CARDIOVASCULAR JOURNAL OF AFRICA • Vol 24, No 7, August 2013
276
AFRICA
The efficacy of SES versus BMS is presented in Table 2. As
shown, the pooled OR was 0.42 (95% CI: 0.24–0.74,
p
<
0.01)
for SES versus BMS. This suggests that, after the data had been
pooled, SES were more effective than BMS in CAD patients
with diabetes. However, there was publication bias (
t
=
–4.19,
p
<
0.05).
As shown in Fig. 2A, the pooled OR was 0.42 (95% CI:
0.24–0.74,
p
<
0.01) for overall events, suggesting that SES
had a better outcome compared with BMS, with a greater
reduction in risk for major cardiac events. However, there were
heterogeneities between the studies (
Q
2
=
20.14,
I
2
=
75.0%,
p
<
0.1) and publication bias, as shown in Fig. 2B (asymmetric
funnel plot). This was further confirmed with Egger’s linear
regression test, shown in Table 2 (
t
=
–4.19,
p
<
0.05).
As shown in Fig. 3, the pooled OR was 0.26 (95% CI: 0.11–
0.59,
p
<
0.01) for SES versus BMS, suggesting that SES had
a better revascularisation rate for target lesions compared with
BMS. However, there were heterogeneities between the studies
(
Q
2
=
24.44,
I
2
=
80.0%,
p
<
0.1) and publication bias (
t
=
–6.44,
p
<
0.05).
As shown in Fig. 4, the pooled OR was 0.92 (95% CI: 0.61–
1.40,
p
>
0.05) for SES versus BMS, suggesting that the overall
risk for myocardial infarction was not significantly different
between these two groups. There was no heterogeneity between
the studies (
Q
2
=
4.37,
I
2
=
0%,
p
>
0.1) but there was publication
bias (
t
=
–3.44,
p
<
0.05).
As shown in Fig. 5, the pooled OR was 1.19 (95% CI:
0.74–1.92,
p
>
0.05) for SES versus BMS, suggesting that the
overall risk of mortality was not significantly different between
the groups. There was no publication bias (
t
=
–1.69,
P
>
0.05)
or heterogeneities between the studies (
Q
2
=
3.88,
I
2
=
0.0%,
p
>
0.1).
Subgroup analyses were stratified by sample size, subjects’
geographical area and study method. As shown in Table 2 and
Figure 6A–C, the pooled OR was 0.28 (95%
CI: 0.16–0.48,
p
<
0.01, Fig. 6A) for SES versus BMS in studies whose sample size
A
SES
BMS
Weight
(%)
Odds ratio
Odds ratio
Study or subgroup
Events Total Events Total
M–H, random, (95% CI)
M–H, random, (95% CI)
Aoki J,
et al.
27 112 37 118 18.5
0.70 (0.39–1.24)
0.01
0.1 1 10 100
SES
BMS
Baumgart D,
et al.
15
94 38
96 17.2
0.29 (0.15–0.58)
Chan C,
et al.
8
54 12
29 12.8
0.25 (0.09–0.71)
Daemen J,
et al.
44 206 54 252 20.1
1.00 (0.64–1.56)
Jimenez-Quevedo P,
et al.
8
80 31
80 15.0
0.18 (0.07–0.41)
Maresta A,
et al.
15
68 28
70 16.4
0.42 (0.20–0.90)
Total (95% CI)
614
645
100.0
0.42 (0.24–0.74)
Total events
117
200
Heterogeneity: Tau
2
= 0.36; Chi
2
= 20.14, df = 5 (
p
= 0.001);
I
2
= 75%
Test for overall effect:
Z
= 3.00 (
p
= 0.003)
0
0.2
0.4
0.6
0.8
B
SE (log OR)
0.01
0.1 1 10 100
OR
Fig. 2. A: Forest plots of studies with major adverse cardiac events in the SES group versus the BMS group. B: Funnel
plots of studies with major adverse cardiac events in the SES group versus the BMS group.
SES
BMS
Weight (%)
Odds ratio
Odds ratio
Study or subgroup
Events
Total
Events
Total
M–H, random, (95% CI)
M–H, random, (95% CI)
Aoki J,
et al.
9
112
23
118
17.9
0.36 (0.16–0.82)
SES
BMS
0.01
0.1 1 10 100
Baumgart D,
et al.
3
94
24
96
14.6
0.10 (0.03–0.34)
Chan C,
et al.
7
54
10
29
15.7
0.28 (0.09–0.85)
Daemen J,
et al.
28
206
35
252
19.9
0.98 (0.57–1.67)
Jimenez-Quevedo P,
et al.
5
80
28
80
16.4
0.12 (0.04–0.34)
Maresta A,
et al.
4
68
21
70
15.5
0.15 (0.05–0.45)
Total (95% CI)
614
645
100.0
0.26 (0.11–0.59)
Total events
56
141
Heterogeneity: Tau
2
= 0.83; Chi
2
= 24.44, df = 5 (
p
= 0.0002);
I
2
= 80%
Test for overall effect:
Z
= 3.22 (
p
= 0.001)
Fig. 3. Forest plots of studies with target-lesion revascularisation events in the SES group versus the BMS group.
SES
BMS
Weight (%)
Odds ratio
Odds ratio
Study or subgroup
Events
Total
Events
Total
M–H, random, (95% CI)
M–H, random, (95% CI)
Aoki J,
et al.
18
112
14
118
25.1
1.42 (0.67–3.02)
SES
BMS
0.01
0.1 1 10 100
Baumgart D,
et al.
4
94
5
96
10.4
0.81 (0.21–3.11)
Chan C,
et al.
1
54
2
29
5.6
0.25 (0.02–2.94)
Daemen J,
et al.
10
206
11
252
20.7
1.12 (0.47–2.69)
Jimenez-Quevedo P,
et al.
2
80
6
80
12.8
0.32 (0.06–1.62)
Maresta A,
et al.
11
68
14
70
25.4
0.77 (0.32–1.85)
Total (95% CI)
614
645
100.0
0.92 (0.61–1.40)
Total events
46
52
Heterogeneity: Chi
2
= 4.37, df = 5 (
p
= 0.50);
I
2
= 0%
Test for overall effect:
Z
= 0.37 (
p
= 0.71)
Fig. 4. Forest plots of studies with myocardial infarction events in the SES group versus the BMS group.
