Quantifying the Treatment Effect of Drug-Eluting Stents Optimized for Biocompatibility vs Bare-Metal Stents With a Single Month of Dual Antiplatelet Therapy

To the Editor Shah et al¹ conducted an interesting meta-analysis to evaluate drug-eluting stents (DESs) vs bare-metal stents (BMSs). The efficacy end points included, for example, major adverse cardiac events and target lesion revascularization observed at 1 year. Since Figure 1B¹ shows that the fixed-effect model assumption was likely invalid, the authors used the random-effects model procedure to combine individual odds ratios (ORs) of DESs vs BMSs to quantify the treatment effect. The pooled ORs for major adverse cardiac events and target lesion revascularization were 0.68 (95% CI, 0.57-0.82; P < .001) and 0.38 (95% CI, 0.22-0.67; P = .001), respectively, which were statistically significant in favor of DESs. However, using pooled ORs to quantify the size of treatment effect in meta-analysis is problematic for the present case.