CHAMGAP
VERIFIEDPassed the Codex final verification and publication gate. Evidence-verification cutoff: 2026-08-26. AI was used for research and drafting; the existence of all 3 cited sources was verified at the original page, followed by blind grading, adversarial audit, and build validation. Methodology v0.8.
Verdict No. 2917 · Search date 2026-08-26 · Methodology v0.8

Bilateral internal thoracic artery grafting in CABG,
does it really help with Improved ten-year overall survival after CABG?

30-Second Summary
D
Evidence Grade D · 34 · Safety warning
No ten-year survival benefit, with more sternal wound complications
Sternal wound complications increased from 1.9% to 3.5%.
What the
research shows
Grade D. In 3,102 ART participants, ten-year mortality was 20.3% versus 21.2%, HR 0.96 (95% CI 0.79 to 1.17), an absolute difference of -0.9 points. The interval leaves tails for benefit and harm, so it does not prove absence of benefit.
What the
ads claim
Observational longevity associations should not replace randomized estimates.
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Useful facts when choosing a product

  • Sternal wound complications were 3.5% versus 1.9%.
  • Treatment crossover diluted contrast.
Gap Measurement · Verdict 2917 · D 34
What advertising claims
What independent, higher-quality research supports
△ GAP
01

What the research actually shows

Axis 6 B0 evidence ① Allocation concealment: "randomization was performed by means of a secure Web-based system" ② Blinding: procedural masking was impossible; "All the outcome events, including adverse events, underwent adjudication" ③ Analysis set and missingness: "analyses were performed according to the intention-to-treat principle"; 71 (2.3%) lacked final vital status and were censored ④ Prespecified primary endpoint: "The primary outcome was death from any cause at 10 years" - consistent with ISRCTN46552265 MRC and British Heart Foundation funding was public/nonprofit. ART asks whether to use both thoracic arteries during bypass; TASTE asks whether to add aspiration during acute primary PCI.

02

Why this is classified as D (34)

A large public hard-outcome null trial with harm gives D, 34.

Counterpoint. The interval retains meaningful benefit.

Rejudgment record. Primary-source cross-check — Large publicly funded ten-year survival RCT with null efficacy and increased sternal harm

Scoring profile behind this grade
EndpointHHard endpoint - actual events such as death
ReplicationR1Single confirmatory trial
IndependenceI2Decisive evidence is publicly or non-profit funded
Effect sizeE-Harm increased in the trials
PrecisionC0The confidence interval leaves room for benefit

The scoring table and the verdict agree (D).

Cross-check — AI research and Codex final gate

AI was used for research and drafting. Blind grading, adversarial audit, and the methodology boundary rules were then reapplied before Codex performed the final evidence, grade, copy, and build checks. If a grade cannot be narrowed, both evidence positions and their reasons are published.
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Evidence Table

StudyDesignSampleFundingEndpointResultWeight
Study 1Multicenter randomized superiority trial3,102UK MRC and British Heart FoundationAll-cause death at ten years20.3% vs 21.2%; HR 0.96 (95% CI 0.79 to 1.17); absolute difference -0.9 pointsLarge pivotal hard-outcome trial
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Receipt — 3 References

All 3 cited sources were verified for existence at the original page (as of 2026-08-26).

Taggart DP, et al. N Engl J Med. 2019;380:437-446. PMID: 30699314.
checked
Reference 2
checked
Reference 3
checked
Research and draft: AI used · Cross-check: blind grading and adversarial audit
Final verification and publication gate: Codex · Verification cutoff: 2026-08-26 · Corrections: none

Cite this verdict

Harm of Bilateral Internal-Thoracic-Artery Grafting for 10-Year Survival and Sternal Wound Complications after CABG Evidence Grade D card
[Chamgap] Harm of Bilateral Internal-Thoracic-Artery Grafting for 10-Year Survival and Sternal Wound Complications after CABG — Evidence Grade D·34. 3 cited sources checked. Source: https://chamgap.com/en/verdicts/heart/bilateral-internal-thoracic-artery-cabg-ten-year-survival/ · CC BY 4.0

CC BY 4.0 — free to use with attribution; do not distort grades, numbers, or verdict meaning.

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What this document does and does not do

Chamgap is an information source. It reports what research has and has not confirmed; it does not tell readers what to take or buy. That decision belongs to readers and, when needed, medical or legal professionals. This verdict reflects literature available up to the search date and may change as new research appears. Nothing here is medical advice.