{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,2]],"date-time":"2026-06-02T05:17:50Z","timestamp":1780377470265,"version":"3.54.1"},"reference-count":15,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"6","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2015,6,15]]},"abstract":"\n Background<\/jats:title>\n \n Little is known about the incidence, predictors, or outcomes of intracranial hemorrhage (\n ICH<\/jats:styled-content>\n ) in patients with non\u2013\n ST<\/jats:styled-content>\n \u2010segment elevation acute coronary syndromes (\n NSTE ACS<\/jats:styled-content>\n ). We aimed to determine the incidence and timing of\n ICH<\/jats:styled-content>\n , characterize the location of\n ICH<\/jats:styled-content>\n , and identify independent baseline predictors of\n ICH<\/jats:styled-content>\n in\n NSTE ACS<\/jats:styled-content>\n patients.\n <\/jats:p>\n <\/jats:sec>\n \n Methods and Results<\/jats:title>\n \n We pooled patient\u2010level data from 4 contemporary antithrombotic therapy trials. Multivariable modeling identified independent predictors of\n ICH<\/jats:styled-content>\n .\n ICH<\/jats:styled-content>\n s were adjudicated by a clinical events committee. Of 37\u00a0815 patients, 135 (0.4%) had an\n ICH<\/jats:styled-content>\n . The median (25th, 75th percentiles) follow\u2010up was 332 (184, 434) days but differed across trials. Locations of\n ICH<\/jats:styled-content>\n were intracerebral (50%), subdural (31%), subarachnoid (18.5%), and intraventricular (11%). Independent predictors of\n ICH<\/jats:styled-content>\n were older age (\n HR<\/jats:styled-content>\n per 10\u00a0years, 1.61; 95%\n CI<\/jats:styled-content>\n , 1.35 to 1.91); prior stroke\/transient ischemic attack;\n HR<\/jats:styled-content>\n , 1.95; 95%\n CI<\/jats:styled-content>\n , 1.14 to 3.35), higher systolic blood pressure;\n HR<\/jats:styled-content>\n per 10\u00a0mm\u00a0Hg increase, 1.09; 95%\n CI<\/jats:styled-content>\n , 1.01 to 1.18), and larger number of antithrombotic agents (\n HR<\/jats:styled-content>\n per each additional agent, 2.06; 95%\n CI<\/jats:styled-content>\n , 1.49 to 2.84). Of all\n ICH<\/jats:styled-content>\n s, 45 (33%) were fatal.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n \n In patients with\n NSTE ACS<\/jats:styled-content>\n enrolled in recent clinical trials of antithrombotic therapies,\n ICH<\/jats:styled-content>\n was uncommon. Patients with older age, prior transient ischemic attack\/stroke, higher systolic blood pressure, or larger number of antithrombotic agents were at increased risk. One\u2010third of patients with\n ICH<\/jats:styled-content>\n died. These data may be useful to trialists and data and safety monitoring committees for trial conduct and monitoring.\n <\/jats:p>\n <\/jats:sec>\n \n Clinical Trial Registration<\/jats:title>\n \n URL:\n https:\/\/www.clinicaltrials.gov\/<\/jats:ext-link>\n . Unique identifiers: TRACER: NCT00527943, PLATO: NCT00391872, APPRAISE\u20102: NCT00831441, TRILOGY ACS: NCT00699998.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1161\/jaha.114.001512","type":"journal-article","created":{"date-parts":[[2015,6,19]],"date-time":"2015-06-19T03:00:12Z","timestamp":1434682812000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":22,"title":["Meta\u2010Analysis of Intracranial Hemorrhage in Acute Coronary Syndromes: Incidence, Predictors, and Clinical Outcomes"],"prefix":"10.1161","volume":"4","author":[{"given":"Kenneth W.","family":"Mahaffey","sequence":"first","affiliation":[{"name":"Department of Medicine, Stanford University, Stanford, CA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rebecca","family":"Hager","sequence":"additional","affiliation":[{"name":"Duke Clinical Research Institute, Durham, NC"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel","family":"Wojdyla","sequence":"additional","affiliation":[{"name":"Duke Clinical Research Institute, Durham, NC"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Harvey D.","family":"White","sequence":"additional","affiliation":[{"name":"Green Lane Cardiovascular Service, Auckland, New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul W.","family":"Armstrong","sequence":"additional","affiliation":[{"name":"Division of Cardiology, University of Alberta, Edmonton, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John H.","family":"Alexander","sequence":"additional","affiliation":[{"name":"Duke Clinical