Key result
Indobufen DAPT cuts bleeding ~53% vs aspirin DAPT without increasing MACCE.
Why the study?
Dual antiplatelet therapy with aspirin and a P2Y12 inhibitor is standard after PCI, but the comparative efficacy and safety of indobufen-based DAPT versus aspirin-based DAPT remained to be evaluated.
Does indobufen-based DAPT reduce bleeding or ischemic events compared to aspirin-based DAPT in patients after PCI?
Does indobufen-based DAPT reduce bleeding or ischemic events compared to aspirin-based DAPT in patients after PCI?
Indobufen-based DAPT may offer a safer alternative to standard aspirin-based DAPT after PCI by reducing bleeding risk without increasing the risk of major adverse cardiac and cerebrovascular events.
Indobufen-based DAPT may reduce post-PCI bleeding without raising MACCE risk; extends evidence from RCTs and cohort studies.
Background Dual antiplatelet therapy (DAPT), which combines aspirin with a P2Y12 receptor inhibitor, is considered the standard of care for patients who have had percutaneous coronary intervention (PCI). This study aimed to compare indobufen‐based (DAPT) to aspirin‐based (DAPT) after PCI. Methods This systematic review and meta‐analysis analyzed randomized controlled trials (RCTs) and propensity‐matched cohort studies comparing indobufen (DAPT) to standard aspirin (DAPT) after PCI. We searched four databases: PubMed, Scopus, Web of Science, and Cochrane through January 2025 and updated the search in September 2025. Dichotomous data were pooled as odds ratios with 95% CIs. Results Our search identified 403 records; only five studies were included in the analysis. Comparing major adverse cardiac and cerebrovascular events (MACCE) between the indobufen and aspirin groups, no difference was observed (OR 1.12, 95% CI: 0.87–1.46; p = 0.38). Bleeding BARC types 2, 3, 5 were compared between the two groups, showing fewer bleeding events in the indobufen group than in the aspirin group (OR: 0.47, 95% CI: 0.24–0.95; p = 0.03). Conclusion Indobufen‐based (DAPT) had a lower incidence of bleeding than aspirin‐based (DAPT), with no difference between the two groups for MACCE, myocardial infarction, ischemic stroke, cardiovascular death, repeat vascularization, or stent thrombosis.
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Saeed et al. (2026) studied this question. Indobufen dual antiplatelet therapy resulted in fewer bleeding events than aspirin dual antiplatelet therapy (OR 0.47, 95% CI: 0.24–0.95; p = 0.03) without increasing MACCE.
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