The authors evaluated the change in risk profile of 65097 patients who underwent CABG between 1997 and 2011 in the Veterans Affairs Surgical Quality Improvement Program (VASQIP). They found that there was a marked increase in the prevalence of obesity, diabetes, left main coronary artery disease and NYHA class. Prevalences of previous myocardial infarction, low ejection fraction and advanced angina decreased. Importantly, operative mortality decreased over time. The trends confirm the general perception of ongoing improvement in outcomes, despite a sicker and older population.