Indobufen versus aspirin after percutaneous coronary intervention in elderly patients with acute coronary syndrome
Abstract Background Antiplatelet therapy is pivotal in managing elderly patients with Acute Coronary Syndrome (ACS) following Percutaneous Coronary Intervention (PCI). While aspirin remains a cornerstone of this therapy, its use is sometimes limited by the risk of gastrointestinal (GI) complications...
Saved in:
| Main Authors: | , , , , , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2025-07-01
|
| Series: | BMC Cardiovascular Disorders |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12872-025-04843-0 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1849767312687628288 |
|---|---|
| author | Wenbo Dai Guanyu Mu Jiayi Ren Sutao Hu Rongxin Guo Tian-shu Gu Jingjin Che Xianghong Ma Tong Liu Xue Wu Jing-Kun Zhang Gary Tse Yajie Wang Jian-Mei Zhou Seung-Woon Rha Kangyin Chen |
| author_facet | Wenbo Dai Guanyu Mu Jiayi Ren Sutao Hu Rongxin Guo Tian-shu Gu Jingjin Che Xianghong Ma Tong Liu Xue Wu Jing-Kun Zhang Gary Tse Yajie Wang Jian-Mei Zhou Seung-Woon Rha Kangyin Chen |
| author_sort | Wenbo Dai |
| collection | DOAJ |
| description | Abstract Background Antiplatelet therapy is pivotal in managing elderly patients with Acute Coronary Syndrome (ACS) following Percutaneous Coronary Intervention (PCI). While aspirin remains a cornerstone of this therapy, its use is sometimes limited by the risk of gastrointestinal (GI) complications or allergic reactions in certain patients. Purpose This study aims to assess the safety and efficacy of Indobufen as an alternative to aspirin when used in combination with clopidogrel in elderly ACS patients post-PCI. Methods This is a single-center, retrospective study employing propensity score matching. Elderly ACS patients who underwent PCI between January 2019 and May 2022 were enrolled. Participant were categorized into two groups based on their medication regimen: the aspirin DAPT group and the indobufen DAPT group. The primary endpoint was the Net Adverse Clinical Event (NACE) at 1 year, which included all-cause mortality, stroke, myocardial infarction (MI), target lesion revascularisation, and bleeding events classified under the Bleeding Academic Research Consortium (BARC) criteria type 2, 3, or 5. Results A total of 2087 patients were enrolled in this study. Based on their medication regimen, 348 patients were assigned to indobufen DAPT group, while 1739 individuals were assigned to aspirin DAPT group. After applying 1:1 propensity score matching, 306 patients were included in each group. During the 1-year follow-up, the NACE occurred in 59 patients (19.9%) of the Indobufen DAPT group and 58 patients (18.6%) in the aspirin DAPT group, with no significant difference between the groups (HR 1.029, 95% CI 0.714–1.484, P = 0.876). Additionally, there were no significant difference in Patient-Oriented Composite Endpoint (POCE) and BARC 2, 3, or 5 bleeding events between the groups at 1, 3, or 6 months of follow-up. However, the indobufen DAPT group experienced a lower incidence of upper GI symptoms compared to the aspirin DAPT group. Conclusion Indobufen, as an alternative to aspirin, demonstrates comparable efficacy and safety in elderly ACS patients after PCI, with a potential reduction in gastrointestinal symptoms. These findings support the use of indobufen as a viable alternative for elderly ACS patients who are intolerant to aspirin. Clinical trial number Not applicable. |
| format | Article |
| id | doaj-art-c10dba3efb724e0a82621a8ece0f6a7d |
| institution | DOAJ |
| issn | 1471-2261 |
| language | English |
| publishDate | 2025-07-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Cardiovascular Disorders |
