Sharma A, et al. - In this post-hoc analysis, researchers examined the clinical results of bleeding among high-risk patients (n=7,392) (median follow-up 241 days) who suffered a recent acute coronary syndrome (ACS) and were randomized to apixaban or placebo in Apixaban for Prevention of Acute Ischemic Safety Events (APPRAISE)-2. They found that irrespective of antithrombotic or anticoagulant strategy, a significantly increased risk of subsequent ischemic events and death was evident in relation to bleeding in a current cohort of high-risk patients following ACS. The bleeding risk observed in patients receiving apixaban plus aspirin was like that seen in those receiving thienopyridine plus aspirin. Strategies to optimize the attenuation in ischemic events while minimizing the risk of bleeding were recommended to be included in the interventions meant to improve outcomes in patients post-ACS.