药物洗脱支架与裸金属支架治疗急性冠脉综合征
Appendices
Appendix 1. Glossary
Acute decompensated heart failure: heart failure where the heart is unable to overcome the pressure in the blood vessels, resulting in symptoms such as difficulty breathing, oedema, and fatigue.
Atheroembolism: embolism originating from an atherosclerotic plaque.
Atherosclerosis: arterial wall‐thickening due to build up of plaque.
Angiography: visualisation of the blood vessels typically by injection of contrast and using X‐ray.
Angina pectoris: medical term for chest pain or discomfort due to ischaemic heart disease.
Arrhythmias: deviation from the normal heart rhythm.
Balloon angioplasty: using a balloon to open a narrowed vessel.
Bifurcation: when a blood vessel splits into two different blood vessels.
Biolimus: the trade name of the drug umirolimus. The mechanism of action is believed to be antiproliferation of smooth muscle cells.
Bioresorbable stents: stents that are absorbed after initial placement with the intent of reducing restenosis.
Cardiomyocyte necrosis: undesirable death of the cells of the heart.
Continuous ischaemia: prolonged reduced blood supply (to the heart).
Coronary vasoconstriction: narrowing of the blood vessels of the heart due to muscle contraction.
Diastolic: the time period in which the ventricles of the heart relax.
Everolimus: a drug used in stents with the aim of reducing restenosis.
Hypertension: increased pressure typically inside the arteries.
Hypotension: decreased pressure typically inside the arteries.
Intraluminal thrombus: formation of a clot inside a vessel.
Ischaemic: reduced blood supply to an organ.
Level of evidence A: data derived from multiple randomised clinical trials or meta‐analyses.
Level of evidence B: data derived from a single randomised clinical trial or large non‐randomised studies.
Level of evidence C: consensus of opinion of the experts and/or small studies, retrospective studies, registries.
Myocardial band isoenzyme of creatine kinase (CK‐MB): a type of the enzyme creatine kinase that is highly specific for the heart.
Myocardial ischaemia: reduced blood supply to the heart.
Myocardial necrosis: death of the muscle tissue of the heart.
Myocardium: the muscle tissue of the heart.
Myocyte: a heart muscle cell.
Neointimal: scar tissue formed in a vessel after an injury.
Nonocclusive thrombus: the blood clot does not completely prevent blood flow through the vessel.
Non‐ST‐elevation myocardial infarction: a type of heart attack that does not show ST‐segment elevation on an electrocardiogram.
Paclitaxel: a drug used in stents with the aim of reducing restenosis.
Paclitaxcel stent: a stent using the paclitaxel drug, a drug used in stents with the aim of reducing restenosis.
Percutaneous: through the skin.
Percutaneous coronary intervention: an intervention where a balloon is guided up to the heart through an access sheath penetrating the skin to reduce the narrowing of a blood vessel.
Re‐endothelialisation: regrowth of endothelium after injury.
Restenosis: narrowing of a previously narrowed blood vessel due to a blood clot.
Retroperitoneal bleeding: bleeding behind the peritoneum, a membrane lining the abdominal cavity.
Revascularisation: removing the cause of the stenosed blood vessel, thereby allowing blood flow to resume.
Saphenous vein grafts: when performing bypass surgery, the saphenous vein (located in the leg) may be used to bypass the occluded vessel, ultimately re‐establishing heart flow.
Sirolimus: a drug used in stents with the aim of reducing restenosis.
Sirolimus stent: a stent using the sirolimus drug, a drug used in stents with the aim of reducing restenosis.
ST: ST is short for the ST‐segment, which is a specific segment of the printout when recording an electrocardiogram that is used to differentiate between ST and non‐ST myocardial infarction.
ST‐elevation myocardial infarction: a type of heart attack that shows ST‐segment elevation on an electrocardiogram.
Stenosis: narrowing of a vessel.
Stent thrombosis: blockage of the stent by a blood clot.
Systolic: the time period in which the ventricles of the heart contract.
Tachycardia: a faster‐than‐normal heart beat, typically above 100 beats per minute.
Thyrotoxicosis: excessive levels of the hormone produced by the thyroid gland, resulting in unwanted symptoms.
Troponin I: a cardiac protein that is released during a heart attack.
Troponin T: a cardiac protein that is released during a heart attack.
Ventricular arrhythmias: deviation from the normal heart rhythm involving the ventricles of the heart.
Zotarolimus: a drug used in stents with the aim of reducing restenosis.
Appendix 2. Search strategies
| Database | Date searched | Search strategy |
|---|---|---|
| CENTRAL (Cochrane Library) | 18/01/2017 | #1 MeSH descriptor: [Stents] explode all trees #2 stent* #3 #1 or #2 #4 drug elut* #5 MeSH descriptor: [Sirolimus] explode all trees #6 sirolimus #7 rapamycin #8 paclitaxel #9 taxol #10 MeSH descriptor: [Immunosuppressive Agents] explode all trees #11 coat* stent* #12 MeSH descriptor: [Taxoids] explode all trees #13 taxane* #14 qp2 #15 hexanoyltaxol #16 everolimus #17 abt‐578 #18 MeSH descriptor: [Tacrolimus] explode all trees #19 MeSH descriptor: [Dactinomycin] explode all trees #20 actinomycin #21 batimastat #22 MeSH descriptor: [Dexamethasone] explode all trees #23 dexamethasone #24 MeSH descriptor: [Estradiol] explode all trees #25 estradiol #26 praxel #27 paxene #28 onxol #29 anzatax #30 immunosuppress* #31 prograf* #32 meractinomycin #33 cosmegen #34 dactinomycin #35 millicorten #36 maxidex #37 decaspray #38 dexpak #39 dexasone #40 oradexon #41 hexadecadrol #42 decaject #43 hexadrol #44 decameth #45 methylfluorprednisolone #46 vivelle #47 oestradiol #48 estrace #49 aerodiol #50 estraderm #51 ovocyclin #52 estramustin* #53 estracyt #54 emcyt #55 tacrolimus #56 taxoids #57 zotarolimus #58 umirolimus #59 biolimus #60 pimecrolimus #61 elidel #62 #4 or #5 or #6 or #7 or #8 or #9 or #10 or #11 or #12 or #13 or #14 or #15 or #16 or #17 or #18 or #19 or #20 or #21 or #22 or #23 or #24 or #25 or #26 or #27 or #28 or #29 or #30 or #31 or #32 or #33 or #34 or #35 or #36 or #37 or #38 or #39 or #40 or #41 or #42 or #43 or #44 or #45 or #46 or #47 or #48 or #49 or #50 or #51 or #52 or #53 or #54 or #55 or #56 or #57 or #58 or #59 or #60 or #61 #63 #3 and #62 #64 eluting stent* #65 #63 or #64 #66 MeSH descriptor: [Angioplasty, Balloon, Coronary] explode all trees #67 MeSH descriptor: [Percutaneous Coronary Intervention] explode all trees #68 balloon angioplast* #69 (percutaneous adj6 coronary intervention*) #70 PCI #71 (intervention* adj6 percutaneous coronary) #72 (revascularization* adj6 percutaneous coronary) #73 (angioplast* adj6 coronary) #74 percutaneous coronary #75 ((transluminal or trans‐luminal) adj6 coronary) #76 #66 or #67 or #68 or #69 or #70 or #71 or #72 or #73 or #74 or #75 #77 MeSH descriptor: [Myocardial Ischemia] explode all trees #78 ((myocardial or myocardium or subendocardial or transmural or cardiac or cardial or coronary or heart) adj2 (infarct* or postinfarct* or hypoxi* or anoxi* or failure* or decompensation or insufficien*)) #79 (heart disease* or coronary disease* or IHD or CIHD or CHD) #80 (myocardial dysfunction or angina or stenocardia) #81 ((ischemi* or ischaemi*) adj2 (myocardium or myocardial or heart or coronary or cardiac or cardial or subendocardial or cardiomyopath*)) #82 ((artery occlusion* or artery disease* or arterioscleros* or atheroscleros*) adj2 coronary) #83 #77 or #78 or #79 or #80 or #81 or #82 #84 MeSH descriptor: [Acute Coronary Syndrome] explode all trees #85 MeSH descriptor: [Myocardial Infarction] explode all trees #86 MeSH descriptor: [Coronary Thrombosis] explode all trees #87 coronary thrombosis #88 acute coronary #89 MeSH descriptor: [Angina, Unstable] explode all trees #90 myocardial infarct* #91 heart infarct* #92 acs #93 ami #94 (coronary adj3 syndrome*) #95 acute angina #96 (unstable adj3 angina) #97 unstable coronary #98 #84 or #85 or #86 or #87 or #88 or #89 or #90 or #91 or #92 or #93 or #94 or #95 or #96 or #97 #99 #65 or #76 #100 #83 or #98 #101 #99 and #100 |
| MEDLINE (Ovid) | 18/01/2017 | 1. Stents/ 2. stent*.tw. 3. 1 or 2 4. drug elut*.tw. 5. Sirolimus/ 6. sirolimus.tw. 7. rapamycin.tw. 8. paclitaxel.tw. 9. taxol.tw. 10. exp Immunosuppressive Agents/ 11. coat* stent*.tw. 12. exp Taxoids/ 13. taxane*.tw. 14. qp2.tw. 15. hexanoyltaxol.tw. 16. everolimus.tw. 17. abt‐578.tw. 18. Tacrolimus/ 19. Dactinomycin/ 20. actinomycin.tw. 21. batimastat.tw. 22. exp Dexamethasone/ 23. dexamethasone.tw. 24. exp Estradiol/ 25. estradiol.tw. 26. praxel.tw. 27. paxene.tw. 28. onxol.tw. 29. anzatax.tw. 30. immunosuppress*.tw. 31. prograf*.tw. 32. meractinomycin.tw. 33. cosmegen.tw. 34. dactinomycin.tw. 35. millicorten.tw. 36. maxidex.tw. 37. decaspray.tw. 38. dexpak.tw. 39. dexasone.tw. 40. oradexon.tw. 41. hexadecadrol.tw. 42. decaject.tw. 43. hexadrol.tw. 44. decameth.tw. 45. methylfluorprednisolone.tw. 46. vivelle.tw. 47. oestradiol.tw. 48. estrace.tw. 49. aerodiol.tw. 50. estraderm.tw. 51. ovocyclin.tw. 52. estramustin*.tw. 53. estracyt.tw. 54. emcyt.tw. 55. tacrolimus.tw. 56. taxoids.tw. 57. zotarolimus.tw. 58. umirolimus.tw. 59. biolimus.tw. 60. pimecrolimus.tw. 61. elidel.tw. 62. or/4‐61 63. 3 and 62 64. eluting stent*.tw. 65. 63 or 64 66. exp Angioplasty, Balloon, Coronary/ or exp Percutaneous Coronary Intervention/ 67. balloon angioplast*.tw. 68. (percutaneous adj6 coronary intervention*).tw. 69. PCI.tw. 70. (intervention* adj6 percutaneous coronary).tw. 71. (revascularization* adj6 percutaneous coronary).tw. 72. (angioplast* adj6 coronary).tw. 73. percutaneous coronary.tw. 74. ((transluminal or trans‐luminal) adj6 coronary).tw. 75. or/66‐74 76. exp Myocardial Ischemia/ 77. ((myocardial or myocardium or subendocardial or transmural or cardiac or cardial or coronary or heart) adj2 (infarct* or postinfarct* or hypoxi* or anoxi* or failure* or decompensation or insufficien*)).tw. 78. (heart disease* or coronary disease* or IHD or CIHD or CHD).tw. 79. (myocardial dysfunction or angina or stenocardia).tw. 80. ((ischemi* or ischaemi*) adj2 (myocardium or myocardial or heart or coronary or cardiac or cardial or subendocardial or cardiomyopath*)).tw. 81. ((artery occlusion* or artery disease* or arterioscleros* or atheroscleros*) adj2 coronary).tw. 82. or/76‐81 83. Acute Coronary Syndrome/ 84. exp Myocardial Infarction/ 85. exp Coronary Thrombosis/ 86. coronary thrombosis.tw. 87. acute coronary.tw. 88. exp Angina, Unstable/ 89. myocardial infarct*. tw. 90. heart infarct*.tw. 91. acs.tw. 92. ami.tw. 93. (coronary adj3 syndrome*).tw. 94. acute angina.tw. 95. (unstable adj3 angina).tw. 96. unstable coronary.tw. 97. or/83‐96 98. randomized controlled trial.pt. 99. controlled clinical trial.pt. 100. randomized.ab. 101. placebo.ab. 102. drug therapy.fs. 103. randomly.ab. 104. trial.ab. 105. groups.ab. 106. or/98‐105 107. exp animals/ not humans.sh. 108. 106 not 107 109. 65 or 75 110. 82 or 97 111. 108 and 109 and 110 |
