PONE-D-20-24066

Short- versus long-term  dual antiplatelet therapy after second-generation drug-eluting stent implantation in patients with diabetes mellitus: A Meta-analysis of Randomized Controlled Trials

PLOS ONE

Dear Dr. Huang,

Thank you for submitting your manuscript to PLOS ONE. After careful consideration, we feel that it has merit but does not fully meet PLOS ONE’s publication criteria as it currently stands. Therefore, we invite you to submit a revised version of the manuscript that addresses the points raised during the review process.

Editors comments:

The major limitation of this study is that it was snot mentioned whether this is all PCI with diabetes  and percentage of ACS or stable ischemic heart disease ( SIHD) patients. The current guidelines have specific recommendations on DAPT such as ACS patients 6-12 month and stable angina patients 3-6 months and can stop after minimum 3 or 6 months if needed. 

I recommend to do 1) a subgroup analysis of ACS and SIHD patients 2) 3 months Vs 6 months instead of 6 months vs 12 months 

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Timir Paul

Academic Editor

PLOS ONE

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Editor Comments :

The major limitation of this study is that it was snot mentioned whether this is all PCI with diabetes  and percentage of ACS or stable ischemic heart disease ( SIHD) patients. The current guidelines have specific recommendations on DAPT such as ACS patients 6-12 month and stable angina patients 3-6 months and can stop after minimum 3 or 6 months if needed. 

I recommend to do 1) a subgroup analysis of ACS and SIHD patients 2) 3 months Vs 6 months instead of 6 months vs 12 months

Reviewers' comments:

Reviewer's Responses to Questions

Comments to the Author

1. Is the manuscript technically sound, and do the data support the conclusions?

The manuscript must describe a technically sound piece of scientific research with data that supports the conclusions. Experiments must have been conducted rigorously, with appropriate controls, replication, and sample sizes. The conclusions must be drawn appropriately based on the data presented.

Reviewer #1: Yes

Reviewer #2: Yes

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2. Has the statistical analysis been performed appropriately and rigorously?

Reviewer #1: Yes

Reviewer #2: I Don't Know

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3. Have the authors made all data underlying the findings in their manuscript fully available?

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Reviewer #1: Yes

Reviewer #2: Yes

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Reviewer #1: Yes

Reviewer #2: Yes

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5. Review Comments to the Author

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Reviewer #1: This meta-analysis is well performed. I have some concern regarding the study as mentioned below.

- 6 months DAPT after PCI has already been accepted in the guidelines to be safe for all patients including diabetes. The question is not to compare 6 months of DAPT to 12 months or more, but rather to compared shorter DAPT therapy duration to 6 months DAPT therapy duration.

- The manuscript is lacking the brief overview of each research studies used in meta-analysis in tabular format including stent types, IDDM vs NIDDM if data is available, bifurcation stenting, anticoagulation used during PCI, duration of DAPT, follow-up time, etc. This is very vital for any meta-analysis. I see some details in the result section, but that is not enough.

Reviewer #2: besides few words corrections, it is a well written nice manuscript. It is written in good intellectual language and lays the strengths and weaknesses of the study. The limitations were laid out nicely and it speaks for the study power.

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Reviewer #1: No

Reviewer #2: No

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Short- versus long-term  dual antiplatelet therapy after second-generation drug-eluting stent implantation in patients with diabetes mellitus: A Meta-analysis of Randomized Controlled Trials

PONE-D-20-24066R1

Dear Dr. Huang,

We’re pleased to inform you that your manuscript has been judged scientifically suitable for publication and will be formally accepted for publication once it meets all outstanding technical requirements.

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Kind regards,

Timir Paul

Academic Editor

PLOS ONE

Additional Editor Comments (optional):

All queries have been addressed appropriately