title":"Incidence, predictors and prognostic implications of bleeding complicating primary percutaneous coronary intervention","volume":"72","author":"Matic","year":"2015","journal-title":"Vojnosanit. Pregl."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"162","DOI":"10.1016\/j.jacc.2020.05.031","article-title":"Post-Discharge Bleeding and Mortality Following Acute Coronary Syndromes With or Without PCI","volume":"76","author":"Dalgaard","year":"2020","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"2197","DOI":"10.1016\/j.jcin.2024.08.022","article-title":"Antithrombotic Therapy in High Bleeding Risk, Part I: Percutaneous Cardiac Interventions","volume":"17","author":"Galli","year":"2024","journal-title":"JACC Cardiovasc. Interv."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"2024-0102","DOI":"10.5797\/jnet.ra.2024-0102","article-title":"Antithrombotic Therapy for Acute Coronary Syndrome","volume":"19","author":"Toyota","year":"2025","journal-title":"J. Neuroendovasc. Ther."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"756","DOI":"10.1093\/ehjqcco\/qcae104","article-title":"Performance of the ARC-HBR criteria in ST-elevation myocardial infarction. Significance of smoking as an additional bleeding risk factor","volume":"11","author":"Kesti","year":"2025","journal-title":"Eur. Heart J. Qual. Care Clin. Outcomes"},{"key":"ref_10","first-page":"804","article-title":"Trade-off of myocardial infarction vs. bleeding types on mortality after acute coronary syndrome: Lessons from the Thrombin Receptor Antagonist for Clinical Event Reduction in Acute Coronary Syndrome (TRACER) randomized trial","volume":"38","author":"Valgimigli","year":"2017","journal-title":"Eur. Heart J."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"322","DOI":"10.1097\/FJC.0000000000001678","article-title":"Impact of In-Hospital Bleeding on Postdischarge Therapies and Prognosis in Acute Coronary Syndromes","volume":"85","author":"Spadafora","year":"2025","journal-title":"J. Cardiovasc. Pharmacol."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"1025","DOI":"10.1016\/S0140-6736(17)30397-5","article-title":"Derivation and validation of the predicting bleeding complications in patients undergoing stent implantation and subsequent dual antiplatelet therapy (PRECISE-DAPT) score: A pooled analysis of individual-patient datasets from clinical trials","volume":"389","author":"Costa","year":"2017","journal-title":"Lancet"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"e21","DOI":"10.1016\/j.jacc.2021.09.006","article-title":"2021 ACC\/AHA\/SCAI Guideline for Coronary Artery Revascularization: A Report of the American College of Cardiology\/American Heart Association Joint Committee on Clinical Practice Guidelines","volume":"79","author":"Lawton","year":"2022","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"3720","DOI":"10.1093\/eurheartj\/ehad191","article-title":"2023 ESC Guidelines for the management of acute coronary syndromes","volume":"44","author":"Byrne","year":"2023","journal-title":"Eur. Heart J."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"2224","DOI":"10.1016\/j.jacc.2016.02.064","article-title":"Coronary Thrombosis and Major Bleeding After PCI With Drug-Eluting Stents: Risk Scores From PARIS","volume":"67","author":"Baber","year":"2016","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"10","DOI":"10.1016\/j.ijcard.2017.10.103","article-title":"Development and external validation of a post-discharge bleeding risk score in patients with acute coronary syndrome: The BleeMACS score","volume":"254","author":"Faxen","year":"2018","journal-title":"Int. J. Cardiol."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"791","DOI":"10.1253\/circj.CJ-17-0760","article-title":"Predictive Validity of CRUSADE, ACTION and ACUITY-HORIZONS Bleeding Risk Scores in Chinese Patients With ST-Segment Elevation Myocardial Infarction","volume":"82","author":"Liu","year":"2018","journal-title":"Circ. J."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"1136","DOI":"10.1016\/j.amjcard.2010.12.009","article-title":"In-hospital major bleeding during ST-elevation and non-ST-elevation myocardial infarction care: Derivation and validation of a model from the ACTION Registry(R)-GWTG","volume":"107","author":"Mathews","year":"2011","journal-title":"Am. J. Cardiol."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"e012157","DOI":"10.1161\/JAHA.119.012157","article-title":"Development and Validation of a Novel Risk Score for In-Hospital Major Bleeding in Acute Myocardial Infarction:-The SWEDEHEART Score","volume":"8","author":"Simonsson","year":"2019","journal-title":"J. Am. Heart Assoc."