| Embase (Ovid) | 18/01/2017 | 1. exp stent/ 2. stent*.tw. 3. 1 or 2 4. exp drug eluting stent/ 5. drug elut*.tw. 6. sirolimus.tw. 7. exp rapamycin/ 8. rapamycin.tw. 9. paclitaxel/ 10. paclitaxel.tw. 11. taxol.tw. 12. exp immunosuppressive agent/ 13. coat* stent*.tw. 14. taxoid/ 15. taxane*.tw. 16. qp2.tw. 17. hexanoyltaxol.tw. 18. everolimus/ 19. everolimus.tw. 20. abt‐578.tw. 21. tacrolimus/ 22. dactinomycin/ 23. actinomycin.tw. 24. batimastat.tw. 25. dexamethasone/ 26. dexamethasone.tw. 27. estradiol/ 28. estradiol.tw. 29. praxel.tw. 30. paxene.tw. 31. onxol.tw. 32. anzatax.tw. 33. immunosuppress*.tw. 34. prograf*.tw. 35. meractinomycin.tw. 36. cosmegen.tw. 37. dactinomycin/ 38. dactinomycin.tw. 39. millicorten.tw. 40. maxidex.tw. 41. decaspray.tw. 42. dexpak.tw. 43. dexasone.tw. 44. oradexon.tw. 45. hexadecadrol.tw. 46. decaject.tw. 47. hexadrol.tw. 48. decameth.tw. 49. methylfluorprednisolone.tw. 50. vivelle.tw. 51. oestradiol.tw. 52. estrace.tw. 53. aerodiol.tw. 54. estraderm.tw. 55. ovocyclin.tw. 56. estramustin*.tw. 57. estracyt.tw. 58. emcyt.tw. 59. tacrolimus/ 60. tacrolimus.tw. 61. taxoids.tw. 62. zotarolimus/ 63. zotarolimus.tw. 64. umirolimus/ 65. umirolimus.tw. 66. biolimus.tw. 67. pimecrolimus/ 68. pimecrolimus.tw. 69. elidel.tw. 70. or/4‐69 71. 3 and 70 72. eluting stent*.tw. 73. 71 or 72 74. exp percutaneous coronary intervention/ 75. balloon angioplast*.tw. 76. (percutaneous adj6 coronary intervention*).tw. 77. PCI.tw. 78. (intervention* adj6 percutaneous coronary).tw. 79. (revascularization* adj6 percutaneous coronary).tw. 80. (angioplast* adj6 coronary).tw. 81. percutaneous coronary.tw. 82. ((transluminal or trans‐luminal) adj6 coronary).tw. 83. or/74‐82 84. exp heart muscle ischemia/ 85. ((myocardial or myocardium or subendocardial or transmural or cardiac or cardial or coronary or heart) adj2 (infarct* or postinfarct* or hypoxi* or anoxi* or failure* or decompensation or insufficien*)).tw. 86. (heart disease* or coronary disease* or IHD or CIHD or CHD).tw. 87. (myocardial dysfunction or angina or stenocardia).tw. 88. ((ischemi* or ischaemi*) adj2 (myocardium or myocardial or heart or coronary or cardiac or cardial or subendocardial or cardiomyopath*)).tw. 89. ((artery occlusion* or artery disease* or arterioscleros* or atheroscleros*) adj2 coronary).tw. 90. or/84‐89 91. exp acute coronary syndrome/ 92. exp heart infarction/ 93. coronary artery thrombosis/ 94. coronary thrombosis.tw. 95. acute coronary.tw. 96. exp unstable angina pectoris/ 97. myocardial infarct*.tw. 98. heart infarct*.tw. 99. acs.tw. 100. ami.tw. 101. (coronary adj3 syndrome*).tw. 102. acute angina.tw. 103. (unstable adj3 angina).tw. 104. unstable coronary.tw. 105. or/91‐104 106. random$.tw. 107. factorial$.tw. 108. crossover$.tw. 109. cross over$.tw. 110. cross‐over$.tw. 111. placebo$.tw. 112. (doubl$ adj blind$).tw. 113. (singl$ adj blind$).tw. 114. assign$.tw. 115. allocat$.tw. 116. volunteer$.tw. 117. crossover procedure/ 118. double blind procedure/ 119. randomized controlled trial/ 120. single blind procedure/ 121. or/106‐120 122. (animal/ or nonhuman/) not human/ 123. 121 not 122 124. 73 or 83 125. 90 or 105 126. 123 and 124 and 125 |
| SCI‐Expanded (Web of Science) (Thomson reuters) | 19/01/2017 | #33 #32 AND #31 AND #14 #32 TS=(random* or blind* or allocat* or assign* or trial* or placebo* or crossover* or cross‐over*) #31 #30 OR #20 #30 #29 OR #28 OR #27 OR #26 OR #25 OR #24 OR #23 OR #22 OR #21 #29 TS=unstable coronary #28 TS=(unstable NEAR/3 angina) #27 TS=acute angina #26 TS=(coronary NEAR/3 syndrome*) #25 TS=(acs or ami) #24 TS=heart infarct* #23 TS=myocardial infarct* #22 TS=acute coronary #21 TS=coronary thrombosis #20 #19 OR #18 OR #17 OR #16 OR #15 #19 TS=(("artery occlusion*" or "artery disease*" or arterioscleros* or atheroscleros*) NEAR/2 coronary) #18 TS=((ischemi* or ischaemi*) NEAR/2 (myocardium or myocardial or heart or coronary or cardiac or cardial or subendocardial or cardiomyopath*)) #17 TS=(myocardial dysfunction or angina or stenocardia) #16 TS=(heart disease* or coronary disease* or IHD or CIHD or CHD) #15 TS=((myocardial or myocardium or subendocardial or transmural or cardiac or cardial or coronary or heart) NEAR/2 (infarct* or postinfarct* or hypoxi* or anoxi* or failure* or decompensation or insufficien*)) #14 #13 OR #5 #13 #12 OR #11 OR #10 OR #9 OR #8 OR #7 OR #6 #12 TS=(trans‐luminal NEAR/6 coronary) #11 TS=(transluminal NEAR/6 coronary) #10 TS="percutaneous coronary" #9 TS=(angioplast* NEAR/6 coronary) #8 TS=PCI #7 TS=(percutaneous NEAR/6 "coronary intervention*") #6 TS="balloon angioplast*" #5 #4 AND #1 #4 #3 OR #2 #3 TS=(sirolimus or rapamycin or paclitaxel or taxol or taxoids or taxane* or gp2 or hexanoyltaxol or everolimus or abt‐578 or tacrolimus or dactinomycin or actinomycin or batimastat or dexamethasone or estradiol or praxel or paxene or onxol or anzatax or immunosuppress* or prograf* or meractinomycin or cosmegen or dactinomycin or millicorten or maxidex or decaspray or dexpak or dexasone or oradexon or hexadecadrol or decaject or hexadrol or decameth or methylfluorprednisolone or vivelle or oestradiol or estrace or aerodiol or estraderm or ovocyclin or estramustin* or estracyt or emcyt or tacrolimus or zotarolimus or umirolimus or biolimus or pimecrolimus or elidel) #2 TS=(drug elut* or eluting stent* or coat* stent*) #1 TS=stent* |
| BIOSIS (Web of Science) | 19/01/2017 | #33 #32 AND #31 AND #14 #32 TS=(random* or blind* or allocat* or assign* or trial* or placebo* or crossover* or cross‐over*) #31 #30 OR #20 #30 #29 OR #28 OR #27 OR #26 OR #25 OR #24 OR #23 OR #22 OR #21 #29 TS=unstable coronary #28 TS=(unstable NEAR/3 angina) #27 TS=acute angina #26 TS=(coronary NEAR/3 syndrome*) #25 TS=(acs or ami) #24 TS=heart infarct* #23 TS=myocardial infarct* #22 TS=acute coronary #21 TS=coronary thrombosis #20 #19 OR #18 OR #17 OR #16 OR #15 #19 TS=(("artery occlusion*" or "artery disease*" or arterioscleros* or atheroscleros*) NEAR/2 coronary) #18 TS=((ischemi* or ischaemi*) NEAR/2 (myocardium or myocardial or heart or coronary or cardiac or cardial or subendocardial or cardiomyopath*)) #17 TS=(myocardial dysfunction or angina or stenocardia) #16 TS=(heart disease* or coronary disease* or IHD or CIHD or CHD) #15 TS=((myocardial or myocardium or subendocardial or transmural or cardiac or cardial or coronary or heart) NEAR/2 (infarct* or postinfarct* or hypoxi* or anoxi* or failure* or decompensation or insufficien*)) #14 #13 OR #5 #13 #12 OR #11 OR #10 OR #9 OR #8 OR #7 OR #6 #12 TS=(trans‐luminal NEAR/6 coronary) #11 TS=(transluminal NEAR/6 coronary) #10 TS="percutaneous coronary" #9 TS=(angioplast* NEAR/6 coronary) #8 TS=PCI #7 TS=(percutaneous NEAR/6 "coronary intervention*") #6 TS="balloon angioplast*" #5 #4 AND #1 #4 #3 OR #2 #3 TS=(sirolimus or rapamycin or paclitaxel or taxol or taxoids or taxane* or gp2 or hexanoyltaxol or everolimus or abt‐578 or tacrolimus or dactinomycin or actinomycin or batimastat or dexamethasone or estradiol or praxel or paxene or onxol or anzatax or immunosuppress* or prograf* or meractinomycin or cosmegen or dactinomycin or millicorten or maxidex or decaspray or dexpak or dexasone or oradexon or hexadecadrol or decaject or hexadrol or decameth or methylfluorprednisolone or vivelle or oestradiol or estrace or aerodiol or estraderm or ovocyclin or estramustin* or estracyt or emcyt or tacrolimus or zotarolimus or umirolimus or biolimus or pimecrolimus or elidel) #2 TS=(drug elut* or eluting stent* or coat* stent*) #1 TS=stent* |
| LILACS (Bireme) | 19/01/2017 | (stent$ or drug elut$ or balloon angioplast$ or percutaneous coronary intervention$ or PCI) and (heart disease$ or coronary disease$ or IHD or CIHD or CHD or coronary thrombosis or acute coronary or myocardial infarct$ or heart infarct$ or acs or ami or coronary syndrome$ or unstable coronary or myocardial dysfunction or angina or stenocardia or myocardial ischemia) |
| 30/03/17 | Searched using 'stent' and using either 'acute coronary syndrome', 'ischaemic heart disease', 'stemi', 'nstemi', or 'unstable angina' as the condition | |
| the World Health Organization International Clinical Trials Registry Platform (ICTRP) (www.apps.who.int/trialsearch) | 31/03/17 | Searched using 'stent' and 'acute coronary syndrome' or 'stemi' or 'nstemi' or 'unstable angina' |
| European Medicines Agency (EMA) (www.ema.europa.eu/ema/) | 03/04/17 | Searched using 'drug‐eluting stent', 'drug eluting stent', 'bare‐metal stent', 'bare metal stent' |
| the Food and Drug Administration (FDA) (www.fda.gov) | 04/04/17 | Searched using 'drug‐eluting stent', 'drug eluting stent', 'bare‐metal stent', 'bare metal stent' |
| 05/04/17 | drug eluting stent bare metal stent "randomized trial" OR "randomised trial" |
Appendix 3. Details on assessment of risk of bias
We will classify each trial according to the domains below for each outcome result.
