The effect of indobufen and aspirin on platelet function in acute ischemic stroke patients with early neurological deterioration.

PURPOSE: This study aimed to compare the effects of indobufen and aspirin on platelet function, neurological recovery, and adverse reactions in acute ischemic stroke patients with early neurological deterioration.

METHODS

A total of 250 patients were randomized into two groups (indobufen group, n = 125; aspirin group, n = 125). Platelet function was assessed using Arachidonic Acid - Platelet Aggregation Ratio (AA-PAR), ADP - Platelet Aggregation Ratio (ADP-PAR0, Thromboxane B2 (TXB2) concentrations, and other hematological parameters. Neurological function was evaluated using MIESSS/NIHSS and mRS scores at 10 days, 3 months, and 1 year post-treatment. Adverse reactions were recorded during follow-up.

RESULTS

The indobufen group showed significantly lower AA-PAR and ADP-PAR levels, as well as reduced TXB2 concentrations compared to the aspirin group, indicating stronger platelet inhibition. Neurological assessments revealed better early and long-term recovery in the indobufen group, with significantly lower MIESSS/NIHSS and mRS scores at all time points. Regarding adverse reactions, the indobufen group exhibited a significantly lower incidence of gastrointestinal discomfort (10.00 % vs. 16.30 %, P = 0.03), though the incidence of bleeding events and renal dysfunction was similar between the groups.

CONCLUSION

Indobufen demonstrated superior platelet inhibition and more favorable neurological recovery compared to aspirin in acute ischemic stroke patients with early neurological deterioration. Indobufen also had a lower incidence of gastrointestinal side effects, while its overall safety profile was comparable to that of aspirin.