Research Institute, Durham, NC"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pierluigi","family":"Tricoci","sequence":"additional","affiliation":[{"name":"Duke Clinical Research Institute, Durham, NC"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Renato D.","family":"Lopes","sequence":"additional","affiliation":[{"name":"Duke Clinical Research Institute, Durham, NC"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"E. Magnus","family":"Ohman","sequence":"additional","affiliation":[{"name":"Duke Clinical Research Institute, Durham, NC"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew T.","family":"Roe","sequence":"additional","affiliation":[{"name":"Duke Clinical Research Institute, Durham, NC"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert A.","family":"Harrington","sequence":"additional","affiliation":[{"name":"Department of Medicine, Stanford University, Stanford, CA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lars","family":"Wallentin","sequence":"additional","affiliation":[{"name":"Department of Medical Sciences, Uppsala Clinical Research Center, Uppsala University, Uppsala, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_5_2_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1109719"},{"key":"e_1_3_5_3_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa0904327"},{"key":"e_1_3_5_4_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1105819"},{"key":"e_1_3_5_5_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1205512"},{"key":"e_1_3_5_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ahj.2009.07.001"},{"key":"e_1_3_5_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ahj.2009.01.003"},{"key":"e_1_3_5_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ahj.2010.04.022"},{"key":"e_1_3_5_9_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.98.14.1376"},{"key":"e_1_3_5_10_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa0706482"},{"key":"e_1_3_5_11_2","first-page":"45","article-title":"Enoxaparin vs unfractionated heparin in high\u2010risk patients with non\u2010ST\u2010segment elevation acute coronary syndromes managed with an intended early invasive strategy: primary results of the SYNERGY randomized trial","volume":"292","author":"Ferguson JJ","year":"2004","unstructured":"Ferguson JJ, Califf RM, Antman EM, Cohen M, Grines CL, Goodman S, Kereiakes DJ, Langer A, Mahaffey KW, Nessel CC, Armstrong PW, Avezum A, Aylward P, Becker RC, Biasucci L, Borzak S, Col J, Frey MJ, Fry E, Gulba DC, Guneri S, Gurfinkel E, Harrington R, Hochman JS, Kleiman NS, Leon MB, Lopez\u2010Sendon JL, Pepine CJ, Ruzyllo W, Steinhubl SR, Teirstein PS, Toro\u2010Figueroa L, White H; SYNERGY Trial Investigators . Enoxaparin vs unfractionated heparin in high\u2010risk patients with non\u2010ST\u2010segment elevation acute coronary syndromes managed with an intended early invasive strategy: primary results of the SYNERGY randomized trial. JAMA. 2004;292:45\u201354.","journal-title":"JAMA"},{"key":"e_1_3_5_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcin.2013.03.010"},{"key":"e_1_3_5_13_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199808133390704"},{"key":"e_1_3_5_14_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1200933"},{"key":"e_1_3_5_15_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.STR.0000080678.09344.8D"},{"key":"e_1_3_5_16_2","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp-2011-300371"}],"container-title":["Journal of the American Heart Association"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ahajournals.org\/doi\/full\/10.1161\/JAHA.114.001512","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,13]],"date-time":"2024-05-13T10:02:01Z","timestamp":1715594521000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ahajournals.org\/doi\/10.1161\/JAHA.114.001512"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2015,6,15]]},"references-count":15,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2015,6,15]]}},"alternative-id":["10.1161\/JAHA.114.001512"],"URL":"https:\/\/doi.org\/10.1161\/jaha.114.001512","relation":{},"ISSN":["2047-9980"],"issn-type":[{"value":"2047-9980","type":"electronic"}],"subject":[],"published":{"date-parts":[[2015,6,15]]},"assertion":[{"value":"2014-10-10","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2015-05-13","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2015-06-18","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e001512"}}