Random sequence generation
-
Low risk: if sequence generation is achieved using a computer random number generator or a random numbers table. We will also consider drawing lots, tossing a coin, shuffling cards, and throwing dice as adequate if an independent adjudicator performs these methods.
-
Unclear risk: if there is insufficient information to permit judgement of 'low risk' or 'high risk'.
-
High risk: if the allocation sequence is not randomised or only quasi‐randomised.
Allocation sequence concealment
-
Low risk: if the allocation of participants results from a central independent unit, on‐site locked computer, identical‐looking numbered, sealed, opaque envelopes, drug bottles or containers prepared by an independent investigator.
-
Unclear risk: if there is insufficient information to permit judgement of 'low risk' or 'high risk'.
-
High risk: if the allocation sequence is known to the investigators who assigned participants.
Blinding of participants and personnel
-
Low risk: if the participants and the personnel are blinded to treatment allocation and this is described.
-
Unclear risk: if there is insufficient information to permit judgement of 'low risk' or 'high risk'.
-
High risk: if blinding of participants and personnel is not performed.
Blinding of outcome assessment
-
Low risk: if the trial investigators performing the outcome assessments, analyses, and calculations are blinded to the intervention.
-
Unclear risk: if there is insufficient information to permit judgement of 'low risk' or 'high risk'.
-
High risk: if blinding of outcome assessment is not performed.
Incomplete outcome data
-
Low risk: (1) there are no dropouts or withdrawals for all outcomes, or (2) the numbers and reasons for withdrawals and dropouts for all outcomes are clearly stated, can be described as being similar in both groups, and the trial handles missing data appropriately in intention‐to‐treat analysis using proper methodology, e.g. multiple imputations.* As a general rule, we will judge the trial as at low risk of bias due to incomplete outcome data if the number of dropouts is less than 5%. However, the 5% cutoff is not definitive.
-
Unclear risk: if there is insufficient information to permit judgement of 'low risk' or 'high risk'.
-
High risk: the pattern of dropouts can be described as being different in the two intervention groups, or the trial uses improper methodology in dealing with the missing data, e.g. last observation carried forward.
*Multiple imputation is a general approach to the problem of missing data. It aims to allow for the uncertainty about the missing data by creating several different plausible imputed datasets and appropriately combining results obtained from each of them. The first stage is to create multiple copies of the dataset, with the missing values replaced by imputed values. These are sampled from their predictive distribution based on the observed data; thus, multiple imputation is based on a Bayesian approach. The imputation procedure must fully account for all uncertainty in predicting the missing values by injecting appropriate variability into the multiple imputed values. The second stage is to use standard statistical methods to fit the model of interest to each of the imputed datasets. The estimated associations from the imputed datasets will differ and are only useful when averaged together to give overall estimated associations. Valid inferences are obtained because we are averaging over the distribution of the missing data given the observed data (Sterne 2009).
Selective outcome reporting
-
Low risk: a protocol is published before or at the time the trial begins, and the outcomes called for in the protocol are reported on. If there is no protocol, or the protocol is published after the trial begins, reporting of the primary outcomes will grant the trial a grade of low risk of bias.
-
Unclear risk: if there is no protocol and the primary outcomes are not reported on.
-
High risk: if the outcomes that are called for in the protocol are not reported on.
Other bias risk
-
Low risk of bias: the trial appears to be free of other components (e.g. academic bias or for‐profit bias) that could put it at risk of bias.
-
Unclear risk of bias: the trial may or may not be free of other components that could put it at risk of bias.
-
High risk of bias: there are other factors in the trial that could put it at risk of bias (e.g. authors have conducted trials on the same topic, for‐profit bias, etc.).
Overall risk of bias
-
Low risk of bias: we will classify the outcome result as overall 'low' risk of bias only if we classify all of the bias domains described in the aforementioned text as low risk of bias. Due to the nature of the percutaneous coronary intervention procedure, we do not expect to find any trials at low risk of bias. We provide a description of how we will deal with this scenario in Data synthesis.
-
High risk of bias: we will classify the outcome result as 'high' risk of bias if we classify any of the bias domains in the aforementioned text as 'unclear' or 'high' risk of bias.
We will grade each potential source of bias as high, low, or unclear and provide a quote from the study report together with a justification for our judgement in the 'Risk of bias' table. We will summarise the 'Risk of bias' judgements across different studies for each of the domains listed. Where information on risk of bias relates to unpublished data or correspondence with a trialist, we will note this in the 'Risk of bias' table.
When considering treatment effects, we will take into account the risk of bias for the studies that contribute to that outcome.
study flow diagram.
Risk of bias graph: review authors' judgements about each risk of bias item presented as percentages across all included studies.
Risk of bias summary: review authors' judgements about each risk of bias item for each included study.
Trial Sequential Analysis of drug‐eluting stents versus bare‐metal stents on all‐cause mortality at maximum follow‐up in 21 trials. The diversity‐adjusted required information size (RIS) was calculated based on mortality in the control group of 7.76%; risk ratio reduction (RRR) of 10% in the experimental group; type I error of 2.0%; and type II error of 20% (80% power). No diversity was noted. The diversity‐adjusted required information size was 45,046 participants. The cumulative Z‐curve (blue line) did not cross the trial sequential monitoring boundaries for benefit or harm (red inward‐sloping lines). The cumulative Z‐curve did not cross the inner‐wedge futility line (the inner‐wedge futility could not be calculated due to too little information). Additionally, the cumulative Z‐score did not cross the RIS. The green dotted line shows conventional boundaries (2.0%).
Trial Sequential Analysis of drug‐eluting stents versus bare‐metal stents on serious adverse events at maximum follow‐up in 22 trials. The diversity‐adjusted required information size (RIS) was calculated based on a rate of serious adverse events in the control group of 22.95%; risk ratio reduction (RRR) of 10% in the experimental group; type I error of 2.0%; and type II error of 20% (80% power). No diversity was noted. The diversity‐adjusted required information size was 24,853 participants. The cumulative Z‐curve (blue line) crossed the trial sequential monitoring boundaries for benefit. The green dotted line shows conventional boundaries (2.0%).
Trial Sequential Analysis of drug‐eluting stents versus bare‐metal stents on target vessel revascularisation at maximum follow‐up in 22 trials. The diversity‐adjusted required information size (RIS) was calculated based on a rate of target vessel revascularisations in the control group of 13.28%; risk ratio reduction (RRR) of 30% in the experimental group; type I error of 3.33%; and type II error of 20% (80% power). No diversity was noted. The diversity‐adjusted required information size was 5361 participants. The cumulative Z‐curve (blue line) crossed the trial sequential monitoring boundaries for benefit. The green dotted line shows conventional boundaries (3.33%).
Comparison 1: Drug‐eluting stents versus bare‐metal stents for acute coronary syndrome at maximum follow‐up, Outcome 1: All‐cause mortality
Comparison 1: Drug‐eluting stents versus bare‐metal stents for acute coronary syndrome at maximum follow‐up, Outcome 2: All‐cause mortality best‐worst
Comparison 1: Drug‐eluting stents versus bare‐metal stents for acute coronary syndrome at maximum follow‐up, Outcome 3: All‐cause mortality worst‐best
Comparison 1: Drug‐eluting stents versus bare‐metal stents for acute coronary syndrome at maximum follow‐up, Outcome 4: All‐cause mortality according to type of drug‐eluting stent
Comparison 1: Drug‐eluting stents versus bare‐metal stents for acute coronary syndrome at maximum follow‐up, Outcome 5: All‐cause mortality according to type of ACS
