Improving the Quality of Coronary Artery Bypass Grafting

NCT07377149 | Not Yet Recruiting

• 2 other identifiers: 2025-28492025ZD0546704
• Study Type: interventional
• Target: 8,700
• Locations: 0 countries
• Sites: N/A

Brief Summary

This is a healthcare quality improvement study focused on increasing the utilization of arterial grafts in isolated coronary artery bypass grafting (CABG). Evidence indicates that arterial grafts, compared with venous grafts, provide superior long-term patency, which are recommended to use by the clinical practice guidelines. In hospitals where the use of the internal mammary artery as a graft is relatively low(\<90%) among CABG patients, multiple interventions will be implemented to improve its adoption rate. In hospitals where internal mammary artery graft utilization is already high(≥90%), various interventions will be introduced to promote the use of multiple arterial grafts (defined as the use of two or more arterial conduits). The study targets healthcare professionals as the primary subjects of intervention, with no direct interventions applied to patients during the study period. Changes in the internal mammary artery graft utilization rate and the multiple arterial graft utilization rate before and after the intervention will serve as the primary endpoints for evaluating intervention effectiveness in the two types of hospitals, respectively.

Conditions

Coronary Artery Bypass Grafting (CABG)

Keywords

coronary artery bypass grafting; quality improvement; arterial graft

Outcome Measures

Primary Outcomes (2)

• Hospitals with low usage rates of internal mammary artery: internal mammary artery graft utilization rate

  Internal mammary artery graft utilization rate: the utilization rate of at least one internal mammary artery graft in patients received isolated coronary artery bypass grafting.

  Duration of hospital stay(from date of admission to date of discharge)

• Hospitals with high usage rates of internal mammary artery: multiple arterial graft utilization rate

  Multiple arterial graft utilization rate: the utilization rate of two or more arterial conduits in patients received isolated coronary artery bypass grafting.

  Duration of hospital stay(from date of admission to date of discharge)

Secondary Outcomes (1)

• In-hospital all-cause mortality rate

  Duration of hospital stay(from date of admission to date of discharge)

Study Arms (1)

Improving the utilization rate of arterial grafts for coronary artery bypass grafting

OTHER

In this stepped-wedge cluster randomized trial (SW-CRT) with a self-controlled design, hospitals were categorized into two groups according to their internal mammary artery graft usage rates, thereby forming two SW-CRT. Healthcare professionals at these hospitals will receive tailored interventions. The effectiveness of each intervention is assessed by comparing the usage rates before and after implementation within each SW-CRT.

Behavioral: Interventions for healthcare professionals in hospitals with low usage rates; Behavioral: Interventions for healthcare professionals in hospitals with high usage rates

Interventions

Interventions for healthcare professionals in hospitals with high usage rates BEHAVIORAL

Hospitals with already high usage rates focus on increasing multi-arterial graft usage rates through similar intervention methods such as education, theoretical training, technical training, conference exchanges focus on multi-arterial graft use. The usage rates of multi-arterial graft for each hospital will be regular feed backed.

Improving the utilization rate of arterial grafts for coronary artery bypass grafting

Interventions for healthcare professionals in hospitals with low usage rates BEHAVIORAL

Hospitals with low usage rates aim to improve internal mammary artery graft utilization through interventions including education, theoretical training, technical training, conference exchanges, and regular feedback on quality monitoring results.

Improving the utilization rate of arterial grafts for coronary artery bypass grafting

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Aged ≥ 18 years old； Indicated for CABG and undergoing CABG.

You may not qualify if:

• History of prior CABG; Concurrent other cardiac surgeries on the day of CABG; Malignant tumor or life expectancy \< 1 year;

Sponsors & Collaborators

• China National Center for Cardiovascular Diseases: lead
• Chinese Academy of Medical Sciences, Fuwai Hospital: collaborator
• Shandong Provincial Hospital: collaborator
• The First Affiliated Hospital with Nanjing Medical University: collaborator
• Guangdong Provincial People's Hospital: collaborator
• Union Hospital, Tongji Medical College, Huazhong University of Science and Technology: collaborator
• West China Hospital: collaborator
• First Affiliated Hospital of Wenzhou Medical University: collaborator
• Ruijin Hospital: collaborator
• The General Hospital of Northern Theater Command: collaborator
• Central China Fuwai Hospital of Zhengzhou University: collaborator

MeSH Terms

Interventions

Methods; Health Personnel; Hospitals

Intervention Hierarchy (Ancestors)

Investigative Techniques; Health Care Facilities Workforce and Services; Health Facilities

Central Study Contacts

Zhe Zheng, MD, PhD

CONTACT

+86 88396051; zhengzhe@fuwai.com

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: NA
• Masking: NONE
• Purpose: HEALTH SERVICES RESEARCH
• Intervention Model: SINGLE GROUP
• Sponsor Type: OTHER GOV
• Responsible Party: SPONSOR

Model Details: This is a stepped-wedge cluster randomized trial (SW-CRT) with a self-controlled design. Hospitals were categorized into two groups based on their internal mammary artery graft usage rates (low or high), forming two SW-CRT.

Study Record Dates

• First Submitted: December 23, 2025
• First Posted: January 29, 2026
• Study Start: March 15, 2026
• Primary Completion (Estimated): January 1, 2029
• Study Completion (Estimated): July 1, 2029
• Last Updated: January 29, 2026

Record last verified: 2026-01

Data Sharing

• IPD Sharing: Will not share