In patients referred for urgent CABG, it may be reasonable to perform surgery less than 5 days after clopidogrel or ticagrelor has been discontinued and less than 7 days after prasugrel has been discontin- ued. (Level of Evidence: C) In-hospital CABG is performed in 7% to 13% of patients hospitalized with NSTE-ACS.420 422 Approximately one third of patients with NSTEMI undergo CABG within 48 hours of In these patients, CABG was performed at a median time of 73 hours after admission (interquartile In-hospital mortality in patients with NSTEMI undergoing CABG is approximately 3.7%.421 Recommendations for management of patients treated with oral and intravenous antiplatelet agents who undergo CABG are given in the 2011 CABG CPG.23 Preoperative aspirin reduces operative morbidity and mortality, and CABG can be performed safely in patients on aspirin therapy with only a modest increase in bleeding risk.23,408 410 The use of inhibitors in patients with NSTE-ACS is associated with an increase in post CABG bleeding and the need for Although it is recommended that clopidogrel and ticagrelor be discontinued at least 5 days before surgery and prasugrel at least 7 days before surgery in patients referred for elective CABG,23,411 413 the timing of CABG in patients with NSTE-ACS treated with a P2Y12 should reflect a balance of the potential increase in bleeding against the potential benefits of not delaying sur- gery 5 to 7 days. 