Comparison 1: Drug‐eluting stents versus bare‐metal stents for acute coronary syndrome at maximum follow‐up, Outcome 6: All‐cause mortality according to length of maximum follow‐up
Comparison 1: Drug‐eluting stents versus bare‐metal stents for acute coronary syndrome at maximum follow‐up, Outcome 7: All‐cause mortality according to registration status
Comparison 1: Drug‐eluting stents versus bare‐metal stents for acute coronary syndrome at maximum follow‐up, Outcome 8: Serious adverse events
Comparison 1: Drug‐eluting stents versus bare‐metal stents for acute coronary syndrome at maximum follow‐up, Outcome 9: Serious adverse events best‐worst
Comparison 1: Drug‐eluting stents versus bare‐metal stents for acute coronary syndrome at maximum follow‐up, Outcome 10: Serious adverse events worst‐best
Comparison 1: Drug‐eluting stents versus bare‐metal stents for acute coronary syndrome at maximum follow‐up, Outcome 11: Serious adverse events according to type of drug‐eluting stent
Comparison 1: Drug‐eluting stents versus bare‐metal stents for acute coronary syndrome at maximum follow‐up, Outcome 12: Serious adverse events according to type of ACS
Comparison 1: Drug‐eluting stents versus bare‐metal stents for acute coronary syndrome at maximum follow‐up, Outcome 13: Serious adverse events according to length of maximum follow‐up
Comparison 1: Drug‐eluting stents versus bare‐metal stents for acute coronary syndrome at maximum follow‐up, Outcome 14: Serious adverse events according to registration status
Comparison 1: Drug‐eluting stents versus bare‐metal stents for acute coronary syndrome at maximum follow‐up, Outcome 15: Major cardiovascular events
Comparison 1: Drug‐eluting stents versus bare‐metal stents for acute coronary syndrome at maximum follow‐up, Outcome 16: Major cardiovascular events best‐worst
Comparison 1: Drug‐eluting stents versus bare‐metal stents for acute coronary syndrome at maximum follow‐up, Outcome 17: Major cardiovascular events worst‐best
Comparison 1: Drug‐eluting stents versus bare‐metal stents for acute coronary syndrome at maximum follow‐up, Outcome 18: Major cardiovascular events according to type of drug‐eluting stent
Comparison 1: Drug‐eluting stents versus bare‐metal stents for acute coronary syndrome at maximum follow‐up, Outcome 19: Major cardiovascular events according to type of ACS
Comparison 1: Drug‐eluting stents versus bare‐metal stents for acute coronary syndrome at maximum follow‐up, Outcome 20: Major cardiovascular events according to length of maximum follow‐up
Comparison 1: Drug‐eluting stents versus bare‐metal stents for acute coronary syndrome at maximum follow‐up, Outcome 21: Major cardiovascular events according to registration status
Comparison 1: Drug‐eluting stents versus bare‐metal stents for acute coronary syndrome at maximum follow‐up, Outcome 22: Cardiovascular mortality
Comparison 1: Drug‐eluting stents versus bare‐metal stents for acute coronary syndrome at maximum follow‐up, Outcome 23: Cardiovascular mortality best‐worst
Comparison 1: Drug‐eluting stents versus bare‐metal stents for acute coronary syndrome at maximum follow‐up, Outcome 24: Cardiovascular mortality worst‐best
Comparison 1: Drug‐eluting stents versus bare‐metal stents for acute coronary syndrome at maximum follow‐up, Outcome 25: Cardiovascular mortality according to type of drug‐eluting stent
Comparison 1: Drug‐eluting stents versus bare‐metal stents for acute coronary syndrome at maximum follow‐up, Outcome 26: Cardiovascular mortality according to type of ACS
Comparison 1: Drug‐eluting stents versus bare‐metal stents for acute coronary syndrome at maximum follow‐up, Outcome 27: Cardiovascular mortality according to length of maximum follow‐up
Comparison 1: Drug‐eluting stents versus bare‐metal stents for acute coronary syndrome at maximum follow‐up, Outcome 28: Cardiovascular mortality according to registration status
Comparison 1: Drug‐eluting stents versus bare‐metal stents for acute coronary syndrome at maximum follow‐up, Outcome 29: Myocardial infarction
Comparison 1: Drug‐eluting stents versus bare‐metal stents for acute coronary syndrome at maximum follow‐up, Outcome 30: Myocardial infarction best‐worst
Comparison 1: Drug‐eluting stents versus bare‐metal stents for acute coronary syndrome at maximum follow‐up, Outcome 31: Myocardial infarction worst‐best
Comparison 1: Drug‐eluting stents versus bare‐metal stents for acute coronary syndrome at maximum follow‐up, Outcome 32: Myocardial infarction according to type of drug‐eluting stent
Comparison 1: Drug‐eluting stents versus bare‐metal stents for acute coronary syndrome at maximum follow‐up, Outcome 33: Myocardial infarction according to type of ACS
Comparison 1: Drug‐eluting stents versus bare‐metal stents for acute coronary syndrome at maximum follow‐up, Outcome 34: Myocardial infarction according to length of maximum follow‐up
Comparison 1: Drug‐eluting stents versus bare‐metal stents for acute coronary syndrome at maximum follow‐up, Outcome 35: Myocardial infarction according to registration status
Comparison 1: Drug‐eluting stents versus bare‐metal stents for acute coronary syndrome at maximum follow‐up, Outcome 36: Stent thrombosis
Comparison 1: Drug‐eluting stents versus bare‐metal stents for acute coronary syndrome at maximum follow‐up, Outcome 37: Stent thrombosis best‐worst
Comparison 1: Drug‐eluting stents versus bare‐metal stents for acute coronary syndrome at maximum follow‐up, Outcome 38: Stent thrombosis worst‐best
Comparison 1: Drug‐eluting stents versus bare‐metal stents for acute coronary syndrome at maximum follow‐up, Outcome 39: Stent thrombosis according to type of drug‐eluting stent
Comparison 1: Drug‐eluting stents versus bare‐metal stents for acute coronary syndrome at maximum follow‐up, Outcome 40: Stent thrombosis according to type of ACS
Comparison 1: Drug‐eluting stents versus bare‐metal stents for acute coronary syndrome at maximum follow‐up, Outcome 41: Stent thrombosis according to length of maximum follow‐up
Comparison 1: Drug‐eluting stents versus bare‐metal stents for acute coronary syndrome at maximum follow‐up, Outcome 42: Stent thrombosis according to registration status
Comparison 1: Drug‐eluting stents versus bare‐metal stents for acute coronary syndrome at maximum follow‐up, Outcome 43: Target vessel revascularisation
Comparison 1: Drug‐eluting stents versus bare‐metal stents for acute coronary syndrome at maximum follow‐up, Outcome 44: Target vessel revascularisation best‐worst
Comparison 1: Drug‐eluting stents versus bare‐metal stents for acute coronary syndrome at maximum follow‐up, Outcome 45: Target vessel revascularisation worst‐best
Comparison 1: Drug‐eluting stents versus bare‐metal stents for acute coronary syndrome at maximum follow‐up, Outcome 46: Target vessel revascularisation according to type of drug‐eluting stent
Comparison 1: Drug‐eluting stents versus bare‐metal stents for acute coronary syndrome at maximum follow‐up, Outcome 47: Target vessel revascularisation according to type of ACS
Comparison 1: Drug‐eluting stents versus bare‐metal stents for acute coronary syndrome at maximum follow‐up, Outcome 48: Target vessel revascularisation according to length of maximum follow‐up
Comparison 1: Drug‐eluting stents versus bare‐metal stents for acute coronary syndrome at maximum follow‐up, Outcome 49: Target vessel revascularisation according to registration status
Comparison 2: Drug‐eluting stents versus bare‐metal stents for acute coronary syndrome at one month, Outcome 1: All‐cause mortality
Comparison 2: Drug‐eluting stents versus bare‐metal stents for acute coronary syndrome at one month, Outcome 2: All‐cause mortality best‐worst
Comparison 2: Drug‐eluting stents versus bare‐metal stents for acute coronary syndrome at one month, Outcome 3: All‐cause mortality worst‐best
Comparison 2: Drug‐eluting stents versus bare‐metal stents for acute coronary syndrome at one month, Outcome 4: All‐cause mortality according to type of drug‐eluting stent
Comparison 2: Drug‐eluting stents versus bare‐metal stents for acute coronary syndrome at one month, Outcome 5: All‐cause mortality according to type of ACS
Comparison 2: Drug‐eluting stents versus bare‐metal stents for acute coronary syndrome at one month, Outcome 6: All‐cause mortality according to registration status
Comparison 2: Drug‐eluting stents versus bare‐metal stents for acute coronary syndrome at one month, Outcome 7: Serious adverse events
Comparison 2: Drug‐eluting stents versus bare‐metal stents for acute coronary syndrome at one month, Outcome 8: Serious adverse events best‐worst
Comparison 2: Drug‐eluting stents versus bare‐metal stents for acute coronary syndrome at one month, Outcome 9: Serious adverse events worst‐best
Comparison 2: Drug‐eluting stents versus bare‐metal stents for acute coronary syndrome at one month, Outcome 10: Serious adverse events according to type of drug‐eluting stent
