Trial reportCirculation2011
Secondary prevention after coronary artery bypass graft surgery: findings of a national randomized controlled trial and sustained society-led incorporation into practice.
Trial report in Circulation, 2011. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 papers, 3 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
22 citing papers in PubMed, 3 syntheses or guidelines pooled it, 79 citations in OpenAlex.
- Effectiveness of quality improvement interventions in improving cardiovascular disease-related outcomes in primary and tertiary care: A systematic review and meta-analyses.BMC primary care · 2025Pooled it
- European guidelines on cardiovascular disease prevention in clinical practice (version 2012) : the fifth joint task force of the European society of cardiology and other societies on cardiovascular disease prevention in clinical practice (constituted by representatives of nine societies and by invited experts).International journal of behavioral medicine · 2012Guideline
- Audit and feedback: effects on professional practice and healthcare outcomes.The Cochrane database of systematic reviews · 2012Pooled it
- Relationship between postoperative clopidogrel use and subsequent angiographic and clinical outcomes following coronary artery bypass grafting.Journal of thrombosis and thrombolysis · 2013Trial
- Edifoligide and long-term outcomes after coronary artery bypass grafting: PRoject of Ex-vivo Vein graft ENgineering via Transfection IV (PREVENT IV) 5-year results.American heart journal · 2012Trial
- Strategies to Improve Health Care Provider Prescription of and Patient Adherence to Guideline-Recommended Cardiovascular Medications for Atherosclerotic Occlusive Disease: Protocol for Two Systematic Reviews and Meta-Analyses of Randomized Controlled Trials.JMIR research protocols · 2025Article
- Medical Therapy After CABG: the Known Knowns, the Known Unknowns, and the Unknown Unknowns.Cardiovascular drugs and therapy · 2024Review
- The MONARCH intervention to enhance the quality of antenatal and postnatal primary health services in rural South Africa: protocol for a stepped-wedge cluster-randomised controlled trial.BMC health services research · 2018Article
- Pharmacotherapy Evaluation and Utilization in Coronary Artery Bypass Grafting Patients in Kosovo during the Period 2016-2017.Open access Macedonian journal of medical sciences · 2018Article
- Do practice gaps exist in evidence-based medication prescription at hospital discharge in patients undergoing coronary artery bypass surgery & coronary angioplasty?The Indian journal of medical research · 2017Article
- Comparative Efficacy of Coronary Revascularization Procedures for Multivessel Coronary Artery Disease in Patients With Chronic Kidney Disease.The American journal of cardiology · 2017Article
- Heart Disease and Stroke Statistics-2017 Update: A Report From the American Heart Association.Circulation · 2017Review
- Optimal medical therapy is vital for patients with coronary artery disease and acute coronary syndromes regardless of revascularization strategy.Annals of translational medicine · 2017Article
- Physiology ofWorld journal of cardiology · 2016Review
- Letters.The Ulster medical journal · 2016Article
- Impact of statins and beta-blocker therapy on mortality after coronary artery bypass graft surgery.Cardiovascular diagnosis and therapy · 2015Article
- Heart disease and stroke statistics--2014 update: a report from the American Heart Association.Circulation · 2014Article
- Heart disease and stroke statistics--2013 update: a report from the American Heart Association.Circulation · 2013Review
- Recent Trends in Adherence to Secondary Prevention Guidelines for Patients Undergoing Coronary Revascularization in Washington State: An Analysis of the Clinical Outcomes Assessment Program (COAP) Registry.Journal of the American Heart Association · 2012Article
- Long-term survival of patients with ischemic cardiomyopathy treated by coronary artery bypass grafting versus medical therapy.The Annals of thoracic surgery · 2012Article
Corrections and comments
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Authors and funding
7 authors at 1 institution in 1 country.
Funding
Abstract
backgroundDespite evidence supporting the use of aspirin, β-blockers, angiotensin-converting enzyme inhibitors, and lipid-lowering therapies in eligible patients, adoption of these secondary prevention measures after coronary artery bypass grafting has been inconsistent. We sought to rigorously test on a national scale whether low-intensity continuous quality improvement interventions can be used to speed secondary prevention adherence after coronary artery bypass grafting. METHODS AND
resultsA total of 458 hospitals participating in the Society of Thoracic Surgeons National Cardiac Database and treating 361 328 patients undergoing isolated coronary artery bypass grafting were randomized to either a control or an intervention group. The intervention group received continuous quality improvement materials designed to influence the prescription of the secondary prevention medications at discharge. The primary outcome measure was discharge prescription rates of the targeted secondary prevention medications at intervention versus control sites, assessed by measuring preintervention and postintervention site differences. Prerandomization treatment patterns and baseline data were similar in the control (n=234) and treatment (n=224) groups. Individual medication use and composite adherence increased over 24 months in both groups, with a markedly more rapid rate of adherence uptake among the intervention hospitals and a statistically significant therapy hazard ratio in the intervention versus control group for all 4 secondary prevention medications.
conclusionsProvider-led, low-intensity continuous quality improvement efforts can improve the adoption of care processes into national practice within the context of a medical specialty society infrastructure. The findings of the present trial have led to the incorporation of study outcome metrics into a medical society rating system for ongoing quality improvement.
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What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.