Post‑CABG Pharmacologic Management Guidelines
Antiplatelet Therapy
- Initiate aspirin within 6 hours after surgery at a dose of 100–325 mg daily and continue indefinitely to preserve graft patency and provide cardiovascular protection (Class I, Level A). American College of Cardiology/American Heart Association guideline. 1
Beta‑Blocker Therapy
- Reinstitute beta‑blockers as soon as feasible after CABG in all patients without contraindications (Class I recommendation, Level A evidence). American College of Cardiology/American Heart Association guideline. 4
Statin Therapy
- Maintain or start high‑intensity statin therapy perioperatively; discontinuation is contraindicated because it is harmful (Class III: Harm, Level A). American College of Cardiology/American Heart Association guideline. 2
Renin‑Angiotensin System Inhibitors
- Resume ACE‑inhibitor or ARB therapy once the patient is hemodynamically stable after surgery (Class I recommendation). American College of Cardiology/American Heart Association guideline. 5
Pain Management
Non‑Opioid Analgesia
- Use acetaminophen as the first‑line non‑opioid analgesic for postoperative pain. American College of Cardiology/American Heart Association guideline. 1
Non‑Pharmacologic Strategies
- Employ positioning, early mobilization, and other non‑pharmacologic measures to complement analgesia. American College of Cardiology/American Heart Association guideline. 1
Clinical Monitoring Requirements
Perform continuous electrocardiographic monitoring for at least 48 hours after CABG to detect arrhythmias. American College of Cardiology/American Heart Association guideline. 1
Maintain a mean arterial pressure > 60 mm Hg, especially in patients with pre‑existing renal dysfunction, to ensure adequate organ perfusion. American College of Cardiology/American Heart Association guideline. 4