Which preoperative medication must be discontinued at least 5 days before CABG?

Which preoperative medication must be discontinued at least 5 days before CABG?

• A. Anticoagulants
• B. Antiplatelets
• C. Beta blockers
• D. Statin

Answer: (B)

When preparing for CABG, stopping antiplatelet therapy is essential to reduce bleeding risk during and after the operation. Antiplatelet drugs work by irreversibly inhibiting platelet function (for example, aspirin blocks thromboxane production, and P2Y12 inhibitors like clopidogrel prevent platelet activation). Because platelets live about 7 to 10 days, their function doesn’t recover until new platelets are produced. Giving a window of roughly five days (often longer for some agents) allows enough platelet turnover so surgical bleeding is more controllable. Beta blockers and statins are usually continued around the time of CABG, as they don’t pose the same bleeding risk and have protective perioperative benefits. Anticoagulants are also stopped, but they’re managed with their own strategy (often with bridging), so the emphasis for the “must be discontinued at least 5 days before” question is on antiplatelet therapy.

When preparing for CABG, stopping antiplatelet therapy is essential to reduce bleeding risk during and after the operation. Antiplatelet drugs work by irreversibly inhibiting platelet function (for example, aspirin blocks thromboxane production, and P2Y12 inhibitors like clopidogrel prevent platelet activation). Because platelets live about 7 to 10 days, their function doesn’t recover until new platelets are produced. Giving a window of roughly five days (often longer for some agents) allows enough platelet turnover so surgical bleeding is more controllable.

Beta blockers and statins are usually continued around the time of CABG, as they don’t pose the same bleeding risk and have protective perioperative benefits. Anticoagulants are also stopped, but they’re managed with their own strategy (often with bridging), so the emphasis for the “must be discontinued at least 5 days before” question is on antiplatelet therapy.