Vorapaxar increased overall occurrences of moderate and severe Global Use of Strategies to Open Occluded Coronary Arteries bleeding ( HR , 1.42 ; 95 % CI , 1.21 to 1.66 ; P < 0.001 ) and Thrombolysis in Myocardial Infarction clinically significant bleeding ( HR , 1.550 ; 95 % CI , 1.403 to 1.713 ; P < 0.001 ) .