A retrospective study performed before the widespread availability of fibrinolysis and primary PCI re- ported an overall in-hospital mortality rate of 5.2% in 440 STEMI patients undergoing CABG as primary reperfusion therapy. 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. 