Response to Letter Regarding Article, “Stent Thrombosis with Everolimus-Eluting Stents: Meta-Analysis of Comparative Randomized Controlled Trials”

We thank Dr Nammas for his interest in our meta-analysis on stent thrombosis (ST).1 We investigated the issue that potential differences in the relative risk (RR) of ST between everolimus-eluting stent (EES) and other drug-eluting stent comparators may invalidate pooling by interaction analysis. Of note, although no significant interaction was apparent between EES and any drug-eluting stent comparator for the RR of definite ST (the primary end point of our study), a significant interaction was present between the RR reduction of definite/probable ST with EES versus paclitaxel-eluting stents compared with EES versus sirolimus-eluting stents (SES). Thus, this statistical uncertainty is ascribed to differences in the relative rates of probable ST, which is a less specific reflection of the true incidence of ST than is definite ST. We, therefore, believe that the consistency of the definite ST findings most reliably affects the …