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

作者：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 · 发表于：BMC Medicine · 年份：2024 · DOI：10.1186/s12916-024-03374-3 · 被引用次数：23 · 研究领域：Antiplatelet Therapy and Cardiovascular Diseases、Acute Myocardial Infarction Research、Atrial Fibrillation Management and Outcomes

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...