{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T12:52:28Z","timestamp":1777639948515,"version":"3.51.4"},"reference-count":37,"publisher":"Elsevier BV","issue":"14","license":[{"start":{"date-parts":[[2009,9,1]],"date-time":"2009-09-01T00:00:00Z","timestamp":1251763200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2009,9,1]],"date-time":"2009-09-01T00:00:00Z","timestamp":1251763200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"},{"start":{"date-parts":[[2013,7,16]],"date-time":"2013-07-16T00:00:00Z","timestamp":1373932800000},"content-version":"vor","delay-in-days":1414,"URL":"http:\/\/www.elsevier.com\/open-access\/userlicense\/1.0\/"}],"content-domain":{"domain":["clinicalkey.com","clinicalkey.com.au","clinicalkey.es","clinicalkey.fr","clinicalkey.jp","jacc.org","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["Journal of the American College of Cardiology"],"published-print":{"date-parts":[[2009,9]]},"DOI":"10.1016\/j.jacc.2009.07.019","type":"journal-article","created":{"date-parts":[[2009,9,23]],"date-time":"2009-09-23T10:46:05Z","timestamp":1253702765000},"page":"1293-1302","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":162,"title":["Gastrointestinal Bleeding in Patients With Acute Coronary Syndromes: Incidence, Predictors, and Clinical Implications"],"prefix":"10.1016","volume":"54","author":[{"given":"Eugenia","family":"Nikolsky","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gregg W.","family":"Stone","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ajay J.","family":"Kirtane","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"George D.","family":"Dangas","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alexandra J.","family":"Lansky","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Brent","family":"McLaurin","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"A. Michael","family":"Lincoff","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Frederick","family":"Feit","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jeffrey W.","family":"Moses","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Martin","family":"Fahy","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Steven V.","family":"Manoukian","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Harvey D.","family":"White","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"E. Magnus","family":"Ohman","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michel E.","family":"Bertrand","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David A.","family":"Cox","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Roxana","family":"Mehran","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"78","reference":[{"key":"10.1016\/j.jacc.2009.07.019_bib1","doi-asserted-by":"crossref","first-page":"119","DOI":"10.1023\/B:THRO.0000024050.78728.35","article-title":"Aspirin use post-acute coronary syndromes: intolerance, bleeding and discontinuation","volume":"16","author":"Newby","year":"2003","journal-title":"J Thromb Thrombolysis"},{"key":"10.1016\/j.jacc.2009.07.019_bib2","doi-asserted-by":"crossref","first-page":"696","DOI":"10.1001\/jama.292.6.696","article-title":"Long-term efficacy of bivalirudin and provisional glycoprotein IIb\/IIIa blockade vs heparin and planned glycoprotein IIb\/IIIa blockade during percutaneous coronary revascularization: REPLACE-2 randomized trial","volume":"292","author":"Lincoff","year":"2004","journal-title":"JAMA"},{"key":"10.1016\/j.jacc.2009.07.019_bib3","first-page":"568","article-title":"Analysis of 3,294 cases of upper gastrointestinal bleeding in military medical facilities","volume":"90","author":"Yavorski","year":"1995","journal-title":"Am J Gastroenterol"},{"key":"10.1016\/j.jacc.2009.07.019_bib4","doi-asserted-by":"crossref","first-page":"1238","DOI":"10.1111\/j.1572-0241.2004.30272.x","article-title":"The Canadian Registry on Nonvariceal Upper Gastrointestinal Bleeding and Endoscopy (RUGBE): endoscopic hemostasis and proton pump inhibition are associated with improved outcomes in a real-life setting","volume":"99","author":"Barkun","year":"2004","journal-title":"Am