In patients referred for urgent CABG, clopidogrel and ticagrelor should be discontinued for at least 24 hours to reduce major bleeding complications.521,523 525 (Level of Evidence: B) 4. In patients referred for CABG, short-acting intra- venous glycoprotein IIb/IIIa inhibitors (eptifibatide or tirofiban) should be discontinued for at least 2 to 4 hours before surgery526,527 and abciximab for at least 12 hours beforehand528 to limit blood loss and transfusions. (Level of Evidence: B) Class IIb 1. 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) Nearly all patients with UA or recent MI in whom CABG is performed will be taking aspirin; CABG can be performed safely in these individuals, with only a modest increase in bleeding risk. Preoperative aspirin use reduces operative morbidity and mortality rates.517,518 Although the use of thienopyridines (clopidogrel or prasugrel) is associated with improved outcomes in subjects with UA or NSTEMI,305,306 their use is associated with an increase in post-CABG bleeding and need for transfusions.520,522,529 533 The risk of major bleeding complications (ie, pericardial tampon- ade or reoperation) is increased when CABG is performed 24 hours after clopidogrel s discontinuation.524,525 Con- versely, no increase in bleeding or transfusions is noted when CABG is performed 5 days after clopidogrel has been stopped.529,532 The magnitude of bleeding risk when CABG is performed 1 to 4 days after the discontinuation of clopidogrel is less certain. 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. 