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"709","DOI":"10.1093\/ehjcvp\/pvad063","article-title":"External validity of the PRECISE-DAPT score in patients undergoing PCI: A systematic review and meta-analysis","volume":"9","author":"Munafo","year":"2023","journal-title":"Eur. Heart J. Cardiovasc. Pharmacother."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"440","DOI":"10.1177\/0003319718807057","article-title":"The Predictive Value of PRECISE-DAPT Score for In-Hospital Mortality in Patients With ST-Elevation Myocardial Infarction Undergoing Primary Percutaneous Coronary Intervention","volume":"70","author":"Tanik","year":"2019","journal-title":"Angiology"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"oeaf012","DOI":"10.1093\/ehjopen\/oeaf012","article-title":"Ischaemic and bleeding risk after ST-elevation myocardial infarction in patients with active cancer: A nationwide study","volume":"5","author":"Dafaalla","year":"2025","journal-title":"Eur. Heart J. Open"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"3138","DOI":"10.1093\/eurheartj\/ehae463","article-title":"Bleeding risk prediction after acute myocardial infarction-integrating cancer data: The updated PRECISE-DAPT cancer score","volume":"45","author":"Dafaalla","year":"2024","journal-title":"Eur. Heart J."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"oeaf137","DOI":"10.1093\/ehjopen\/oeaf137","article-title":"Prediction of major bleeding events for patients with dual antiplatelet therapy after myocardial infarction-a validation of the PRECISE-DAPT cancer score","volume":"5","author":"Mamas","year":"2025","journal-title":"Eur. Heart J. Open"},{"key":"ref_25","first-page":"1912","article-title":"External Validation of the PRECISE-DAPT Cancer Score in Patients With Acute Myocardial Infarction","volume":"106","author":"Dafaalla","year":"2025","journal-title":"Catheter. Cardiovasc. Interv."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"240","DOI":"10.1161\/CIRCULATIONAHA.119.040167","article-title":"Defining High Bleeding Risk in Patients Undergoing Percutaneous Coronary Intervention","volume":"140","author":"Urban","year":"2019","journal-title":"Circulation"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"505","DOI":"10.1161\/CIRCULATIONAHA.111.059022","article-title":"Six-month versus 12-month dual antiplatelet therapy after implantation of drug-eluting stents: The Efficacy of Xience\/Promus Versus Cypher to Reduce Late Loss After Stenting (EXCELLENT) randomized, multicenter study","volume":"125","author":"Gwon","year":"2012","journal-title":"Circulation"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"1340","DOI":"10.1016\/j.jacc.2012.06.043","article-title":"A new strategy for discontinuation of dual antiplatelet therapy: The RESET Trial (REal Safety and Efficacy of 3-month dual antiplatelet Therapy following Endeavor zotarolimus-eluting stent implantation)","volume":"60","author":"Kim","year":"2012","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"2155","DOI":"10.1056\/NEJMoa1409312","article-title":"Twelve or 30 months of dual antiplatelet therapy after drug-eluting stents","volume":"371","author":"Mauri","year":"2014","journal-title":"N. Engl. J. Med."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"2038","DOI":"10.1056\/NEJMoa1503943","article-title":"Polymer-free Drug-Coated Coronary Stents in Patients at High Bleeding Risk","volume":"373","author":"Urban","year":"2015","journal-title":"N. Engl. J. Med."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"426","DOI":"10.1016\/j.jcin.2015.11.015","article-title":"Is Bare-Metal Stent Implantation Still Justifiable in High Bleeding Risk Patients Undergoing Percutaneous Coronary Intervention?: A Pre-Specified Analysis From the ZEUS Trial","volume":"9","author":"Ariotti","year":"2016","journal-title":"JACC Cardiovasc. Interv."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"41","DOI":"10.1016\/S0140-6736(17)32713-7","article-title":"Drug-eluting stents in elderly patients with coronary artery disease (SENIOR): A randomised single-blind trial","volume":"391","author":"Varenne","year":"2018","journal-title":"Lancet"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"343","DOI":"10.1161\/CIRCULATIONAHA.124.072009","article-title":"Derivation and Validation of the PRECISE-HBR Score to Predict Bleeding After Percutaneous Coronary Intervention","volume":"151","author":"Gragnano","year":"2025","journal-title":"Circulation"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"159","DOI":"10.1253\/circj.CJ-20-0806","article-title":"Predictive Ability of Academic Research Consortium for High Bleeding Risk Criteria in ST-Elevation Myocardial Infarction Patients Undergoing Primary Coronary Intervention","volume":"85","author":"Fujii","year":"2021","journal-title":"Circ. J."