Efficacy of dual antiplatelet therapy for three months versus 12 months after coronary artery bypass grafting: multicentre, double blinded, randomised controlled trial.

Name: Αlpha¹ Rigor Record — Efficacy of dual antiplatelet therapy for three months versus 12 months after coronary artery bypass grafting: multicentre, double blinded, randomised controlled trial.
Item: Efficacy of dual antiplatelet therapy for three months versus 12 months after coronary artery bypass grafting: multicentre, double blinded, randomised controlled trial.
Rating: 39
Author: Αlpha¹

Yuan X, Li J, Lei L, Zhang L, Chen K, Chu Q, Feng W, Wang X, Wang X, Xu F, Liu S, Yang Y, Wang X, Wang H, Dong A, Cheng Z, Guo H, Zhou T, Chen X, Ge J, Zhang L, Liu S, Shen Z, Wang J, Wang Y, Li W, Hu S, TOP-CABG Collaborative Group

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Αlpha¹ Rigor Review — 1★ (Critical), 1 critical, 3 high issues for “Efficacy of dual antiplatelet therapy for three months versus 12 months after coronary artery bypass grafting: multicentre, double blinded, randomised controlled trial.”

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Αlpha¹ Editorial

This rigor review was examined and confirmed by Αlpha¹ Editorial · August 15, 2026

Αlpha¹ Rigor Review

Rigor Reviewed

1 / 5

Critical — a demonstrable failure

Interventional Study

Critical

High-priority

How this rating was calculated▸

Started at 5★ — deductions

StatisticsImpossible or misreported statistic−1★
IntegrityIntegrity concern−0.5★
ClaimsEfficacy rests on an unvalidated surrogate endpoint−0.5★
ClaimsTreatment effect not shown to be clinically meaningful−0.5★

A demonstrable critical failure caps the rating at the minimum, regardless of the deductions above.

Model-reported confidence: moderateReviewer agreement: highEngine: 7.39.0Source: full text

Not verified in this report

No data or code availability links were detected to verify.

Problems surfaced5 types

Numerical inconsistencies1

Values that contradict each other or are impossible for the stated sample: recomputed p-values and test statistics, GRIM/GRIMMER checks on summary numbers, percentages against their own counts, totals against their parts, and estimates against their own confidence intervals.

Internal contradictions in the reported numbersAssessed

Overstated conclusions4

Conclusions that reach past what the paper's own results support — including a significance claim that no longer holds when the statistic is recomputed, and efficacy resting on an unvalidated surrogate endpoint.

Significance claim flips when recomputedRecomputed
Efficacy rests on an unvalidated surrogate endpointAssessed
Treatment effect not shown to be clinically meaningfulAssessed
Conclusions only partially backed by the presented evidenceAssessed

This Αlpha¹ Rigor Review uses AI Rigor Reviewers trained on a curated corpus of high-fidelity and retracted papers, with expert supervision and curation. It can still make mistakes; verify each finding against the source before relying on it.

Critical findings

• Recomputed 4 tests: 3 consistent, 1 inconsistent (1 change significance at p<.05); 2 recomputed directly from the reported test statistics, 2 via agent-written checks.

This is a well-conducted and well-reported multicentre RCT with strong design, ethics, and transparency. The main concerns are a truncated data availability statement and a statistical inconsistency in the reported non-inferiority p-value for the primary outcome, which warrant attention in a post-publication audit.

Both reviewers agreed on study type (interventional) and on all dimensions except statistical analysis and data code availability, where the deterministic verification components provided additional evidence. The statistics verification only recomputed a subset of tests (4 total), so the inconsistency in one p-value is a specific finding, not a blanket assessment of all statistics.

5 major claims checked against the paper's own evidence: 1 only partially supported (evidence backs part of the claim; gaps or caveats remain); the rest adequately supported.

Premise concern: surrogate not validated for clinical benefit; effect size not shown to be clinically meaningful.

Recomputed 4 tests: 3 consistent, 1 inconsistent (1 change significance at p<.05); 2 recomputed directly from the reported test statistics, 2 via agent-written checks.

1 integrity concern flagged (0 high).

Reporting

Eight Dimensions8 pass

The introduction cites prior studies (DACAB, POPular CABG) and a meta-analysis showing ticagrelor-based DAPT reduces SVG occlusion but increases bleeding. The rationale for shorter DAPT is based on the temporal dynamics of platelet activation and graft healing. Limitations of prior research are addressed by noting the lack of testing of short-term DAPT in CABG patients.

Sub-criteria

prior work citedADEQUATE

premise rationaleADEQUATE

limitations addressedADEQUATE

Per reviewer (2) — the votes behind the verdict

PASSReviewer 1· 90% conf

The paper establishes a clear scientific premise with prior work cited and a logical rationale for the hypothesis.

Evidence

direct quote[Introduction, paragraph 1]

“Studies have shown a statistically significant reduction in SVG failure with ticagrelor based dual antiplatelet therapy (DAPT) for 12 months, but at the expense of increased bleeding risk.”