Comparison 2: Drug‐eluting stents versus bare‐metal stents for acute coronary syndrome at one month, Outcome 11: Serious adverse events according to type of ACS
Comparison 2: Drug‐eluting stents versus bare‐metal stents for acute coronary syndrome at one month, Outcome 12: Serious adverse events according to registration status
Comparison 2: Drug‐eluting stents versus bare‐metal stents for acute coronary syndrome at one month, Outcome 13: Major cardiovascular events
Comparison 2: Drug‐eluting stents versus bare‐metal stents for acute coronary syndrome at one month, Outcome 14: Major cardiovascular events best‐worst
Comparison 2: Drug‐eluting stents versus bare‐metal stents for acute coronary syndrome at one month, Outcome 15: Major cardiovascular events worst‐best
Comparison 2: Drug‐eluting stents versus bare‐metal stents for acute coronary syndrome at one month, Outcome 16: Major cardiovascular events according to type of drug‐eluting stent
Comparison 2: Drug‐eluting stents versus bare‐metal stents for acute coronary syndrome at one month, Outcome 17: Major cardiovascular events according to type of ACS
Comparison 2: Drug‐eluting stents versus bare‐metal stents for acute coronary syndrome at one month, Outcome 18: Major cardiovascular events according to registration status
Comparison 2: Drug‐eluting stents versus bare‐metal stents for acute coronary syndrome at one month, Outcome 19: Cardiovascular mortality
Comparison 2: Drug‐eluting stents versus bare‐metal stents for acute coronary syndrome at one month, Outcome 20: Cardiovascular mortality best‐worst
Comparison 2: Drug‐eluting stents versus bare‐metal stents for acute coronary syndrome at one month, Outcome 21: Cardiovascular mortality worst‐best
Comparison 2: Drug‐eluting stents versus bare‐metal stents for acute coronary syndrome at one month, Outcome 22: Cardiovascular mortality according to type of drug‐eluting stent
Comparison 2: Drug‐eluting stents versus bare‐metal stents for acute coronary syndrome at one month, Outcome 23: Cardiovascular mortality according to type of ACS
Comparison 2: Drug‐eluting stents versus bare‐metal stents for acute coronary syndrome at one month, Outcome 24: Cardiovascular mortality according to registration status
Comparison 2: Drug‐eluting stents versus bare‐metal stents for acute coronary syndrome at one month, Outcome 25: Myocardial infarction
Comparison 2: Drug‐eluting stents versus bare‐metal stents for acute coronary syndrome at one month, Outcome 26: Myocardial infarction best‐worst
Comparison 2: Drug‐eluting stents versus bare‐metal stents for acute coronary syndrome at one month, Outcome 27: Myocardial infarction worst‐best
Comparison 2: Drug‐eluting stents versus bare‐metal stents for acute coronary syndrome at one month, Outcome 28: Myocardial infarction according to type of drug‐eluting stent
Comparison 2: Drug‐eluting stents versus bare‐metal stents for acute coronary syndrome at one month, Outcome 29: Myocardial infarction according to type of ACS
Comparison 2: Drug‐eluting stents versus bare‐metal stents for acute coronary syndrome at one month, Outcome 30: Myocardial infarction according to registration status
Comparison 2: Drug‐eluting stents versus bare‐metal stents for acute coronary syndrome at one month, Outcome 31: Stent thrombosis
Comparison 2: Drug‐eluting stents versus bare‐metal stents for acute coronary syndrome at one month, Outcome 32: Stent thrombosis best‐worst
Comparison 2: Drug‐eluting stents versus bare‐metal stents for acute coronary syndrome at one month, Outcome 33: Stent thrombosis worst‐best
Comparison 2: Drug‐eluting stents versus bare‐metal stents for acute coronary syndrome at one month, Outcome 34: Stent thrombosis according to type of drug‐eluting stent
Comparison 2: Drug‐eluting stents versus bare‐metal stents for acute coronary syndrome at one month, Outcome 35: Stent thrombosis according to type of ACS
Comparison 2: Drug‐eluting stents versus bare‐metal stents for acute coronary syndrome at one month, Outcome 36: Stent thrombosis according to registration status
Comparison 2: Drug‐eluting stents versus bare‐metal stents for acute coronary syndrome at one month, Outcome 37: Target vessel revascularisation
Comparison 2: Drug‐eluting stents versus bare‐metal stents for acute coronary syndrome at one month, Outcome 38: Target vessel revascularisation best‐worst
Comparison 2: Drug‐eluting stents versus bare‐metal stents for acute coronary syndrome at one month, Outcome 39: Target vessel revascularisation worst‐best
Comparison 2: Drug‐eluting stents versus bare‐metal stents for acute coronary syndrome at one month, Outcome 40: Target vessel revascularisation according to type of drug‐eluting stent
Comparison 2: Drug‐eluting stents versus bare‐metal stents for acute coronary syndrome at one month, Outcome 41: Target vessel revascularisation according to type of ACS
Comparison 2: Drug‐eluting stents versus bare‐metal stents for acute coronary syndrome at one month, Outcome 42: Target vessel revascularisation according to registration status
| Drug‐eluting stents compared to bare‐metal stents for acute coronary syndrome | ||||||
| Patient or population: People with acute coronary syndrome | ||||||
| Outcomes | Anticipated absolute effects* (95% CI) | Relative effect | № of participants | Quality of the evidence | Comments | |
|---|---|---|---|---|---|---|
| Risk with bare‐metal stents | Risk with drug‐eluting stents | |||||
| All‐cause mortality at maximum follow‐up | Study population | RR 0.90 | 11,250 | ⊕⊕⊝⊝ | Trial Sequential Analysis for a RRR of 10% showed that neither the boundary for futility, benefit or harm was breached, hence the risk of imprecision of the outcome result is high. Multiple eligible treatments were used in 1 trial, generating a further comparison (21 trials reporting on 22 experimental groups). | |
| 78 per 1000 | 70 per 1000 | |||||
| Serious adverse events at maximum follow‐up | Study population | RR 0.80 | 11,724 | ⊕⊕⊝⊝ | Trial Sequential Analysis for a RRR of 10% showed that the boundary for benefit was breached, hence the risk of imprecision of the outcome result is low. Multiple eligible treatments were used in 1 trial, generating a further comparison (22 trials reporting on 23 experimental groups). | |
| 230 per 1000 | 184 per 1000 | |||||
| Major cardiovascular events at maximum Follow‐up: median 12 months | Study population | RR 0.96 | 10,939 | ⊕⊝⊝⊝ | Trial Sequential Analysis for a RRR of 10% showed that neither the boundary for futility, benefit or harm was breached, hence the risk of imprecision of the outcome result is high. Multiple eligible treatments were used in 1 trial, generating a further comparison (19 trials reporting on 20 experimental groups). | |
| 66 per 1000 | 63 per 1000 | |||||
| Quality of life at maximum follow‐up ‐ not reported | ‐ | ‐ | ‐ | ‐ | ‐ | |
| Cardiovascular mortality at maximum follow‐up | Study population | RR 0.91 | 9248 | ⊕⊝⊝⊝ | Trial Sequential Analysis for a RRR of 10% showed that neither the boundary for futility, benefit or harm was breached, hence the risk of imprecision of the outcome result is high. Multiple eligible treatments were used in 1 trial, generating a further comparison (14 trials reporting on 15 experimental groups). | |
| 58 per 1000 | 53 per 1000 | |||||
| Myocardial infarction at maximum follow‐up | Study population | RR 0.98 | 10,217 | ⊕⊝⊝⊝ | Trial Sequential Analysis for a RRR of 10% showed that neither the boundary for futility, benefit or harm was breached, hence the risk of imprecision of the outcome result is high. Multiple eligible treatments were used in 1 trial, generating a further comparison (18 trials reporting on 19 experimental groups). | |
| 48 per 1000 | 47 per 1000 | |||||
| Angina at maximum follow‐up ‐ not reported | ‐ | ‐ | ‐ | ‐ | ‐ | |
| *The risk in the intervention group (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI). | ||||||
| GRADE Working Group grades of evidence | ||||||
| 1Downgraded one level for serious risk of imprecision due to our required information size not being met. | ||||||
| Outcome or subgroup title | No. of studies | No. of participants | Statistical method | Effect size |
| 1.1 All‐cause mortality Show forest plot | 22 | 11250 | Risk Ratio (M‐H, Random, 95% CI) | 0.90 [0.78, 1.03] |
| 1.2 All‐cause mortality best‐worst Show forest plot | 22 | 11775 | Risk Ratio (M‐H, Random, 95% CI) | 0.60 [0.44, 0.80] |
| 1.3 All‐cause mortality worst‐best Show forest plot | 22 | 11775 | Risk Ratio (M‐H, Random, 95% CI) | 1.27 [0.99, 1.64] |
| 1.4 All‐cause mortality according to type of drug‐eluting stent Show forest plot | 22 | 11250 | Risk Ratio (M‐H, Random, 95% CI) | 0.90 [0.78, 1.03] |
| 1.4.1 Biodegradable (Biolimus) | 1 | 1157 | Risk Ratio (M‐H, Random, 95% CI) | 0.89 [0.54, 1.45] |
| 1.4.2 Everolimus | 1 | 1458 | Risk Ratio (M‐H, Random, 95% CI) | 0.73 [0.54, 1.00] |