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"1236","DOI":"10.5551\/jat.62999","article-title":"Practical Assessment of the Tradeoff between Fatal Bleeding and Coronary Thrombotic Risks using the Academic Research Consortium for High Bleeding Risk Criteria","volume":"29","author":"Sotomi","year":"2022","journal-title":"J. Atheroscler. Thromb."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"117","DOI":"10.1038\/s41569-021-00598-1","article-title":"Bleeding avoidance strategies in percutaneous coronary intervention","volume":"19","author":"Capodanno","year":"2022","journal-title":"Nat. Rev. Cardiol."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"1193","DOI":"10.1080\/14740338.2023.2291865","article-title":"Bleeding in acute coronary syndrome: From definitions, incidence, and prognosis to prevention and management","volume":"22","author":"Laudani","year":"2023","journal-title":"Expert. Opin. Drug Saf."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"e2134322","DOI":"10.1001\/jamanetworkopen.2021.34322","article-title":"Assessment of Pretreatment With Oral P2Y12 Inhibitors and Cardiovascular and Bleeding Outcomes in Patients With Non-ST Elevation Acute Coronary Syndromes: A Systematic Review and Meta-analysis","volume":"4","author":"Dawson","year":"2021","journal-title":"JAMA Netw. Open"},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"1016","DOI":"10.1056\/NEJMoa1407024","article-title":"Prehospital ticagrelor in ST-segment elevation myocardial infarction","volume":"371","author":"Montalescot","year":"2014","journal-title":"N. Engl. J. Med."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"e005528","DOI":"10.1161\/CIRCINTERVENTIONS.117.005528","article-title":"No Benefit of Ticagrelor Pretreatment Compared With Treatment During Percutaneous Coronary Intervention in Patients With ST-Segment-Elevation Myocardial Infarction Undergoing Primary Percutaneous Coronary Intervention","volume":"11","author":"Koul","year":"2018","journal-title":"Circ. Cardiovasc. Interv."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"17","DOI":"10.1016\/j.jcin.2023.10.064","article-title":"Pretreatment With P2Y(12) Inhibitors in ST-Segment Elevation Myocardial Infarction: Insights From the Bern-PCI Registry","volume":"17","author":"Rohla","year":"2024","journal-title":"JACC Cardiovasc. Interv."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"2318","DOI":"10.1056\/NEJMoa0908628","article-title":"Platelet inhibition with cangrelor in patients undergoing PCI","volume":"361","author":"Harrington","year":"2009","journal-title":"N. Engl. J. Med."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"1303","DOI":"10.1056\/NEJMoa1300815","article-title":"Effect of platelet inhibition with cangrelor during PCI on ischemic events","volume":"368","author":"Bhatt","year":"2013","journal-title":"N. Engl. J. Med."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"493","DOI":"10.1007\/s11886-014-0493-4","article-title":"Cangrelor: Review of the drug and the CHAMPION programme (including PHOENIX)","volume":"16","author":"Marino","year":"2014","journal-title":"Curr. Cardiol. Rep."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"132660","DOI":"10.1016\/j.ijcard.2024.132660","article-title":"Downstream cangrelor versus upstream ticagrelor in patients with ST-segment elevation myocardial infarction: A propensity score-matched analysis","volume":"418","author":"Greco","year":"2025","journal-title":"Int. J. Cardiol."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"1854","DOI":"10.1093\/eurheartj\/ehr204","article-title":"Bleeding in acute coronary syndromes and percutaneous coronary interventions: Position paper by the Working Group on Thrombosis of the European Society of Cardiology","volume":"32","author":"Steg","year":"2011","journal-title":"Eur. Heart J."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"2001","DOI":"10.1056\/NEJMoa0706482","article-title":"Prasugrel versus clopidogrel in patients with acute coronary syndromes","volume":"357","author":"Wiviott","year":"2007","journal-title":"N. Engl. J. Med."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"1045","DOI":"10.1056\/NEJMoa0904327","article-title":"Ticagrelor versus clopidogrel in patients with acute coronary syndromes","volume":"361","author":"Wallentin","year":"2009","journal-title":"N. Engl. J. Med."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"1374","DOI":"10.1016\/S0140-6736(20)30325-1","article-title":"Clopidogrel versus ticagrelor or prasugrel in patients aged 70 years or older with non-ST-elevation acute coronary syndrome (POPular AGE): The randomised, open-label, non-inferiority trial","volume":"395","author":"Gimbel","year":"2020","journal-title":"Lancet"},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"578","DOI":"10.1093\/ehjcvp\/pvae054","article-title":"Ticagrelor 60 vs. 90 mg in elderly ACS patients undergoing PCI: A randomized, crossover trial","volume":"10","author":"Piccolo","year":"2024","journal-title":"Eur. Heart J. Cardiovasc. Pharmacother."