A dvances in antithrombotic therapy, along with an early invasive strategy, have reduced the incidence of recurrent ischemic events and death in patients with acute coronary syndromes (ACS; unstable angina, non-ST-segment-elevation myocardial infarction [MI], and ST-segment-elevation MI). [1][2][3][4] However, the combination of multiple pharmacotherapies, including aspirin, platelet P2Y 12 inhibitors, heparin plus glycoprotein IIb/IIIa inhibitors, direct thrombin inhibitors, and the increasing use of invasive procedures, has also been associated with an increased risk of bleeding.