Aim. To assess the effectiveness of transfusion therapy during cardiac surgery in different types of preoperative antiplatelet therapy with the expansion of diagnostic tests of hemostasis. Material and methods. Retrospective evaluation of 1356 patients with coronary artery disease (CAD) and coronary artery bypass grafting (CABG) under cardiopulmonary bypass for the period 2012—2014 was performed. From the standpoint of transfusion strategy three periods were retrospectively compared: 1) standard transfusion strategy based on coagulogram data, retrospective period of 2012 (the main component is abolition of antiplatelet agents prior to surgery); 2) extended transfusion therapy including correction of certain clotting factors without the abolition of antiplatelet agents, retrospective period of 2013; 3) the goal-directed correction of hemostasis disorders, retrospective period of 2014. Results. The inclusion of additional parameters for instrumental evaluation of platelet and coagulation hemostasis allows significant reducing total number of transfusion procedures and optimizing the structure of transfusion support. Conclusion. We demonstrate the safety of preserved preoperative full antiplatelet therapy before cardiac surgery in case of purposeful correction of hemostasis in postoperative period.