Reduced Antithrombotic Strategy for High Bleeding Risk Patients With Myocardial Infarction

Inclusion Criteria: 1. MI caused by atherothrombotic CAD (Type 1 MI) according to "The Fourth Universal Definition of MI", which has been treated with PCI with contemporary drug-eluting stents. This definition of type 1 MI requires the detection of a rise and/or fall of cardiac troponin values with at least one value \>99th percentile and at least one of the following criteria assessed by the treating physician: * symptoms indicating acute myocardial ischemia * new ischemic changes on the electrocardiogram * development of pathological Q-waves * imaging evidence of new loss of viable myocardium or new regional wall motion abnormality in a pattern consistent with an ischemic etiology * visible coronary thrombus by angiography 2. PRECISE-DAPT score ≥25 3. Age ≥18 years Exclusion Criteria: 1. Contraindications including allergies to ASA or P2Y12 inhibitors 2. Indication for oral anticoagulation 3. Previous stent thrombosis 4. Life expectancy \<1 year 5. Resuscitated cardiac arrest with Glasgow Coma Scale \<8 and/or need of intubation 6. Prior intracranial hemorrhage 7. Active bleeding (BARC ≥2) at randomization 8. Women who are pregnant, have given birth recently (within the past 90 days), are lactating, or are fertile without contraception 9. Hypertensive crisis (systolic blood pressure \>180 mmHg and/or diastolic blood pressure \>120 mmHg) 10. Unable to understand and follow study-related instructions or to comply with study protocol