| 1.4.3 Paclitaxel | 8 | 4468 | Risk Ratio (M‐H, Random, 95% CI) | 0.89 [0.71, 1.12] |
| 1.4.4 Sirolimus | 9 | 3113 | Risk Ratio (M‐H, Random, 95% CI) | 0.89 [0.68, 1.16] |
| 1.4.5 Zotarolimus | 1 | 44 | Risk Ratio (M‐H, Random, 95% CI) | Not estimable |
| 1.4.6 Mixed | 1 | 626 | Risk Ratio (M‐H, Random, 95% CI) | 1.34 [0.91, 1.98] |
| 1.4.7 Unclear | 1 | 384 | Risk Ratio (M‐H, Random, 95% CI) | 0.43 [0.02, 7.39] |
| 1.5 All‐cause mortality according to type of ACS Show forest plot | 22 | 11250 | Risk Ratio (M‐H, Random, 95% CI) | 0.90 [0.78, 1.03] |
| 1.5.1 STEMI | 21 | 11171 | Risk Ratio (M‐H, Random, 95% CI) | 0.90 [0.78, 1.03] |
| 1.5.2 Acute coronary syndrome | 1 | 79 | Risk Ratio (M‐H, Random, 95% CI) | Not estimable |
| 1.6 All‐cause mortality according to length of maximum follow‐up Show forest plot | 22 | 11250 | Risk Ratio (M‐H, Random, 95% CI) | 0.90 [0.78, 1.03] |
| 1.6.1 Less or equal to 6 months | 4 | 726 | Risk Ratio (M‐H, Random, 95% CI) | 0.85 [0.29, 2.53] |
| 1.6.2 Between 6 and 12 months | 6 | 1315 | Risk Ratio (M‐H, Random, 95% CI) | 0.81 [0.54, 1.21] |
| 1.6.3 Between 1 and 3 years | 3 | 703 | Risk Ratio (M‐H, Random, 95% CI) | 0.99 [0.55, 1.76] |
| 1.6.4 More or equal to 3 years | 8 | 8490 | Risk Ratio (M‐H, Random, 95% CI) | 0.90 [0.77, 1.05] |
| 1.6.5 Unclear | 1 | 16 | Risk Ratio (M‐H, Random, 95% CI) | Not estimable |
| 1.7 All‐cause mortality according to registration status Show forest plot | 22 | 11250 | Risk Ratio (M‐H, Random, 95% CI) | 0.90 [0.78, 1.03] |
| 1.7.1 Pre‐registration | 3 | 1301 | Risk Ratio (M‐H, Random, 95% CI) | 0.85 [0.52, 1.39] |
| 1.7.2 Post‐registration | 13 | 9028 | Risk Ratio (M‐H, Random, 95% CI) | 0.89 [0.77, 1.03] |
| 1.7.3 No registration | 6 | 921 | Risk Ratio (M‐H, Random, 95% CI) | 1.09 [0.54, 2.20] |
| 1.8 Serious adverse events Show forest plot | 23 | 11724 | Risk Ratio (M‐H, Fixed, 95% CI) | 0.80 [0.74, 0.86] |
| 1.9 Serious adverse events best‐worst Show forest plot | 23 | 12249 | Risk Ratio (M‐H, Fixed, 95% CI) | 0.67 [0.62, 0.71] |
| 1.10 Serious adverse events worst‐best Show forest plot | 23 | 12249 | Risk Ratio (M‐H, Fixed, 95% CI) | 0.98 [0.91, 1.05] |
| 1.11 Serious adverse events according to type of drug‐eluting stent Show forest plot | 23 | 11724 | Risk Ratio (M‐H, Fixed, 95% CI) | 0.80 [0.74, 0.86] |
| 1.11.1 Biodegradable (Biolimus) | 1 | 1157 | Risk Ratio (M‐H, Fixed, 95% CI) | 0.75 [0.58, 0.98] |
| 1.11.2 Everolimus | 2 | 1932 | Risk Ratio (M‐H, Fixed, 95% CI) | 0.82 [0.69, 0.97] |
| 1.11.3 Paclitaxel | 8 | 4468 | Risk Ratio (M‐H, Fixed, 95% CI) | 0.86 [0.76, 0.96] |
| 1.11.4 Sirolimus | 9 | 3113 | Risk Ratio (M‐H, Fixed, 95% CI) | 0.74 [0.64, 0.84] |
| 1.11.5 Zotarolimus | 1 | 44 | Risk Ratio (M‐H, Fixed, 95% CI) | 1.33 [0.17, 10.70] |
| 1.11.6 Mixed | 1 | 626 | Risk Ratio (M‐H, Fixed, 95% CI) | 0.74 [0.54, 1.01] |
| 1.11.7 Unclear | 1 | 384 | Risk Ratio (M‐H, Fixed, 95% CI) | 0.93 [0.52, 1.69] |
| 1.12 Serious adverse events according to type of ACS Show forest plot | 23 | 11724 | Risk Ratio (M‐H, Fixed, 95% CI) | 0.80 [0.74, 0.86] |
| 1.12.1 STEMI | 21 | 11171 | Risk Ratio (M‐H, Fixed, 95% CI) | 0.80 [0.75, 0.86] |
| 1.12.2 Acute coronary syndrome | 1 | 79 | Risk Ratio (M‐H, Fixed, 95% CI) | 0.58 [0.29, 1.15] |
| 1.12.3 NSTEMI | 1 | 474 | Risk Ratio (M‐H, Fixed, 95% CI) | 0.78 [0.50, 1.23] |
| 1.13 Serious adverse events according to length of maximum follow‐up Show forest plot | 23 | 11724 | Risk Ratio (M‐H, Fixed, 95% CI) | 0.80 [0.74, 0.86] |
| 1.13.1 Less or equal to 6 months | 4 | 726 | Risk Ratio (M‐H, Fixed, 95% CI) | 0.67 [0.45, 0.99] |
| 1.13.2 Between 6 and 12 months | 7 | 1748 | Risk Ratio (M‐H, Fixed, 95% CI) | 0.85 [0.69, 1.05] |
| 1.13.3 Between 1 and 3 years | 3 | 744 | Risk Ratio (M‐H, Fixed, 95% CI) | 0.64 [0.47, 0.88] |
| 1.13.4 More or equal to 3 years | 8 | 8490 | Risk Ratio (M‐H, Fixed, 95% CI) | 0.81 [0.75, 0.88] |
| 1.13.5 Unclear | 1 | 16 | Risk Ratio (M‐H, Fixed, 95% CI) | Not estimable |
| 1.14 Serious adverse events according to registration status Show forest plot | 23 | 11724 | Risk Ratio (M‐H, Fixed, 95% CI) | 0.80 [0.74, 0.86] |
| 1.14.1 Pre‐registration | 3 | 1301 | Risk Ratio (M‐H, Fixed, 95% CI) | 0.71 [0.55, 0.91] |
| 1.14.2 Post‐registration | 14 | 9502 | Risk Ratio (M‐H, Fixed, 95% CI) | 0.81 [0.75, 0.87] |
| 1.14.3 No registration | 6 | 921 | Risk Ratio (M‐H, Fixed, 95% CI) | 0.83 [0.57, 1.20] |
| 1.15 Major cardiovascular events Show forest plot | 20 | 10939 | Risk Ratio (M‐H, Random, 95% CI) | 0.96 [0.83, 1.11] |
| 1.16 Major cardiovascular events best‐worst Show forest plot | 20 | 11596 | Risk Ratio (M‐H, Random, 95% CI) | 0.53 [0.39, 0.72] |
| 1.17 Major cardiovascular events worst‐best Show forest plot | 20 | 11596 | Risk Ratio (M‐H, Random, 95% CI) | 1.40 [0.97, 2.00] |
| 1.18 Major cardiovascular events according to type of drug‐eluting stent Show forest plot | 20 | 10939 | Risk Ratio (M‐H, Random, 95% CI) | 0.96 [0.83, 1.11] |
| 1.18.1 Biodegradable (Biolimus) | 1 | 1104 | Risk Ratio (M‐H, Random, 95% CI) | 0.90 [0.54, 1.49] |
| 1.18.2 Everolimus | 1 | 1458 | Risk Ratio (M‐H, Random, 95% CI) | 0.85 [0.58, 1.24] |
| 1.18.3 Paclitaxel | 7 | 4305 | Risk Ratio (M‐H, Random, 95% CI) | 1.01 [0.81, 1.26] |
| 1.18.4 Sirolimus | 8 | 3018 | Risk Ratio (M‐H, Random, 95% CI) | 0.89 [0.64, 1.24] |
| 1.18.5 Zotarolimus | 1 | 44 | Risk Ratio (M‐H, Random, 95% CI) | Not estimable |
| 1.18.6 Mixed | 1 | 626 | Risk Ratio (M‐H, Random, 95% CI) | 1.04 [0.60, 1.81] |
| 1.18.7 Unclear | 1 | 384 | Risk Ratio (M‐H, Random, 95% CI) | 1.36 [0.54, 3.40] |
| 1.19 Major cardiovascular events according to type of ACS Show forest plot | 20 | 10939 | Risk Ratio (M‐H, Random, 95% CI) | 0.96 [0.83, 1.11] |
| 1.19.1 STEMI | 19 | 10860 | Risk Ratio (M‐H, Random, 95% CI) | 0.96 [0.83, 1.12] |
| 1.19.2 Acute coronary syndrome | 1 | 79 | Risk Ratio (M‐H, Random, 95% CI) | 0.68 [0.12, 3.87] |
| 1.20 Major cardiovascular events according to length of maximum follow‐up Show forest plot | 20 | 10939 | Risk Ratio (M‐H, Random, 95% CI) | 0.96 [0.83, 1.11] |
| 1.20.1 Less or equal to 6 months | 3 | 563 | Risk Ratio (M‐H, Random, 95% CI) | 1.04 [0.48, 2.28] |
| 1.20.2 Between 1 and 3 years | 9 | 2018 | Risk Ratio (M‐H, Random, 95% CI) | 0.89 [0.69, 1.16] |
| 1.20.3 More or equal to 3 years | 8 | 8358 | Risk Ratio (M‐H, Random, 95% CI) | 0.99 [0.82, 1.19] |
| 1.21 Major cardiovascular events according to registration status Show forest plot | 20 | 10939 | Risk Ratio (M‐H, Random, 95% CI) | 0.96 [0.83, 1.11] |
| 1.21.1 Pre‐registration | 3 | 1248 | Risk Ratio (M‐H, Random, 95% CI) | 0.86 [0.52, 1.42] |
| 1.21.2 Post‐registration | 13 | 8949 | Risk Ratio (M‐H, Random, 95% CI) | 0.97 [0.83, 1.14] |
| 1.21.3 No registration | 4 | 742 | Risk Ratio (M‐H, Random, 95% CI) | 0.95 [0.47, 1.93] |
| 1.22 Cardiovascular mortality Show forest plot | 15 | 9248 | Risk Ratio (M‐H, Random, 95% CI) | 0.91 [0.76, 1.09] |
| 1.23 Cardiovascular mortality best‐worst Show forest plot | 15 | 9742 | Risk Ratio (M‐H, Random, 95% CI) | 0.50 [0.32, 0.77] |
| 1.24 Cardiovascular mortality worst‐best Show forest plot | 15 | 9742 | Risk Ratio (M‐H, Random, 95% CI) | 1.49 [1.06, 2.11] |
| 1.25 Cardiovascular mortality according to type of drug‐eluting stent Show forest plot | 15 | 9248 | Risk Ratio (M‐H, Random, 95% CI) | 0.91 [0.76, 1.09] |
| 1.25.1 Biodegradable (Biolimus) | 1 | 1104 | Risk Ratio (M‐H, Random, 95% CI) | 0.90 [0.54, 1.49] |
| 1.25.2 Everolimus | 1 | 1458 | Risk Ratio (M‐H, Random, 95% CI) | 0.85 [0.58, 1.24] |
| 1.25.3 Paclitaxel | 6 | 4141 | Risk Ratio (M‐H, Random, 95% CI) | 0.86 [0.65, 1.13] |
| 1.25.4 Sirolimus | 5 | 1875 | Risk Ratio (M‐H, Random, 95% CI) | 0.81 [0.52, 1.25] |
| 1.25.5 Zotarolimus | 1 | 44 | Risk Ratio (M‐H, Random, 95% CI) | Not estimable |
| 1.25.6 Mixed | 1 | 626 | Risk Ratio (M‐H, Random, 95% CI) | 2.40 [1.17, 4.93] |
| 1.26 Cardiovascular mortality according to type of ACS Show forest plot | 15 | 9248 | Risk Ratio (M‐H, Random, 95% CI) | 0.91 [0.76, 1.09] |
| 1.26.1 STEMI | 15 | 9248 | Risk Ratio (M‐H, Random, 95% CI) | 0.91 [0.76, 1.09] |
| 1.26.2 Acute coronary syndrome | 0 | 0 | Risk Ratio (M‐H, Random, 95% CI) | Not estimable |
| 1.27 Cardiovascular mortality according to length of maximum follow‐up Show forest plot | 15 | 9248 | Risk Ratio (M‐H, Random, 95% CI) | 0.91 [0.76, 1.09] |
| 1.27.1 Less or equal to 6 months | 1 | 100 | Risk Ratio (M‐H, Random, 95% CI) | 0.21 [0.01, 4.23] |
| 1.27.2 Between 6 and 12 months | 6 | 1584 | Risk Ratio (M‐H, Random, 95% CI) | 0.94 [0.65, 1.35] |
| 1.27.3 Between 1 and 3 years | 2 | 270 | Risk Ratio (M‐H, Random, 95% CI) | 0.56 [0.23, 1.32] |
| 1.27.4 More or equal to 3 years | 6 | 7294 | Risk Ratio (M‐H, Random, 95% CI) | 0.95 [0.72, 1.27] |
| 1.28 Cardiovascular mortality according to registration status Show forest plot | 15 | 9248 | Risk Ratio (M‐H, Random, 95% CI) | 0.91 [0.76, 1.09] |
| 1.28.1 Pre‐registration | 3 | 1248 | Risk Ratio (M‐H, Random, 95% CI) | 0.86 [0.52, 1.42] |
