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March 31, 2026Heart Lung and Circulation0 citationsOpen Access

Impact of Dedicated Cardiologist Input on the Rate of Prescription of Guideline-Directed Medical Therapy After Coronary Artery Bypass Graft Surgery—A Retrospective Cohort Study (The ROSS Effect)

MLMatthew LimRoyal Adelaide HospitalMNMau T. NguyenWomen's and Children's Health NetworkPPPeter J. PsaltisSouth Australian Health and Medical Research Institute

Key Result

The presence of a dedicated cardiologist on a cardiothoracic surgery unit significantly increased the prescription of high-intensity statins at discharge after CABG surgery (OR 2.7).

Study Design

Type

Cohort (n=572)

Multicenter

No

Structured PICO

Does dedicated cardiologist input improve the rate of prescription of guideline-directed medical therapy at discharge in patients undergoing coronary artery bypass graft surgery?

P
Population
572 consecutive patients undergoing coronary artery bypass graft (CABG) surgery (n=236 before in 2020, n=336 after in 2021), including semi-elective (MI within prior 21 days), elective (no MI within 21 days), and non-elective cases. Median age ~65, ~16-19% female, at a single center in South Australia.
I
Intervention
Dedicated cardiologist input assisting in perioperative management, including twice-weekly ward rounds on all preoperative and postoperative CABG patients, optimization of medical management, multidisciplinary meetings, and junior doctor education.
C
Comparator
Standard care without dedicated cardiologist input (historical cohort from the year 2020).
O
Outcome
Rate of individual guideline-directed medical therapy (GDMT) prescription at discharge (specifically high-intensity statins, dual antiplatelet therapy [DAPT], and glucagon-like peptide-1 receptor agonists [GLP1ra]).

Embedding a dedicated cardiologist in a cardiothoracic surgery unit significantly improves the prescription rates of guideline-directed medical therapies, such as high-intensity statins and DAPT, at discharge following CABG.

Main Result

Effect estimate: OR 2.7 (95% CI 1.61-4.5)

Absolute Event Rate: 86.36% vs 80.08%

p-value: p=<0.001

Limitations

  • Small sample size
  • Single center
  • Only one cardiologist involved
  • Changes in PBS subsidy criteria and contemporaneous publication of guidelines may have influenced prescribing behaviors
  • Single centre
  • Single cardiologist
  • Changes in Pharmaceutical Benefits Scheme (PBS) subsidy criteria
  • Contemporaneous publication of the 2021 ACC/AHA/SCAI revascularisation guidelines
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Cite This Study

Lim et al. (2026) conducted a cohort in Coronary artery bypass graft (CABG) surgery (n=572). Dedicated cardiologist input vs. Standard care (no dedicated cardiologist) was evaluated on Prescription of high-intensity statins at discharge (OR 2.7, 95% CI 1.61-4.5, p=<0.001). The presence of a dedicated cardiologist on a cardiothoracic surgery unit significantly increased the prescription of high-intensity statins at discharge after CABG surgery (OR 2.7).

synapsesocial.com/papers/6a025cbdedf6f4813859493ahttps://doi.org/10.1016/j.hlc.2025.11.004
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Prescription of secondary prevention medications, lifestyle advice, and referral to rehabilitation among acute coronary syndrome inpatients: results from a large prospective audit in Australia and New Zealand2014 · 130 citations
  2. 22011 ACCF/AHA Guideline for Coronary Artery Bypass Graft Surgery2011 · 827 citations
  3. 3Secondary Prevention After Coronary Artery Bypass Graft Surgery2010 · 80 citations
  4. 4Secondary prevention therapies in acute coronary syndrome and relation to outcomes: observational study2019 · 40 citations
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