J Gastroenterol"},{"key":"10.1016\/j.jacc.2009.07.019_bib5","doi-asserted-by":"crossref","first-page":"865","DOI":"10.1111\/j.1572-0241.2007.01715.x","article-title":"Gastrointestinal bleeding in patients receiving a combination of aspirin, clopidogrel, and enoxaparin in acute coronary syndrome","volume":"103","author":"Ng","year":"2008","journal-title":"Am J Gastroenterol"},{"key":"10.1016\/j.jacc.2009.07.019_bib6","doi-asserted-by":"crossref","first-page":"2411","DOI":"10.1111\/j.1572-0241.2007.01460.x","article-title":"Predictive and protective factors associated with upper gastrointestinal bleeding after percutaneous coronary intervention: a case-control study","volume":"102","author":"Chin","year":"2007","journal-title":"Am J Gastroenterol"},{"key":"10.1016\/j.jacc.2009.07.019_bib7","doi-asserted-by":"crossref","first-page":"764","DOI":"10.1016\/j.ahj.2004.04.036","article-title":"Acute Catheterization and Urgent Intervention Triage strategY (ACUITY) trial: study design and rationale","volume":"148","author":"Stone","year":"2004","journal-title":"Am Heart J"},{"key":"10.1016\/j.jacc.2009.07.019_bib8","doi-asserted-by":"crossref","first-page":"907","DOI":"10.1016\/S0140-6736(07)60450-4","article-title":"Bivalirudin in patients with acute coronary syndromes undergoing percutaneous coronary intervention: a subgroup analysis from the Acute Catheterization and Urgent Intervention Triage strategy (ACUITY) trial","volume":"369","author":"Stone","year":"2007","journal-title":"Lancet"},{"key":"10.1016\/j.jacc.2009.07.019_bib9","doi-asserted-by":"crossref","first-page":"591","DOI":"10.1001\/jama.297.6.591","article-title":"Routine upstream initiation vs deferred selective use of glycoprotein IIb\/IIIa inhibitors in acute coronary syndromes: the ACUITY Timing trial","volume":"297","author":"Stone","year":"2007","journal-title":"JAMA"},{"key":"10.1016\/j.jacc.2009.07.019_bib10","doi-asserted-by":"crossref","first-page":"256","DOI":"10.7326\/0003-4819-115-4-256","article-title":"Hemorrhagic events during therapy with recombinant tissue-type plasminogen activator, heparin, and aspirin for acute myocardial infarction","volume":"115","author":"Bovill","year":"1991","journal-title":"Ann Intern Med"},{"key":"10.1016\/j.jacc.2009.07.019_bib11","series-title":"Nutritional Anemias: Report of a WHO Scientific Group","year":"1968"},{"key":"10.1016\/j.jacc.2009.07.019_bib12","doi-asserted-by":"crossref","first-page":"31","DOI":"10.1159\/000180580","article-title":"Prediction of creatinine clearance from serum creatinine","volume":"16","author":"Cockcroft","year":"1976","journal-title":"Nephron"},{"key":"10.1016\/j.jacc.2009.07.019_bib13","doi-asserted-by":"crossref","first-page":"2344","DOI":"10.1161\/CIRCULATIONAHA.106.685313","article-title":"Clinical endpoints in coronary stent trials: a case for standardized definitions","volume":"115","author":"Cutlip","year":"2007","journal-title":"Circulation"},{"key":"10.1016\/j.jacc.2009.07.019_bib14","doi-asserted-by":"crossref","first-page":"547","DOI":"10.1016\/j.jacc.2004.03.080","article-title":"Impact of anemia in patients with acute myocardial infarction undergoing primary percutaneous coronary intervention: analysis from the Controlled Abciximab and Device Investigation to Lower Late Angioplasty Complications (CADILLAC) trial","volume":"44","author":"Nikolsky","year":"2004","journal-title":"J Am Coll Cardiol"},{"key":"10.1016\/j.jacc.2009.07.019_bib15","doi-asserted-by":"crossref","first-page":"67","DOI":"10.1016\/j.ahj.2004.06.003","article-title":"Impact of age on management and outcome of acute coronary syndrome: observations from the Global Registry of Acute Coronary Events (GRACE)","volume":"149","author":"Avezum","year":"2005","journal-title":"Am Heart J"},{"key":"10.1016\/j.jacc.2009.07.019_bib16","doi-asserted-by":"crossref","first-page":"845","DOI":"10.1053\/j.ajkd.2005.07.043","article-title":"Outcomes of acute coronary syndrome in a large Canadian cohort: impact of chronic renal insufficiency, cardiac interventions, and anemia","volume":"46","author":"Keough-Ryan","year":"2005","journal-title":"Am