(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. The risk of major bleeding complications is increased when CABG is performed <24 hours after dis- continuation of clopidogrel.23,416,417 In patients who undergo CABG 1 to 4 days after discontinuation of clopidogrel, it appears that the incidence of life-threatening bleeding is not significantly increased, but an increase in blood transfusions is In the TRITON-TIMI 38 trial,302 the inci- dence of CABG-related major bleeding was higher in patients treated with prasugrel than in patients treated with clopido- In the PLATO trial, the rates of major bleeding and transfusion requirements were similar between patients treated with ticagrelor and patients treated with clopidogrel.294 The more rapid recovery of platelet function in pharmacokinetic Table 9. 