How would that affect the inference being made here? That is, the claim being made is with regard to combined cardiovascular events. This effect is significant and the GRADE quality is moderate.

One of the main purposes of meta-analyses is to summate multiple studies that may have insufficient statistical power in isolation to find a significant effect, but when summated they do.

I _think_ you're trying to suggest that the insignificant individual event types aren't contributing to the significant findings on the combined event endpoint, so we should ignore the GRADE quality of those (correct me if I'm wrong). But that's not how meta analysis functions - those events are also contributing to the significant finding on that endpoint (which is also why the GRADE quality of the combined endpoint is moderate). They just aren't significant _in isolation_.