Those undergoing CABG 6 hours after symptom onset had a lower in-hospital and long-term (10 years) mortality rate than those undergoing CABG 6 hours after symptom onset.237 Other studies have provided conflicting results, because of, at least in part, the lack of clear delinea- tion between STEMI and NSTEMI patients in these large database reports.259,265 In an analysis of 9476 patients hospi- talized with an acute coronary syndrome (ACS) who under- went CABG during the index hospitalization, 1344 (14%) were STEMI patients with shock or intra-aortic balloon placement preoperatively.264 These individuals had a mortal- ity rate of 4% when CABG was performed on the third hospital day, which was lower than the mortality rates reported when CABG was performed earlier or later during the hospitalization.264 In studies in which the data from STEMI patients were analyzed separately with regard to the optimal timing of CABG, however, the results appear to be different. In 1 analysis of 44 365 patients who underwent CABG after MI (22 984 with STEMI; 21 381 with NSTEMI), the inhospital mortality rate was similar in the 2 groups undergoing CABG 6 hours after diagnosis (12.5% and 11.5%, respectively), but it was higher in STEMI patients than in NSTEMI patients when CABG was performed 6 to 23 hours after diagnosis (13.6% versus 6.2%; P 0.006).262 The groups had similar in-hospital mortality rates when CABG was performed at all later time points (1 to 7 days, 8 to 14 days, and 15 days after the acute event).262 Similarly, in a study of 138 subjects with STEMI unresponsive to maximal nonsurgical therapy who underwent emergency CABG, the overall mortality rate was 8.7%, but it varied according to the time interval from symptom onset to time of operation. 