Abstract
PurposeIndobufen reversibly inhibits platelet aggregation and has potential efficacy in acute coronary syndrome and long-term cardiovascular prevention. As an alternative treatment for patients intolerant to other antiplatelet drugs, evidence-based medicine is insufficient. The purpose of this study was to evaluate the efficacy and safety of indobufen therapy in patients with coronary artery disease, and to provide reference for expanded clinical use.MethodsWe conducted a systematic review and meta-analysis of studies from the establishment of PubMed, EMBASE and other databases until their publication on November 21, 2024 The primary endpoints were major adverse cardiovascular and cerebrovascular events (MACCE), the primary safety index was the rate of hemorrhage of the Academic Research Consortium type 2, 3, or 5. The risk of ischemic stroke and myocardial infarction were used as the secondary indexes.ResultsThis meta-analysis included eight studies with a total of 13,545 patients. According to subgroup analysis, there was no significant difference in the incidence of unconscious-cerebrovascular events between indobufen monotherapy and dual antiplatelet agents (OR 1.02, 95%CI 0.84-1.23, p = 0.84, I(2) = 48%). Indobufen reduced the bleeding risk in patients with coronary artery disease (OR 0.66, 95%CI 0.51-0.85, p = .001, I(2) = 0%). The risk of ischemic stroke for secondary indicators was comparable (OR 0.98, 95%CI 0.63-1.52, p = 0.92, I(2) = 3%). Similarly, the risk of myocardial infarction was comparable (OR 0.61, 95%CI 0.35-1.09, p = .10, I(2) = 0%).ConclusionsAccording to the results of this meta-analysis, indobufen based treatment may reduce the bleeding risk with better efficacy than dual antiplatelet agents for the patients with coronary artery disease.