Among the 136 patients in CLARITY-TIMI 28 who underwent CABG within 5 days of clopidogrel exposure, there was no differ- ence in the rates of major bleeding through 30 days of follow- up between the clopidogrel and placebo groups (7.5% versus In a prospective RCT exam- ining the effect of the timing of clopidogrel discontinuation before CABG, 3 groups were studied: clopidogrel continued to the day of surgery, clopidogrel discontinued 3 days before surgery, and clopidogrel discontinued 5 days before surgery. Patients in the continuation group experienced increased rates of bleeding and blood product utilization, but the 3- and 5-day discontinuation groups had comparably low bleeding rates and blood product usage that resembled historical con- In a retrospective analysis of a nonrandomized subgroup of patients in the PLATO trial, in which several definitions of bleeding were used, no significant differences in CABG-related bleeding were observed between patients allocated ticagrelor and patients who received clopidogrel, and there were no observed differences in the rates of reop- In contrast, among the relatively few patients with STEMI in TRITON-TIMI 38 who underwent CABG during the 15-month course of the study, rates of TIMI major or minor bleeding after CABG were significantly higher with prasugrel The excess bleeding hazard observed with prasugrel should prompt consideration of an alternative antiplatelet strategy in patients with STEMI who may require urgent CABG during their index hospitalization. The timing of elective CABG in relation to the use of P2Y12 receptor antagonists is referenced in Section 4.1 of the 2011 ACCF/AHA Guideline for Coronary Artery Bypass Graft 8. Routine Medical Therapies See Table 12 for a summary of selected routine medical therapies. 8.1. Beta Blockers: Recommendations Class I 1. 