Preoperative and postoperative beta blockers (or possibly amiodarone) are most effective at reducing its incidence, with several RCTs showing that they effectively accomplish this goal. In contrast, glucocorticoste- roids, hormonal agents, and statins are not effective at decreasing its occurrence.604 606,608b,608c,1042 In subjects with- out pre-CABG AF, post-CABG AF usually resolves sponta- neously within 6 weeks of surgery. As a result, the preferred management strategy of post-CABG AF in such patients often consists of control of the ventricular rate (with beta blockers) in anticipation of spontaneous reversion to sinus rhythm within a few weeks. In addition, if the patient is considered to be at risk for a thromboembolic event while in AF, anticoagulation (with heparin and then warfarin) is warranted. For a more detailed description of the manage- ment of subjects with postoperative AF, the reader is referred to the 2011 ACCF/AHA/HRS guidelines for the Management of Patients with Atrial Fibrillation.608 5.2.6. Perioperative Bleeding/ Transfusion: Recommendations Class I 1. Lysine analogues are useful intraoperatively and postoperatively in patients undergoing on-pump CABG to reduce perioperative blood loss and trans- fusion requirements.1044 1051 (Level of Evidence: A) 2. A multimodal approach with transfusion algorithms, point-of-care testing, and a focused blood conservation strategy should be used to limit the number of trans- fusions.1052 1057 (Level of Evidence: A) 3. In patients taking thienopyridines (clopidogrel or prasugrel) or ticagrelor in whom elective CABG is planned, clopidogrel and ticagrelor should be with- held for at least 5 days520,521,523,524,531,1058 1063 (Level of Evidence: B) and prasugrel for at least 7 days533 (Level of Evidence: C) before surgery. 4. It is recommended that surgery be delayed after the administration of streptokinase, urokinase, and tissue-type plasminogen activators until hemostatic capacity is restored, if possible. 