In patients who are receiving antiplatelet drugs, we suggest against the routine use of platelet function assays to monitor the antithrombotic effect of aspirin or clopidogrel. (2C)

For patients who are not at high risk for cardiac events, we recommend interruption of antiplatelet drugs .. (1C) For patients at high risk of cardiac events (exclusive of coronary stents) scheduled for noncardiac surgery,we suggest continuing aspirin up to and beyond the time of surgery (Grade 2C); if patients arereceiving clopidogrel, we suggest interrupting clopidogrel at least 5 days and, preferably,within 10 days prior to surgery .. (2C) In patients scheduled for CABG, we recommend continuing aspirin up to and beyond the time of CABG (Grade 1 C); if aspirin is interrupted, we recommend it be reinitiated between 6 hand 48h after CABG .. (1C) In patients scheduled for CABG, we recommend interrupting clopidogrel at least 5 days and, preferably, 10days prior to surgery .. (1C) In patients scheduled for PCI, we suggest continuing aspirin up to and beyond the time of the procedure;if clopidogrel is interrupted prior to PCI, we suggest resuming clopidogrel after PCI with a loading dose of 300 to 600 mg. (2C)

In patients with a bare metal coronary stent who require surgery within 6 weeks of stent placement, we recommend continuing aspirin and clopidogrel in the perioperative period .. (1C) In patients with a drug-eluting coronary stent who require surgery within 12 months of stent placement, we recommend continuing aspirin and clopidogrel in the perioperative period .. (1C) In patients with a coronary stent who have interruption of antiplatelet therapy before surgery, we suggest against the routine use of bridging therapy with UFH, LMWH, direct thrombin inhibitors, or glycoprotein IIb/IIIa inhibitors. (2C)

In patients who are undergoing minor dental procedures and are receiving VKAs, we recommend continuing VKAs around the time of the procedure and coadministering an oral prohemostatic agent. (1B) In patients who are undergoing minor dental procedures and are receiving aspirin, we recommend continuing aspirin around the time of the procedure. (1C)

In patients who are undergoing cataract removal and are receiving VKAs, we recommend continuing VKAs around the time of the procedure. (1C) In patients who are undergoing cataract removal and are receiving aspirin, we recommend continuing aspirin around the time of the procedure. (1C)

In patients who are receiving VKAs and require reversal of the anticoagulant effect for an urgent surgical or other invasive procedure, we recommend treatment with low-dose (2.5 to 5.0mg) IV or oral vitamin K.. (1C) For more immediate reversal of the anticoagulant effect, we suggest treatment with fresh-frozen plasma or another prothrombin concentrate in addition to low-dose IV or oral vitamin K. (2C)

For patients receiving aspirin, clopi-ogrel, or both, are undergoing surgery, and have excessive or life-threatening perioperative bleeding, we suggest transfusion of platelets or administration of other prohemostatic agents. (2C)

In patients who are undergoing minor dermatologic procedures and are receiving VKAs, we recommend continuing VKAs around the time of the procedure. (1B) In patients who are undergoing minor dermatologic procedures and are receiving aspirin, we recommend continuing aspirin around the time of the procedure. (1B)

In patients who require temporary inter-ruption of aspirin- or clopidogrel-containing drugs before surgery or a procedure, we suggest stopping this treatment 7 to 10 days before the procedure over stopping this treatment closer to surgery. (2C)

Early and continuous patient education, information, and coaching within a multidisciplinary approach is advised to holistically support and empower patients. (V, A)