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"1621","DOI":"10.1056\/NEJMoa1907096","article-title":"A Genotype-Guided Strategy for Oral P2Y(12) Inhibitors in Primary PCI","volume":"381","author":"Claassens","year":"2019","journal-title":"N. Engl. J. Med."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"997","DOI":"10.1056\/NEJMoa1507854","article-title":"Bivalirudin or Unfractionated Heparin in Acute Coronary Syndromes","volume":"373","author":"Valgimigli","year":"2015","journal-title":"N. Engl. J. Med."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"835","DOI":"10.1016\/S0140-6736(18)31714-8","article-title":"Radial versus femoral access and bivalirudin versus unfractionated heparin in invasively managed patients with acute coronary syndrome (MATRIX): Final 1-year results of a multicentre, randomised controlled trial","volume":"392","author":"Valgimigli","year":"2018","journal-title":"Lancet"},{"key":"ref_54","first-page":"704","article-title":"Real-time ultrasound guidance facilitates femoral arterial access and reduces vascular complications: Results from a large multicenter registry","volume":"80","author":"Seto","year":"2012","journal-title":"Catheter. Cardiovasc. Interv."},{"key":"ref_55","first-page":"753","article-title":"Ultrasound guidance for femoral arterial access in percutaneous coronary intervention: A systematic review and meta-analysis","volume":"7","author":"Kantor","year":"2014","journal-title":"JACC Cardiovasc. Interv."},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"e025666","DOI":"10.1161\/JAHA.122.025666","article-title":"Femoral Vascular Closure Devices and Bleeding, Hemostasis, and Ambulation Following Percutaneous Coronary Intervention","volume":"12","author":"Huang","year":"2023","journal-title":"J. Am. Heart Assoc."},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"1438","DOI":"10.1016\/j.jcin.2016.04.036","article-title":"6-Month Versus 12-Month Dual-Antiplatelet Therapy Following Long Everolimus-Eluting Stent Implantation: The IVUS-XPL Randomized Clinical Trial","volume":"9","author":"Hong","year":"2016","journal-title":"JACC Cardiovasc. Interv."},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"1668","DOI":"10.1056\/NEJMoa2216607","article-title":"Intravascular Imaging-Guided or Angiography-Guided Complex PCI","volume":"388","author":"Lee","year":"2023","journal-title":"N. Engl. J. Med."},{"key":"ref_59","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":"ref_60","doi-asserted-by":"crossref","first-page":"1555","DOI":"10.1001\/jama.292.13.1555","article-title":"Relationship of blood transfusion and clinical outcomes in patients with acute coronary syndromes","volume":"292","author":"Rao","year":"2004","journal-title":"JAMA"},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"132","DOI":"10.1001\/2013.jamainternmed.1001","article-title":"Association of blood transfusion with increased mortality in myocardial infarction: A meta-analysis and diversity-adjusted study sequential analysis","volume":"173","author":"Chatterjee","year":"2013","journal-title":"JAMA Intern. Med."},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"2446","DOI":"10.1056\/NEJMoa2307983","article-title":"Restrictive or Liberal Transfusion Strategy in Myocardial Infarction and Anemia","volume":"389","author":"Carson","year":"2023","journal-title":"N. Engl. J. Med."},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"2218","DOI":"10.1056\/NEJMoa0708191","article-title":"Bivalirudin during primary PCI in acute myocardial infarction","volume":"358","author":"Stone","year":"2008","journal-title":"N. Engl. J. Med."},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"583","DOI":"10.1161\/CIRCULATIONAHA.120.050438","article-title":"Antithrombotic Therapy in Patients With Atrial Fibrillation Treated With Oral Anticoagulation Undergoing Percutaneous Coronary Intervention: A North American Perspective: 2021 Update","volume":"143","author":"Angiolillo","year":"2021","journal-title":"Circulation"},{"key":"ref_65","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":"ref_66","doi-asserted-by":"crossref","first-page":"216","DOI":"10.1093\/ehjcvp\/pvaa135","article-title":"Antithrombotic therapy according to baseline bleeding risk in patients with atrial fibrillation undergoing percutaneous coronary intervention: Applying the PRECISE-DAPT score in RE-DUAL PCI","volume":"8","author":"Costa","year":"2022","journal-title":"Eur. Heart J. Cardiovasc. Pharmacother."},{"key":"ref_67","doi-asserted-by":"crossref","first-page":"1909","DOI":"10.1056\/NEJMoa1007964","article-title":"Clopidogrel with or without omeprazole in coronary artery disease","volume":"363","author":"Bhatt","year":"2010","journal-title":"N. Engl. J. 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