| 1.28.2 Post‐registration | 10 | 7806 | Risk Ratio (M‐H, Random, 95% CI) | 0.93 [0.73, 1.18] |
| 1.28.3 No registration | 2 | 194 | Risk Ratio (M‐H, Random, 95% CI) | 0.71 [0.16, 3.16] |
| 1.29 Myocardial infarction Show forest plot | 19 | 10217 | Risk Ratio (M‐H, Random, 95% CI) | 0.98 [0.82, 1.18] |
| 1.30 Myocardial infarction best‐worst Show forest plot | 19 | 10851 | Risk Ratio (M‐H, Random, 95% CI) | 0.46 [0.33, 0.66] |
| 1.31 Myocardial infarction worst‐best Show forest plot | 19 | 10851 | Risk Ratio (M‐H, Random, 95% CI) | 1.56 [1.00, 2.45] |
| 1.32 Myocardial infarction according to type of drug‐eluting stent Show forest plot | 19 | 10217 | Risk Ratio (M‐H, Random, 95% CI) | 0.98 [0.82, 1.18] |
| 1.32.1 Biodegradable (Biolimus) | 1 | 1118 | Risk Ratio (M‐H, Random, 95% CI) | 0.64 [0.36, 1.15] |
| 1.32.2 Everolimus | 1 | 1458 | Risk Ratio (M‐H, Random, 95% CI) | 1.29 [0.79, 2.11] |
| 1.32.3 Paclitaxel | 7 | 4305 | Risk Ratio (M‐H, Random, 95% CI) | 1.05 [0.75, 1.46] |
| 1.32.4 Sirolimus | 7 | 2282 | Risk Ratio (M‐H, Random, 95% CI) | 0.90 [0.58, 1.39] |
| 1.32.5 Zotarolimus | 1 | 44 | Risk Ratio (M‐H, Random, 95% CI) | Not estimable |
| 1.32.6 Mixed | 1 | 626 | Risk Ratio (M‐H, Random, 95% CI) | 0.74 [0.40, 1.36] |
| 1.32.7 Unclear | 1 | 384 | Risk Ratio (M‐H, Random, 95% CI) | 1.36 [0.54, 3.40] |
| 1.33 Myocardial infarction according to type of ACS Show forest plot | 19 | 10217 | Risk Ratio (M‐H, Random, 95% CI) | 0.98 [0.82, 1.18] |
| 1.33.1 STEMI | 18 | 10138 | Risk Ratio (M‐H, Random, 95% CI) | 0.98 [0.82, 1.18] |
| 1.33.2 Acute coronary syndrome | 1 | 79 | Risk Ratio (M‐H, Random, 95% CI) | 0.68 [0.12, 3.87] |
| 1.34 Myocardial infarction according to length of maximum follow‐up Show forest plot | 19 | 10217 | Risk Ratio (M‐H, Random, 95% CI) | 0.98 [0.82, 1.18] |
| 1.34.1 Less or equal to 6 months | 3 | 563 | Risk Ratio (M‐H, Random, 95% CI) | 1.17 [0.52, 2.63] |
| 1.34.2 Between 6 and 12 months | 7 | 1748 | Risk Ratio (M‐H, Random, 95% CI) | 0.98 [0.58, 1.66] |
| 1.34.3 Between 1 and 3 years | 2 | 270 | Risk Ratio (M‐H, Random, 95% CI) | 0.55 [0.24, 1.25] |
| 1.34.4 More or equal to 3 years | 7 | 7636 | Risk Ratio (M‐H, Random, 95% CI) | 1.00 [0.80, 1.25] |
| 1.35 Myocardial infarction according to registration status Show forest plot | 19 | 10217 | Risk Ratio (M‐H, Random, 95% CI) | 0.98 [0.82, 1.18] |
| 1.35.1 Pre‐registration | 3 | 1262 | Risk Ratio (M‐H, Random, 95% CI) | 0.64 [0.36, 1.15] |
| 1.35.2 Post‐registration | 12 | 8213 | Risk Ratio (M‐H, Random, 95% CI) | 1.03 [0.85, 1.26] |
| 1.35.3 No registration | 4 | 742 | Risk Ratio (M‐H, Random, 95% CI) | 0.97 [0.44, 2.12] |
| 1.36 Stent thrombosis Show forest plot | 21 | 11350 | Risk Ratio (M‐H, Random, 95% CI) | 0.96 [0.80, 1.16] |
| 1.37 Stent thrombosis best‐worst Show forest plot | 21 | 12007 | Risk Ratio (M‐H, Random, 95% CI) | 0.47 [0.32, 0.67] |
| 1.38 Stent thrombosis worst‐best Show forest plot | 21 | 12007 | Risk Ratio (M‐H, Random, 95% CI) | 1.55 [1.12, 2.15] |
| 1.39 Stent thrombosis according to type of drug‐eluting stent Show forest plot | 21 | 11350 | Risk Ratio (M‐H, Random, 95% CI) | 0.96 [0.80, 1.16] |
| 1.39.1 Biodegradable (Biolimus) | 1 | 1104 | Risk Ratio (M‐H, Random, 95% CI) | 0.72 [0.40, 1.30] |
| 1.39.2 Everolimus | 2 | 1932 | Risk Ratio (M‐H, Random, 95% CI) | 0.60 [0.34, 1.08] |
| 1.39.3 Paclitaxel | 7 | 4305 | Risk Ratio (M‐H, Random, 95% CI) | 1.01 [0.73, 1.39] |
| 1.39.4 Sirolimus | 8 | 2957 | Risk Ratio (M‐H, Random, 95% CI) | 1.04 [0.76, 1.41] |
| 1.39.5 Zotarolimus | 1 | 44 | Risk Ratio (M‐H, Random, 95% CI) | Not estimable |
| 1.39.6 Mixed | 1 | 626 | Risk Ratio (M‐H, Random, 95% CI) | 1.00 [0.52, 1.92] |
| 1.39.7 Unclear | 1 | 382 | Risk Ratio (M‐H, Random, 95% CI) | 2.16 [0.82, 5.70] |
| 1.40 Stent thrombosis according to type of ACS Show forest plot | 21 | 11350 | Risk Ratio (M‐H, Random, 95% CI) | 0.96 [0.80, 1.16] |
| 1.40.1 STEMI | 20 | 10876 | Risk Ratio (M‐H, Random, 95% CI) | 0.98 [0.81, 1.18] |
| 1.40.2 NSTEMI | 1 | 474 | Risk Ratio (M‐H, Random, 95% CI) | 0.44 [0.12, 1.68] |
| 1.41 Stent thrombosis according to length of maximum follow‐up Show forest plot | 21 | 11350 | Risk Ratio (M‐H, Random, 95% CI) | 0.96 [0.80, 1.16] |
| 1.41.1 Less or equal to 6 months | 2 | 482 | Risk Ratio (M‐H, Random, 95% CI) | 2.16 [0.82, 5.70] |
| 1.41.2 Between 6 and 12 months | 7 | 1748 | Risk Ratio (M‐H, Random, 95% CI) | 0.83 [0.46, 1.49] |
| 1.41.3 Between 1 and 3 years | 3 | 744 | Risk Ratio (M‐H, Random, 95% CI) | 0.57 [0.25, 1.29] |
| 1.41.4 More or equal to 3 years | 8 | 8360 | Risk Ratio (M‐H, Random, 95% CI) | 0.98 [0.78, 1.22] |
| 1.41.5 Unclear | 1 | 16 | Risk Ratio (M‐H, Random, 95% CI) | 0.20 [0.01, 3.61] |
| 1.42 Stent thrombosis according to registration status Show forest plot | 21 | 11350 | Risk Ratio (M‐H, Random, 95% CI) | 0.96 [0.80, 1.16] |
| 1.42.1 Pre‐registration | 3 | 1248 | Risk Ratio (M‐H, Random, 95% CI) | 0.72 [0.40, 1.30] |
| 1.42.2 Post‐registration | 13 | 9346 | Risk Ratio (M‐H, Random, 95% CI) | 0.99 [0.81, 1.21] |
| 1.42.3 No registration | 5 | 756 | Risk Ratio (M‐H, Random, 95% CI) | 0.70 [0.22, 2.20] |
| 1.43 Target vessel revascularisation Show forest plot | 23 | 11770 | Risk Ratio (M‐H, Fixed, 95% CI) | 0.58 [0.52, 0.65] |
| 1.44 Target vessel revascularisation best‐worst Show forest plot | 23 | 12368 | Risk Ratio (M‐H, Fixed, 95% CI) | 0.41 [0.37, 0.45] |
| 1.45 Target vessel revascularisation worst‐best Show forest plot | 23 | 12368 | Risk Ratio (M‐H, Fixed, 95% CI) | 0.98 [0.89, 1.07] |
| 1.46 Target vessel revascularisation according to type of drug‐eluting stent Show forest plot | 23 | 11770 | Risk Ratio (M‐H, Fixed, 95% CI) | 0.58 [0.52, 0.65] |
| 1.46.1 Biodegradable (Biolimus) | 1 | 1118 | Risk Ratio (M‐H, Fixed, 95% CI) | 0.45 [0.29, 0.70] |
| 1.46.2 Everolimus | 2 | 1932 | Risk Ratio (M‐H, Fixed, 95% CI) | 0.57 [0.42, 0.78] |
| 1.46.3 Sirolimus | 9 | 3062 | Risk Ratio (M‐H, Fixed, 95% CI) | 0.54 [0.44, 0.66] |
| 1.46.4 Paclitaxel | 8 | 4530 | Risk Ratio (M‐H, Fixed, 95% CI) | 0.63 [0.53, 0.75] |
| 1.46.5 Mixed | 1 | 626 | Risk Ratio (M‐H, Fixed, 95% CI) | 0.52 [0.35, 0.76] |
| 1.46.6 Unclear | 1 | 382 | Risk Ratio (M‐H, Fixed, 95% CI) | 2.16 [0.82, 5.70] |
| 1.46.7 Dexamethasone | 1 | 120 | Risk Ratio (M‐H, Fixed, 95% CI) | 0.60 [0.32, 1.12] |
| 1.47 Target vessel revascularisation according to type of ACS Show forest plot | 23 | 11770 | Risk Ratio (M‐H, Fixed, 95% CI) | 0.58 [0.52, 0.65] |
| 1.47.1 STEMI | 20 | 11097 | Risk Ratio (M‐H, Fixed, 95% CI) | 0.59 [0.53, 0.66] |
| 1.47.2 Acute coronary syndrome | 2 | 199 | Risk Ratio (M‐H, Fixed, 95% CI) | 0.49 [0.27, 0.86] |
| 1.47.3 NSTEMI | 1 | 474 | Risk Ratio (M‐H, Fixed, 95% CI) | 0.37 [0.18, 0.77] |
| 1.48 Target vessel revascularisation according to length of maximum follow‐up Show forest plot | 23 | 11770 | Risk Ratio (M‐H, Fixed, 95% CI) | 0.58 [0.52, 0.65] |
| 1.48.1 Less or equal to 6 months | 4 | 724 | Risk Ratio (M‐H, Fixed, 95% CI) | 0.46 [0.25, 0.84] |
| 1.48.2 Between 6 and 12 months | 8 | 1930 | Risk Ratio (M‐H, Fixed, 95% CI) | 0.58 [0.43, 0.78] |
| 1.48.3 Between 1 and 3 years | 3 | 744 | Risk Ratio (M‐H, Fixed, 95% CI) | 0.33 [0.19, 0.56] |
| 1.48.4 More or equal to 3 years | 8 | 8372 | Risk Ratio (M‐H, Fixed, 95% CI) | 0.61 [0.54, 0.69] |
| 1.48.5 Unclear | 0 | 0 | Risk Ratio (M‐H, Fixed, 95% CI) | Not estimable |
| 1.49 Target vessel revascularisation according to registration status Show forest plot | 23 | 11770 | Risk Ratio (M‐H, Fixed, 95% CI) | 0.58 [0.52, 0.65] |
| 1.49.1 Pre‐registration | 3 | 1262 | Risk Ratio (M‐H, Fixed, 95% CI) | 0.42 [0.28, 0.65] |
| 1.49.2 Post‐registration | 14 | 9425 | Risk Ratio (M‐H, Fixed, 95% CI) | 0.60 [0.53, 0.67] |
| 1.49.3 No registration | 6 | 1083 | Risk Ratio (M‐H, Fixed, 95% CI) | 0.56 [0.38, 0.82] |
| Outcome or subgroup title | No. of studies | No. of participants | Statistical method | Effect size |
| 2.1 All‐cause mortality Show forest plot | 6 | 3213 | Risk Ratio (M‐H, Fixed, 95% CI) | 0.78 [0.49, 1.22] |
| 2.2 All‐cause mortality best‐worst Show forest plot | 6 | 3231 | Risk Ratio (M‐H, Random, 95% CI) | 0.61 [0.40, 0.95] |
| 2.3 All‐cause mortality worst‐best Show forest plot | 6 | 3231 | Risk Ratio (M‐H, Random, 95% CI) | 0.92 [0.60, 1.43] |
| 2.4 All‐cause mortality according to type of drug‐eluting stent Show forest plot | 6 | 3213 | Risk Ratio (M‐H, Fixed, 95% CI) | 0.78 [0.49, 1.22] |
| 2.4.1 Everolimus | 1 | 1498 | Risk Ratio (M‐H, Fixed, 95% CI) | 0.78 [0.36, 1.71] |
| 2.4.2 Paclitaxel | 3 | 857 | Risk Ratio (M‐H, Fixed, 95% CI) | 0.83 [0.42, 1.64] |
| 2.4.3 Sirolimus | 2 | 858 | Risk Ratio (M‐H, Fixed, 95% CI) | 0.68 [0.26, 1.78] |
| 2.5 All‐cause mortality according to type of ACS Show forest plot | 6 | 3213 | Risk Ratio (M‐H, Fixed, 95% CI) | 0.78 [0.49, 1.22] |
| 2.5.1 STEMI | 6 | 3213 | Risk Ratio (M‐H, Fixed, 95% CI) | 0.78 [0.49, 1.22] |
