BACKGROUND: The number of cardiovascular research articles is growing rapidly, but the subsequent incorporation into newer guidelines remains uncertain. We aimed to quantify the proportion of topic-relevant literature published between consecutive European Society of Cardiology (ESC) guideline editions that was cited in the later edition. METHODS: Using PubMed Medical Subject Heading (MeSH) searches and OpenAlex citation graphs, we identified all publications published between two ESC guideline editions across eight topics. We quantified the proportion of inter-guideline publications that were cited in the subsequent guideline. RESULTS: Across the eight topics, a mean of 2.2% (SD = 2.0) of inter-guideline publications were directly cited in the successive guideline. Clinical trials were more frequently cited than non-clinical trial publications (8.5% [SD = 6.8] vs 2.0% [SD = 2.0]) in a topic-adjusted logistic regression; the odds were roughly fivefold higher (OR 5.45, 95% CI 4.87-6.10). CONCLUSIONS: ESC guidelines cite a small proportion of the cardiovascular literature published since their preceding edition, drawing disproportionately on clinical trials.