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Figure 1. U-shaped distribution of the surgical mortality as a function of timing of coronary artery bypass grafting in patients with acute
myocardial infarction. The lowest mortality can be achieved after the hyperacute phase of systemic inflammation and before the
development of irreversible complications from myocardial injury. AKI: Acute kidney injury; LCOS: low cardiac output syndrome; LV:
left ventricle.

individual decisions regarding the optimal timing of complete revascularization for patients who suffer from
an ACS should be made with a multidisciplinary Heart Team . There seems to be a benefit in delaying
[26]
surgery by 48 h after initial ACS presentation; however, there is a paucity of data on the additional value of
further postponing surgery to a few weeks after the index event. Higher quality studies with standardized
patient selection criteria and randomized treatment assignment are required to better guide decision-
making for appropriate timing of surgical revascularization in patients who underwent primary PCI for
ACS.

DECLARATIONS
Authors contributions
Made substantial contributions to the conception and design of the study and performed all data analysis
and interpretation: Zahrai A, Rahmouni K, Rubens FD

Availability of data and materials
Not applicable.

Financial Support and Sponsorship
None.

Conflicts of Interest
All authors declared that there are no conflicts of interest.

Ethical approval and consent to participate
Not applicable.

Consent for publication
Not applicable.