Although the incidence of life-threatening bleeding does not appear to be significantly increased during this time, an increase in blood transfusions is likely.523,524,529,531 Accordingly, from the perspective of blood conservation, it is reasonable to delay elective CABG for 5 days after discontinuing clopidogrel. For patients requiring more urgent CABG, it can be performed 24 hours after clopidogrel has been stopped with little or no increased risk of major bleeding. Approximately two thirds of clopidogrel- treated patients undergo CABG 5 days after clopidogrel discontinuation,529,532 driven largely by concerns for patient stability, resource utilization, patient preference, and the confidence of the surgical team in managing hemostasis. Little experience with CABG in patients treated with prasu- grel has been reported. In the TRITON-TIMI 38 (Trial to Assess Improvement in Therapeutic Outcomes by Optimizing Platelet Inhibition With Prasugrel Thrombolysis in Myocar- dial Infarction) trial, the incidence of CABG-related major bleeding was higher in prasugrel-treated patients than in those possible, therefore, CABG should be delayed for 7 days after prasugrel is discontinued.533 Ticagrelor, an oral agent that binds reversibly to the platelet P2Y12 receptor, provides faster, more effective, and more consistent inhibition of platelet aggregation and more rapid recovery of platelet function after discontinuation than clopi- dogrel.534 In the PLATO (Platelet Inhibition and Patient Out- comes) trial, 632 patients in the ticagrelor group and 629 in the clopidogrel group underwent CABG within 7 days of the last dose of study drug.521 Although the study protocol recom- mended waiting 5 days after stopping clopidogrel and 24 to 72 hours after ticagrelor, many patients underwent surgery before the recommended waiting times. The rates of major bleeding (59.3% with ticagrelor, 57.6% with clopidogrel) and transfusion requirements (55.7% with ticagrelor, 56.5% with clopidogrel) were similar. 