VIII. MEDICATIONS
A. Perioperative
1. Aspirin
Aspirin given perioperatively has been shown to reduce graft occlusion.
2. Beta-Adrenergic Blockers
Beta-blockers have been shown to decrease morbidity and mortality following cardiac surgery and other forms of surgery. These agents quell the effects of catecholamines and allow safer induction of anesthesia and help to prevent the hypertensive response to endotracheal intubation. They also prevent recurrent arrhythmias and have been shown to improve morbidity and mortality. Atenolol has been shown in a randomized controlled trial to reduce morbid¬ity and mortality when given before operation and one week postoperatively. In a randomized controlled trial of 1351 high-risk patients undergoing vascular surgery, biso-prolol significantly reduced events ( P < 0.001). Bisoprolol was commenced one week preoperatively and continued for 30 days postoperatively. There were two deaths and no myocardial infarctions versus nine deaths and nine infarctions in the untreated group.
B. Postoperative Maintenance
Maintenance medications that are given after coronary bypass surgery include aspirin, beta-adrenergic blockers, statins, and calcium antagonists.
1. Aspirin
Coated aspirin 325 mg daily is given to patients indefi¬nitely to prevent graft occlusion and to prevent recurrent fatal or nonfatal myocardial infarction.