Key result
Indobufen-based DAPT matches aspirin for MACE while cutting bleeding events ~49% after PCI.
Why the study?
Aspirin in conventional DAPT post-PCI increases gastrointestinal and bleeding risks, making it important to evaluate whether indobufen offers comparable efficacy and improved safety.
Does indobufen-based dual antiplatelet therapy reduce bleeding events and prevent MACE in patients undergoing PCI compared to aspirin-based dual antiplatelet therapy?
Meta-Analysis (n=7,928)
Does indobufen-based dual antiplatelet therapy reduce bleeding events and prevent MACE in patients undergoing PCI compared to aspirin-based dual antiplatelet therapy?
Odds Ratio: 0.89 (95% CI 0.73–1.1)
p-value: p=0.284
In patients undergoing PCI, replacing aspirin with indobufen in dual antiplatelet therapy provides comparable protection against MACE while significantly reducing the risk of bleeding and gastrointestinal adverse events.
Indobufen may replace aspirin in DAPT after PCI to cut bleeding; extends trial data via meta-analysis confirmation.
Background Conventional dual antiplatelet therapy (DAPT) post percutaneous coronary intervention (PCI) comprises aspirin and a P2Y 12 inhibitor. However, aspirin increases gastrointestinal and bleeding risks. Indobufen, a reversible COX-1 inhibitor, may offer a safer alternative. Objectives To evaluate whether replacing aspirin with indobufen in DAPT provides comparable efficacy and improved safety in patients undergoing PCI. Methods Six databases were systematically searched until 24 February 2026. The primary outcomes were major adverse cardiovascular events (MACE) for efficacy and bleeding events for safety. Subgroup analyses, particularly for acute coronary syndrome (ACS) patients, were conducted. Results Twelve studies involving 7,928 patients were included. Indobufen demonstrated comparable efficacy to aspirin in preventing MACE (OR = 0.89, 95% CI 0.73–1.10, P = 0.284). Crucially, indobufen significantly reduced bleeding events compared to aspirin (OR = 0.51, 95% CI 0.35–0.74, P < 0.001). Subgroup analyses across ACS status and specific P2Y 12 inhibitors (clopidogrel or ticagrelor) consistently supported these findings. Conclusion For patients undergoing PCI, an indobufen-based DAPT regimen appears to reduce bleeding risk while offering comparable MACE prevention relative to conventional aspirin-based DAPT. However, these findings should be interpreted cautiously due to existing limitations.
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Liu et al. (2026) conducted a meta-analysis in Coronary heart disease (CHD) undergoing PCI (n=7,928). Indobufen-based dual antiplatelet therapy vs. Aspirin-based dual antiplatelet therapy was evaluated on Major adverse cardiovascular events (MACE) (OR 0.89, 95% CI 0.73-1.10, p=0.284). Indobufen-based dual antiplatelet therapy demonstrated comparable efficacy to aspirin in preventing major adverse cardiovascular events (OR 0.89) while significantly reducing bleeding events (OR 0.51) in patients undergoing percutaneous coronary intervention.
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