Key Points The incidence of gastrointestinal (GI) bleeding after percutaneous coronary interventional has remained stable recently although those undergoing treatment for ST‐elevation myocardial infarction appear to be doing better. Short‐term prognosis is worsened after a GI bleed and this adverse outcome persists out to at least 1 year. Poor outcomes late after a GI bleed suggest persistence patient factors that require further study to understand who is at risk, whether short‐term measures can prevent bleeding, and whether interventions after bleeding can improve long‐term outcomes.