| 2.6 All‐cause mortality according to registration status Show forest plot | 6 | 3213 | Risk Ratio (M‐H, Fixed, 95% CI) | 0.78 [0.49, 1.22] |
| 2.6.1 Post‐registration | 3 | 2856 | Risk Ratio (M‐H, Fixed, 95% CI) | 0.68 [0.41, 1.14] |
| 2.6.2 No registration | 3 | 357 | Risk Ratio (M‐H, Fixed, 95% CI) | 1.28 [0.47, 3.47] |
| 2.7 Serious adverse events Show forest plot | 7 | 3313 | Risk Ratio (M‐H, Random, 95% CI) | 0.65 [0.45, 0.93] |
| 2.8 Serious adverse events best‐worst Show forest plot | 7 | 3331 | Risk Ratio (M‐H, Random, 95% CI) | 0.56 [0.40, 0.80] |
| 2.9 Serious adverse events worst‐best Show forest plot | 7 | 3331 | Risk Ratio (M‐H, Random, 95% CI) | 0.73 [0.52, 1.03] |
| 2.10 Serious adverse events according to type of drug‐eluting stent Show forest plot | 7 | 3313 | Risk Ratio (M‐H, Random, 95% CI) | 0.65 [0.45, 0.93] |
| 2.10.1 Everolimus | 1 | 1498 | Risk Ratio (M‐H, Random, 95% CI) | 0.55 [0.30, 0.98] |
| 2.10.2 Paclitaxel | 4 | 957 | Risk Ratio (M‐H, Random, 95% CI) | 0.77 [0.41, 1.46] |
| 2.10.3 Sirolimus | 2 | 858 | Risk Ratio (M‐H, Random, 95% CI) | 0.67 [0.35, 1.28] |
| 2.11 Serious adverse events according to type of ACS Show forest plot | 7 | 3313 | Risk Ratio (M‐H, Random, 95% CI) | 0.65 [0.45, 0.93] |
| 2.11.1 STEMI | 7 | 3313 | Risk Ratio (M‐H, Random, 95% CI) | 0.65 [0.45, 0.93] |
| 2.12 Serious adverse events according to registration status Show forest plot | 7 | 3313 | Risk Ratio (M‐H, Random, 95% CI) | 0.65 [0.45, 0.93] |
| 2.12.1 Pre‐registration | 1 | 100 | Risk Ratio (M‐H, Random, 95% CI) | 0.35 [0.01, 8.31] |
| 2.12.2 Post‐registration | 3 | 2856 | Risk Ratio (M‐H, Random, 95% CI) | 0.60 [0.41, 0.88] |
| 2.12.3 No registration | 3 | 357 | Risk Ratio (M‐H, Random, 95% CI) | 1.09 [0.43, 2.76] |
| 2.13 Major cardiovascular events Show forest plot | 6 | 3150 | Risk Ratio (M‐H, Random, 95% CI) | 0.68 [0.43, 1.08] |
| 2.14 Major cardiovascular events best‐worst Show forest plot | 6 | 3168 | Risk Ratio (M‐H, Random, 95% CI) | 0.54 [0.35, 0.84] |
| 2.15 Major cardiovascular events worst‐best Show forest plot | 6 | 3168 | Risk Ratio (M‐H, Random, 95% CI) | 0.82 [0.53, 1.27] |
| 2.16 Major cardiovascular events according to type of drug‐eluting stent Show forest plot | 6 | 3150 | Risk Ratio (M‐H, Random, 95% CI) | 0.68 [0.43, 1.08] |
| 2.16.1 Everolimus | 1 | 1498 | Risk Ratio (M‐H, Random, 95% CI) | 0.78 [0.36, 1.71] |
| 2.16.2 Paclitaxel | 3 | 794 | Risk Ratio (M‐H, Random, 95% CI) | 0.66 [0.32, 1.37] |
| 2.16.3 Sirolimus | 2 | 858 | Risk Ratio (M‐H, Random, 95% CI) | 0.60 [0.25, 1.45] |
| 2.17 Major cardiovascular events according to type of ACS Show forest plot | 6 | 3150 | Risk Ratio (M‐H, Random, 95% CI) | 0.68 [0.43, 1.08] |
| 2.17.1 STEMI | 6 | 3150 | Risk Ratio (M‐H, Random, 95% CI) | 0.68 [0.43, 1.08] |
| 2.18 Major cardiovascular events according to registration status Show forest plot | 6 | 3150 | Risk Ratio (M‐H, Random, 95% CI) | 0.68 [0.43, 1.08] |
| 2.18.1 Pre‐registration | 1 | 100 | Risk Ratio (M‐H, Random, 95% CI) | 0.35 [0.01, 8.31] |
| 2.18.2 Post‐registration | 3 | 2856 | Risk Ratio (M‐H, Random, 95% CI) | 0.67 [0.41, 1.09] |
| 2.18.3 No registration | 2 | 194 | Risk Ratio (M‐H, Random, 95% CI) | 0.92 [0.24, 3.58] |
| 2.19 Cardiovascular mortality Show forest plot | 5 | 2406 | Risk Ratio (M‐H, Fixed, 95% CI) | 0.73 [0.43, 1.25] |
| 2.20 Cardiovascular mortality best‐worst Show forest plot | 5 | 2423 | Risk Ratio (M‐H, Fixed, 95% CI) | 0.53 [0.32, 0.88] |
| 2.21 Cardiovascular mortality worst‐best Show forest plot | 5 | 2423 | Risk Ratio (M‐H, Random, 95% CI) | 0.90 [0.54, 1.50] |
| 2.22 Cardiovascular mortality according to type of drug‐eluting stent Show forest plot | 5 | 2406 | Risk Ratio (M‐H, Fixed, 95% CI) | 0.73 [0.43, 1.25] |
| 2.22.1 Everolimus | 1 | 1498 | Risk Ratio (M‐H, Fixed, 95% CI) | 0.78 [0.36, 1.71] |
| 2.22.2 Paclitaxel | 3 | 794 | Risk Ratio (M‐H, Fixed, 95% CI) | 0.67 [0.30, 1.46] |
| 2.22.3 Sirolimus | 1 | 114 | Risk Ratio (M‐H, Fixed, 95% CI) | 0.90 [0.13, 6.17] |
| 2.23 Cardiovascular mortality according to type of ACS Show forest plot | 5 | 2406 | Risk Ratio (M‐H, Fixed, 95% CI) | 0.73 [0.43, 1.25] |
| 2.23.1 STEMI | 5 | 2406 | Risk Ratio (M‐H, Fixed, 95% CI) | 0.73 [0.43, 1.25] |
| 2.24 Cardiovascular mortality according to registration status Show forest plot | 5 | 2406 | Risk Ratio (M‐H, Fixed, 95% CI) | 0.73 [0.43, 1.25] |
| 2.24.1 Pre‐registration | 1 | 100 | Risk Ratio (M‐H, Fixed, 95% CI) | 0.35 [0.01, 8.31] |
| 2.24.2 Post‐registration | 2 | 2112 | Risk Ratio (M‐H, Fixed, 95% CI) | 0.70 [0.39, 1.25] |
| 2.24.3 No registration | 2 | 194 | Risk Ratio (M‐H, Fixed, 95% CI) | 1.30 [0.27, 6.38] |
| 2.25 Myocardial infarction Show forest plot | 6 | 3150 | Risk Ratio (M‐H, Random, 95% CI) | 0.51 [0.26, 0.98] |
| 2.26 Myocardial infarction best‐worst Show forest plot | 6 | 3168 | Risk Ratio (M‐H, Random, 95% CI) | 0.37 [0.20, 0.68] |
| 2.27 Myocardial infarction worst‐best Show forest plot | 6 | 3168 | Risk Ratio (M‐H, Random, 95% CI) | 0.74 [0.41, 1.32] |
| 2.28 Myocardial infarction according to type of drug‐eluting stent Show forest plot | 6 | 3150 | Risk Ratio (M‐H, Random, 95% CI) | 0.51 [0.26, 0.98] |
| 2.28.1 Everolimus | 1 | 1498 | Risk Ratio (M‐H, Random, 95% CI) | 0.55 [0.19, 1.64] |
| 2.28.2 Paclitaxel | 3 | 794 | Risk Ratio (M‐H, Random, 95% CI) | 0.38 [0.09, 1.63] |
| 2.28.3 Sirolimus | 2 | 858 | Risk Ratio (M‐H, Random, 95% CI) | 0.54 [0.20, 1.46] |
| 2.29 Myocardial infarction according to type of ACS Show forest plot | 6 | 3150 | Risk Ratio (M‐H, Random, 95% CI) | 0.51 [0.26, 0.98] |
| 2.29.1 STEMI | 6 | 3150 | Risk Ratio (M‐H, Random, 95% CI) | 0.51 [0.26, 0.98] |
| 2.30 Myocardial infarction according to registration status Show forest plot | 6 | 3150 | Risk Ratio (M‐H, Random, 95% CI) | 0.51 [0.26, 0.98] |
| 2.30.1 Pre‐registration | 1 | 100 | Risk Ratio (M‐H, Random, 95% CI) | Not estimable |
| 2.30.2 Post‐registration | 3 | 2856 | Risk Ratio (M‐H, Random, 95% CI) | 0.50 [0.25, 1.00] |
| 2.30.3 No registration | 2 | 194 | Risk Ratio (M‐H, Random, 95% CI) | 0.59 [0.07, 4.69] |
| 2.31 Stent thrombosis Show forest plot | 5 | 3070 | Risk Ratio (M‐H, Random, 95% CI) | 0.48 [0.26, 0.90] |
| 2.32 Stent thrombosis best‐worst Show forest plot | 5 | 3088 | Risk Ratio (M‐H, Random, 95% CI) | 0.36 [0.20, 0.65] |
| 2.33 Stent thrombosis worst‐best Show forest plot | 5 | 3088 | Risk Ratio (M‐H, Random, 95% CI) | 0.68 [0.39, 1.18] |
| 2.34 Stent thrombosis according to type of drug‐eluting stent Show forest plot | 5 | 3070 | Risk Ratio (M‐H, Random, 95% CI) | 0.48 [0.26, 0.90] |
| 2.34.1 Everolimus | 1 | 1498 | Risk Ratio (M‐H, Random, 95% CI) | 0.37 [0.15, 0.95] |
| 2.34.2 Paclitaxel | 2 | 714 | Risk Ratio (M‐H, Random, 95% CI) | 0.66 [0.11, 3.94] |
| 2.34.3 Sirolimus | 2 | 858 | Risk Ratio (M‐H, Random, 95% CI) | 0.58 [0.23, 1.46] |
| 2.35 Stent thrombosis according to type of ACS Show forest plot | 5 | 3070 | Risk Ratio (M‐H, Random, 95% CI) | 0.48 [0.26, 0.90] |
| 2.35.1 STEMI | 5 | 3070 | Risk Ratio (M‐H, Random, 95% CI) | 0.48 [0.26, 0.90] |
| 2.36 Stent thrombosis according to registration status Show forest plot | 5 | 3070 | Risk Ratio (M‐H, Random, 95% CI) | 0.48 [0.26, 0.90] |
| 2.36.1 Pre‐registration | 1 | 100 | Risk Ratio (M‐H, Random, 95% CI) | Not estimable |
| 2.36.2 Post‐registration | 3 | 2856 | Risk Ratio (M‐H, Random, 95% CI) | 0.47 [0.25, 0.88] |
| 2.36.3 No registration | 1 | 114 | Risk Ratio (M‐H, Random, 95% CI) | 0.90 [0.06, 14.04] |
| 2.37 Target vessel revascularisation Show forest plot | 6 | 3233 | Risk Ratio (M‐H, Random, 95% CI) | 0.50 [0.31, 0.82] |
| 2.38 Target vessel revascularisation best‐worst Show forest plot | 6 | 3251 | Risk Ratio (M‐H, Random, 95% CI) | 0.41 [0.26, 0.66] |
| 2.39 Target vessel revascularisation worst‐best Show forest plot | 6 | 3251 | Risk Ratio (M‐H, Random, 95% CI) | 0.62 [0.40, 0.98] |
| 2.40 Target vessel revascularisation according to type of drug‐eluting stent Show forest plot | 6 | 3233 | Risk Ratio (M‐H, Random, 95% CI) | 0.50 [0.31, 0.82] |
| 2.40.1 Everolimus | 1 | 1498 | Risk Ratio (M‐H, Random, 95% CI) | 0.36 [0.17, 0.76] |
| 2.40.2 Paclitaxel | 3 | 877 | Risk Ratio (M‐H, Random, 95% CI) | 0.52 [0.18, 1.49] |
| 2.40.3 Sirolimus | 2 | 858 | Risk Ratio (M‐H, Random, 95% CI) | 0.77 [0.29, 2.04] |
| 2.41 Target vessel revascularisation according to type of ACS Show forest plot | 6 | 3233 | Risk Ratio (M‐H, Random, 95% CI) | 0.50 [0.31, 0.82] |
| 2.41.1 STEMI | 6 | 3233 | Risk Ratio (M‐H, Random, 95% CI) | 0.50 [0.31, 0.82] |
| 2.42 Target vessel revascularisation according to registration status Show forest plot | 6 | 3233 | Risk Ratio (M‐H, Random, 95% CI) | 0.50 [0.31, 0.82] |
| 2.42.1 Pre‐registration | 1 | 100 | Risk Ratio (M‐H, Random, 95% CI) | Not estimable |
| 2.42.2 Post‐registration | 3 | 2856 | Risk Ratio (M‐H, Random, 95% CI) | 0.53 [0.32, 0.90] |
| 2.42.3 No registration | 2 | 277 | Risk Ratio (M‐H, Random, 95% CI) | 0.34 [0.09, 1.29] |
