The Efficacy and Safety of Indobufen-Based DAPT in ACS Patients with a History of Gastrointestinal Damage Undergoing PCI: A Single-Center, Observational Study

一项单中心观察性研究:在既往有胃肠道损伤史的急性冠脉综合征(ACS)患者中,基于吲哚布芬的双联抗血小板治疗(DAPT)的疗效和安全性

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Abstract

PurposeIndobufen, an alternative to aspirin in acute coronary syndrome (ACS) patients with gastrointestinal damage undergoing percutaneous coronary intervention (PCI), has limited data on its efficacy and safety in long-term use. This study compared indobufen-based dual antiplatelet therapy (DAPT) to aspirin-based DAPT in such patients.MethodsWe retrospectively analyzed 255 PCI patients with a history of gastrointestinal damage, divided into indobufen (n = 90) and aspirin (n = 165) groups. We defined the composite of major adverse gastrointestinal events as a composite endpoint event of dyspepsia, peptic ulcer disease and gastrointestinal hemorrhage. Concurrently, the composite of clinically significant adverse gastrointestinal events has been designated as a composite endpoint comprising peptic ulcer disease and gastrointestinal hemorrhage.ResultsIndobufen significantly reduced the incidence of the composite of major adverse gastrointestinal events (25.6% vs 39.4%, HR = 0.58, 95% CI:0.36-0.94, P = 0.026) and the composite of clinically significant adverse gastrointestinal events (18.9% vs 33.3%, HR = 0.53, 95% CI:0.30-0.90, P = 0.020) compared to aspirin. There was no significant difference in major adverse cardiovascular events (MACE) incidence between the two groups (4.4% vs 6.7%, P = 0.400).ConclusionIn conclusion, compared with aspirin, the use of indobufen-based DAPT was associated with a lower incidence of the composite of major adverse gastrointestinal events, which was mainly driven by a reduction in the clinical symptoms and an improvement in quality of life.

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