Author Affiliations: Department of Epidemiology and Public Health, University College London, London, England (firstname.lastname@example.org).
In Reply: We considered all included trials to be within the remit of our systematic review, including those involving patients receiving clopidogrel for indications other than PCI.1- 3 However, based on the letters from Dr Shuldiner and Dr Mega and their colleagues, we excluded these studies, which yielded a summary relative risk (RR) of 1.22 (95% CI, 1.11-1.33) for the association of CYP2C19 genotype with cardiovascular disease (CVD) events. The addition of the 3 studies alluded to by Mega et al, excluded by us because they focused solely on stent thrombosis, yielded a summary RR of 1.21 (95% CI, 1.12-1.30) for CVD events. These modest effect estimates also remain affected by small-study bias.
Holmes MV, Hingorani AD, Casas JP. CYP2C19 Genotype and Cardiovascular Events—Reply. JAMA. 2012;307(14):1482-1485. doi:10.1001/jama.2012.446