Table 3.

GRADE assessment of evidence for key outcomes.

Outcome	Certainty of Evidence (GRADE)	Reasons for Downgrading
Nonfatal Myocardial Infarction	Moderate	Downgraded due to imprecision caused by relatively low event numbers and wide confidence intervals, which limited the certainty regarding small differences between DCB and DES.
Cardiac Death	Moderate	Downgraded due to imprecision resulting from the low frequency of cardiac death events and insufficient statistical power to detect clinically meaningful differences, despite consistent effects across studies.
All-Cause Death	Moderate	Downgraded because the number of observed deaths was relatively small, resulting in uncertainty regarding the precision of pooled estimates despite low statistical heterogeneity.
Target Lesion Revascularization	Moderate	Downgraded due to potential risk of outcome assessment bias related to open-label trial designs and variations in endpoint definitions, including differences between clinically driven and protocol-driven revascularization.
Target Vessel Revascularization	Low to Moderate	Downgraded due to multiple sources of uncertainty, including non-blinded outcome assessment, protocol-driven angiographic surveillance in some trials, and heterogeneity in TVR definitions across studies.