J Kidney Dis"},{"key":"10.1016\/j.jacc.2009.07.019_bib17","doi-asserted-by":"crossref","first-page":"1645","DOI":"10.1016\/j.jacc.2007.11.081","article-title":"Safety and efficacy of bivalirudin monotherapy in patients with diabetes mellitus and acute coronary syndromes: a report from the ACUITY (Acute Catheterization and Urgent Intervention Triage Strategy) trial","volume":"51","author":"Feit","year":"2008","journal-title":"J Am Coll Cardiol"},{"key":"10.1016\/j.jacc.2009.07.019_bib18","doi-asserted-by":"crossref","first-page":"1490","DOI":"10.1016\/j.jacc.2005.06.072","article-title":"The implications of blood transfusions for patients with non-ST-segment elevation acute coronary syndromes: results from the CRUSADE National Quality Improvement Initiative","volume":"46","author":"Yang","year":"2005","journal-title":"J Am Coll Cardiol"},{"key":"10.1016\/j.jacc.2009.07.019_bib19","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":"10.1016\/j.jacc.2009.07.019_bib20","doi-asserted-by":"crossref","first-page":"474","DOI":"10.1016\/j.amjcard.2005.04.005","article-title":"Impact of in-hospital acquired thrombocytopenia in patients undergoing primary angioplasty for acute myocardial infarction","volume":"96","author":"Nikolsky","year":"2005","journal-title":"Am J Cardiol"},{"key":"10.1016\/j.jacc.2009.07.019_bib21","doi-asserted-by":"crossref","first-page":"734","DOI":"10.1016\/j.jacc.2007.01.003","volume":"49","author":"Grines","year":"2007","journal-title":"J Am Coll Cardiol"},{"key":"10.1016\/j.jacc.2009.07.019_bib22","doi-asserted-by":"crossref","first-page":"456","DOI":"10.1016\/j.jacc.2004.11.041","article-title":"Coronary syndromes following aspirin withdrawal: a special risk for late stent thrombosis","volume":"45","author":"Ferrari","year":"2005","journal-title":"J Am Coll Cardiol"},{"key":"10.1016\/j.jacc.2009.07.019_bib23","doi-asserted-by":"crossref","first-page":"1731","DOI":"10.1136\/gut.2005.080754","article-title":"Risk of upper gastrointestinal ulcer bleeding associated with selective cyclo-oxygenase-2 inhibitors, traditional non-aspirin non-steroidal anti-inflammatory drugs, aspirin and combinations","volume":"55","author":"Lanas","year":"2006","journal-title":"Gut"},{"key":"10.1016\/j.jacc.2009.07.019_bib24","doi-asserted-by":"crossref","first-page":"1080","DOI":"10.1016\/j.ahj.2008.07.026","article-title":"Design and rationale of CURRENT-OASIS 7: a randomized, 2 x 2 factorial trial evaluating optimal dosing strategies for clopidogrel and aspirin in patients with ST and non-ST-elevation acute coronary syndromes managed with an early invasive strategy","volume":"156","author":"Mehta","year":"2008","journal-title":"Am Heart J"},{"key":"10.1016\/j.jacc.2009.07.019_bib25","doi-asserted-by":"crossref","first-page":"65","DOI":"10.1001\/jama.1994.03520010077036","article-title":"Helicobacter pylori in peptic ulcer disease","volume":"272","year":"1994","journal-title":"JAMA"},{"key":"10.1016\/j.jacc.2009.07.019_bib26","doi-asserted-by":"crossref","first-page":"1345","DOI":"10.1007\/BF02065549","article-title":"Nonsteroidal antiinflammatory drugs and dyspepsia in the elderly","volume":"40","author":"Talley","year":"1995","journal-title":"Dig Dis Sci"},{"key":"10.1016\/j.jacc.2009.07.019_bib27","doi-asserted-by":"crossref","first-page":"434","DOI":"10.1097\/00001648-200007000-00012","article-title":"Smoking and alcohol intake as risk factors for bleeding and perforated peptic ulcers: a population-based cohort study","volume":"11","author":"Andersen","year":"2000","journal-title":"Epidemiology"},{"key":"10.1016\/j.jacc.2009.07.019_bib28","doi-asserted-by":"crossref","first-page":"881","DOI":"10.1016\/S0140-6736(94)90007-8","article-title":"Randomised trial of coronary intervention with antibody against platelet IIb\/IIIa integrin for reduction of clinical restenosis: results at six months","volume":"343","author":"Topol","year":"1994","journal-title":"Lancet"},{"key":"10.1016\/j.jacc.2009.07.019_bib29","first-page":"1861","article-title":"Platelet glycoprotein IIb\/IIIa receptor blockade