| spelling | doaj-art-c10dba3efb724e0a82621a8ece0f6a7d2025-08-20T03:04:16ZengBMCBMC Cardiovascular Disorders1471-22612025-07-0125111210.1186/s12872-025-04843-0Indobufen versus aspirin after percutaneous coronary intervention in elderly patients with acute coronary syndromeWenbo Dai0Guanyu Mu1Jiayi Ren2Sutao Hu3Rongxin Guo4Tian-shu Gu5Jingjin Che6Xianghong Ma7Tong Liu8Xue Wu9Jing-Kun Zhang10Gary Tse11Yajie Wang12Jian-Mei Zhou13Seung-Woon Rha14Kangyin Chen15Tianjin Key Laboratory of Ionic-Molecular Function of Cardiovascular disease, Department of Cardiology, Tianjin Institute of Cardiology, Second Hospital of Tianjin Medical UniversityTianjin Key Laboratory of Ionic-Molecular Function of Cardiovascular disease, Department of Cardiology, Tianjin Institute of Cardiology, Second Hospital of Tianjin Medical UniversityTianjin Key Laboratory of Ionic-Molecular Function of Cardiovascular disease, Department of Cardiology, Tianjin Institute of Cardiology, Second Hospital of Tianjin Medical UniversityTianjin Key Laboratory of Ionic-Molecular Function of Cardiovascular disease, Department of Cardiology, Tianjin Institute of Cardiology, Second Hospital of Tianjin Medical UniversityTianjin Key Laboratory of Ionic-Molecular Function of Cardiovascular disease, Department of Cardiology, Tianjin Institute of Cardiology, Second Hospital of Tianjin Medical UniversityTianjin Key Laboratory of Ionic-Molecular Function of Cardiovascular disease, Department of Cardiology, Tianjin Institute of Cardiology, Second Hospital of Tianjin Medical UniversityTianjin Key Laboratory of Ionic-Molecular Function of Cardiovascular disease, Department of Cardiology, Tianjin Institute of Cardiology, Second Hospital of Tianjin Medical UniversityTianjin Key Laboratory of Ionic-Molecular Function of Cardiovascular disease, Department of Cardiology, Tianjin Institute of Cardiology, Second Hospital of Tianjin Medical UniversityTianjin Key Laboratory of Ionic-Molecular Function of Cardiovascular disease, Department of Cardiology, Tianjin Institute of Cardiology, Second Hospital of Tianjin Medical UniversityInstitute for Global Health Sciences, University of CaliforniaCardiovascular Research Institute, University of CaliforniaTianjin Key Laboratory of Ionic-Molecular Function of Cardiovascular disease, Department of Cardiology, Tianjin Institute of Cardiology, Second Hospital of Tianjin Medical UniversityDepartment of Cardiology, TEDA International Cardiovascular HospitalDepartment of Cadre health care, Zhejiang HospitalCardiovascular Center, Korea University Guro HospitalTianjin Key Laboratory of Ionic-Molecular Function of Cardiovascular disease, Department of Cardiology, Tianjin Institute of Cardiology, Second Hospital of Tianjin Medical UniversityAbstract Background Antiplatelet therapy is pivotal in managing elderly patients with Acute Coronary Syndrome (ACS) following Percutaneous Coronary Intervention (PCI). While aspirin remains a cornerstone of this therapy, its use is sometimes limited by the risk of gastrointestinal (GI) complications or allergic reactions in certain patients. Purpose This study aims to assess the safety and efficacy of Indobufen as an alternative to aspirin when used in combination with clopidogrel in elderly ACS patients post-PCI. Methods This is a single-center, retrospective study employing propensity score matching. Elderly ACS patients who underwent PCI between January 2019 and May 2022 were enrolled. Participant were categorized into two groups based on their medication regimen: the aspirin DAPT group and the indobufen DAPT group. The primary endpoint was the Net Adverse Clinical Event (NACE) at 1 year, which included all-cause mortality, stroke, myocardial infarction (MI), target lesion revascularisation, and bleeding events classified under the Bleeding Academic Research Consortium (BARC) criteria type 2, 3, or 5. Results A total of 2087 patients were enrolled in this study. Based on their medication regimen, 348 patients were assigned to indobufen DAPT group, while 1739 individuals were assigned to aspirin DAPT group. After applying 1:1 propensity score matching, 306 patients were included in each group. During the 1-year follow-up, the NACE occurred in 59 patients (19.9%) of the Indobufen DAPT group and 58 patients (18.6%) in the aspirin DAPT group, with no significant difference between the groups (HR 1.029, 95% CI 0.714–1.484, P = 0.876). Additionally, there were no significant difference in Patient-Oriented Composite Endpoint (POCE) and BARC 2, 3, or 5 bleeding events between the groups at 1, 3, or 6 months of follow-up. However, the indobufen DAPT group experienced a lower incidence of upper GI symptoms compared to the aspirin DAPT group. Conclusion Indobufen, as an alternative to aspirin, demonstrates comparable efficacy and safety in elderly ACS patients after PCI, with a potential reduction in gastrointestinal symptoms. These findings support the use of indobufen as a viable alternative for elderly ACS patients who are intolerant to aspirin. Clinical trial number Not applicable.https://doi.org/10.1186/s12872-025-04843-0IndobufenAspirinPercutaneous coronary interventionAcute coronary syndromeElderly patients |
| spellingShingle | Wenbo Dai Guanyu Mu Jiayi Ren Sutao Hu Rongxin Guo Tian-shu Gu Jingjin Che Xianghong Ma Tong Liu Xue Wu Jing-Kun Zhang Gary Tse Yajie Wang Jian-Mei Zhou Seung-Woon Rha Kangyin Chen Indobufen versus aspirin after percutaneous coronary intervention in elderly patients with acute coronary syndrome BMC Cardiovascular Disorders Indobufen Aspirin Percutaneous coronary intervention Acute coronary syndrome Elderly patients |
| title | Indobufen versus aspirin after percutaneous coronary intervention in elderly patients with acute coronary syndrome |
| title_full | Indobufen versus aspirin after percutaneous coronary intervention in elderly patients with acute coronary syndrome |
| title_fullStr | Indobufen versus aspirin after percutaneous coronary intervention in elderly patients with acute coronary syndrome |
| title_full_unstemmed | Indobufen versus aspirin after percutaneous coronary intervention in elderly patients with acute coronary syndrome |
| title_short | Indobufen versus aspirin after percutaneous coronary intervention in elderly patients with acute coronary syndrome |
| title_sort | indobufen versus aspirin after percutaneous coronary intervention in elderly patients with acute coronary syndrome |
| topic | Indobufen Aspirin Percutaneous coronary intervention Acute coronary syndrome Elderly patients |
| url | https://doi.org/10.1186/s12872-025-04843-0 |
| work_keys_str_mv | AT wenbodai indobufenversusaspirinafterpercutaneouscoronaryinterventioninelderlypatientswithacutecoronarysyndrome AT guanyumu indobufenversusaspirinafterpercutaneouscoronaryinterventioninelderlypatientswithacutecoronarysyndrome AT jiayiren indobufenversusaspirinafterpercutaneouscoronaryinterventioninelderlypatientswithacutecoronarysyndrome AT sutaohu indobufenversusaspirinafterpercutaneouscoronaryinterventioninelderlypatientswithacutecoronarysyndrome AT rongxinguo indobufenversusaspirinafterpercutaneouscoronaryinterventioninelderlypatientswithacutecoronarysyndrome AT tianshugu indobufenversusaspirinafterpercutaneouscoronaryinterventioninelderlypatientswithacutecoronarysyndrome AT jingjinche indobufenversusaspirinafterpercutaneouscoronaryinterventioninelderlypatientswithacutecoronarysyndrome AT xianghongma indobufenversusaspirinafterpercutaneouscoronaryinterventioninelderlypatientswithacutecoronarysyndrome AT tongliu indobufenversusaspirinafterpercutaneouscoronaryinterventioninelderlypatientswithacutecoronarysyndrome AT xuewu indobufenversusaspirinafterpercutaneouscoronaryinterventioninelderlypatientswithacutecoronarysyndrome AT jingkunzhang indobufenversusaspirinafterpercutaneouscoronaryinterventioninelderlypatientswithacutecoronarysyndrome AT garytse indobufenversusaspirinafterpercutaneouscoronaryinterventioninelderlypatientswithacutecoronarysyndrome AT yajiewang indobufenversusaspirinafterpercutaneouscoronaryinterventioninelderlypatientswithacutecoronarysyndrome AT jianmeizhou indobufenversusaspirinafterpercutaneouscoronaryinterventioninelderlypatientswithacutecoronarysyndrome AT seungwoonrha indobufenversusaspirinafterpercutaneouscoronaryinterventioninelderlypatientswithacutecoronarysyndrome AT kangyinchen indobufenversusaspirinafterpercutaneouscoronaryinterventioninelderlypatientswithacutecoronarysyndrome |