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BMC Medicine
Published in: BMC Medicine 1/2024

Open Access 01-12-2024 | Acute Coronary Syndrome | Research article

Real-world performance of indobufen versus aspirin after percutaneous coronary intervention: insights from the ASPIRATION registry

Authors: Chunfeng Dai, Muyin Liu, Zheng Yang, Youran Li, You Zhou, Danbo Lu, Yan Xia, Ao Chen, Chenguang Li, Hao Lu, Yuxiang Dai, Jianying Ma, Zhangwei Chen, Juying Qian, Junbo Ge

Published in: BMC Medicine | Issue 1/2024

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Abstract

Background

Indobufen is widely used in patients with aspirin intolerance in East Asia. The OPTION trial launched by our cardiac center examined the performance of indobufen based dual antiplatelet therapy (DAPT) after percutaneous coronary intervention (PCI). However, the vast majority of patients with acute coronary syndrome (ACS) and aspirin intolerance were excluded. We aimed to explore this question in a real-world population.

Methods

Patients enrolled in the ASPIRATION registry were grouped according to the DAPT strategy that they received after PCI. The primary endpoints were major adverse cardiovascular and cerebrovascular events (MACCE) and Bleeding Academic Research Consortium (BARC) type 2, 3, or 5 bleeding. Propensity score matching (PSM) was adopted for confounder adjustment.

Results

A total of 7135 patients were reviewed. After one-year follow-up, the indobufen group was associated with the same risk of MACCE versus the aspirin group after PSM (6.5% vs. 6.5%, hazard ratio [HR] = 0.99, 95% confidence interval [CI] = 0.65 to 1.52, P = 0.978). However, BARC type 2, 3, or 5 bleeding was significantly reduced (3.0% vs. 11.9%, HR = 0.24, 95% CI = 0.15 to 0.40, P < 0.001). These results were generally consistent across different subgroups including aspirin intolerance, except that indobufen appeared to increase the risk of MACCE in patients with ACS.

Conclusions

Indobufen shared the same risk of MACCE but a lower risk of bleeding after PCI versus aspirin from a real-world perspective. Due to the observational nature of the current analysis, future studies are still warranted to further evaluate the efficacy of indobufen based DAPT, especially in patients with ACS.

Trial registration

Chinese Clinical Trial Register (https://​www.​chictr.​org.​cn); Number: ChiCTR2300067274.
Appendix
Available only for authorised users
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Metadata
Title
Real-world performance of indobufen versus aspirin after percutaneous coronary intervention: insights from the ASPIRATION registry
Authors
Chunfeng Dai
Muyin Liu
Zheng Yang
Youran Li
You Zhou
Danbo Lu
Yan Xia
Ao Chen
Chenguang Li
Hao Lu
Yuxiang Dai
Jianying Ma
Zhangwei Chen
Juying Qian
Junbo Ge
Publication date
01-12-2024
Publisher
BioMed Central
Published in
BMC Medicine / Issue 1/2024
Electronic ISSN: 1741-7015
DOI
https://doi.org/10.1186/s12916-024-03374-3

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