Evaluating drug-coated balloon versus drug-eluting stent for the treatment of small coronary artery disease: a meta-analysis and systematic review

Figures

• 

  Figure 1. Flowchart of literature selection process.

• 

  Figure 2. Risk of bias assessment of the included randomized controlled trials using the cochrane RoB 2 tool. (A) Summary plot showing the proportion of judgments across each risk-of-bias domain among the included randomized controlled trials; (B) traffic light plot showing risk-of-bias judgments for each individual randomized controlled trial.

• 

  Figure 3. Meta-analysis of nonfatal myocardial infarction comparing drug-coated balloons with drug-eluting stents after accounting for overlapping randomized controlled trial cohorts. (A) Forest plot showing pooled odds ratios for nonfatal myocardial infarction. (B) Funnel plot showing the distribution of effect estimates. Because fewer than 10 randomized controlled trials contributed to this outcome, funnel plot asymmetry was interpreted as an exploratory assessment rather than definitive evidence of publication bias.

• 

  Figure 4. Meta-analysis of cardiac death comparing drug-coated balloons with drug-eluting stents after accounting for overlapping randomized controlled trial cohorts. (A) Forest plot showing pooled odds ratios for cardiac death. (B) Funnel plot showing the distribution of effect estimates for cardiac death. Because only a limited number of randomized controlled trials contributed to this outcome, funnel plot asymmetry was interpreted cautiously as an exploratory assessment rather than definitive evidence of publication bias.

• 

  Figure 5. Meta-analysis of all-cause death comparing drug-coated balloons with drug-eluting stents using unique randomized controlled trial cohorts. (A) Forest plot showing pooled odds ratios for all-cause death. (B) Funnel plot showing the distribution of effect estimates for all-cause death.

• 

  Figure 6. Meta-analysis of target lesion revascularization comparing drug-coated balloons with drug-eluting stents. (A) Forest plot showing pooled odds ratios for target lesion revascularization. (B) Funnel plot showing the distribution of effect estimates for target lesion revascularization.

• 

  Figure 7. Meta-analysis of target-vessel revascularization comparing drug-coated balloons with drug-eluting stents after accounting for unique randomized controlled trial cohorts. (A) Forest plot showing pooled odds ratios for target-vessel revascularization. The random-effects model demonstrated no statistically significant difference between DCB and DES groups (OR = 0.76, 95% CI: 0.47–1.23; I2 = 34%). (B) Funnel plot showing the distribution of effect estimates. No apparent asymmetry was observed; however, because fewer than 10 randomized controlled trials contributed to this outcome, funnel plot interpretation should be considered exploratory rather than definitive evidence of publication bias.