and low-dose heparin during percutaneous coronary revascularization","volume":"339","year":"1998","journal-title":"N Engl J Med"},{"key":"10.1016\/j.jacc.2009.07.019_bib30","first-page":"87","article-title":"Evaluation of Platelet IIb\/IIIa Inhibitor for Stenting","volume":"352","year":"1998","journal-title":"Lancet"},{"key":"10.1016\/j.jacc.2009.07.019_bib31","doi-asserted-by":"crossref","first-page":"1498","DOI":"10.1056\/NEJM199805213382103","article-title":"A comparison of aspirin plus tirofiban with aspirin plus heparin for unstable angina","volume":"338","year":"1998","journal-title":"N Engl J Med"},{"key":"10.1016\/j.jacc.2009.07.019_bib32","doi-asserted-by":"crossref","first-page":"436","DOI":"10.1056\/NEJM199808133390704","article-title":"Inhibition of platelet glycoprotein IIb\/IIIa with eptifibatide in patients with acute coronary syndromes","volume":"339","year":"1998","journal-title":"N Engl J Med"},{"key":"10.1016\/j.jacc.2009.07.019_bib33","doi-asserted-by":"crossref","first-page":"529","DOI":"10.1016\/j.jacc.2007.09.053","article-title":"The relative safety and efficacy of abciximab and eptifibatide in patients undergoing primary percutaneous coronary intervention: insights from a large regional registry of contemporary percutaneous coronary intervention","volume":"51","author":"Gurm","year":"2008","journal-title":"J Am Coll Cardiol"},{"key":"10.1016\/j.jacc.2009.07.019_bib34","doi-asserted-by":"crossref","first-page":"1631","DOI":"10.1056\/NEJMoa065703","article-title":"Omeprazole before endoscopy in patients with gastrointestinal bleeding","volume":"356","author":"Lau","year":"2007","journal-title":"N Engl J Med"},{"key":"10.1016\/j.jacc.2009.07.019_bib35","doi-asserted-by":"crossref","first-page":"238","DOI":"10.1056\/NEJMoa042087","article-title":"Clopidogrel versus aspirin and esomeprazole to prevent recurrent ulcer bleeding","volume":"352","author":"Chan","year":"2005","journal-title":"N Engl J Med"},{"key":"10.1016\/j.jacc.2009.07.019_bib36","doi-asserted-by":"crossref","first-page":"256","DOI":"10.1016\/j.jacc.2007.06.064","article-title":"Influence of omeprazole on the antiplatelet action of clopidogrel associated with aspirin: the randomized, double-blind OCLA (Omeprazole CLopidogrel Aspirin) study","volume":"51","author":"Gilard","year":"2008","journal-title":"J Am Coll Cardiol"},{"key":"10.1016\/j.jacc.2009.07.019_bib37","doi-asserted-by":"crossref","first-page":"937","DOI":"10.1001\/jama.2009.261","article-title":"Risk of adverse outcomes associated with concomitant use of clopidogrel and proton pump inhibitors following acute coronary syndrome","volume":"301","author":"Ho","year":"2009","journal-title":"JAMA"}],"container-title":["Journal of the American College of Cardiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S0735109709024991?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S0735109709024991?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T12:33:46Z","timestamp":1760013226000},"score":1,"resource":{"primary":{"URL":"https:\/\/linkinghub.elsevier.com\/retrieve\/pii\/S0735109709024991"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2009,9]]},"references-count":37,"journal-issue":{"issue":"14","published-print":{"date-parts":[[2009,9]]}},"alternative-id":["S0735109709024991"],"URL":"https:\/\/doi.org\/10.1016\/j.jacc.2009.07.019","relation":{},"ISSN":["0735-1097"],"issn-type":[{"value":"0735-1097","type":"print"}],"subject":[],"published":{"date-parts":[[2009,9]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"Gastrointestinal Bleeding in Patients With Acute Coronary Syndromes: Incidence, Predictors, and Clinical Implications","name":"articletitle","label":"Article Title"},{"value":"Journal of the American College of Cardiology","name":"journaltitle","label":"Journal Title"},{"value":"https:\/\/doi.org\/10.1016\/j.jacc.2009.07.019","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"article","name":"content_type","label":"Content Type"},{"value":"Copyright \u00a9 2009 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.","name":"copyright","label":"Copyright"}]}}