Clinical interventions in aging · 2026
Indobufen versus Aspirin After CABG in Septuagenarians: A Propensity Score-Matched Cohort Study.
СтатьяСравнительное исследованиеНазвание и аннотация: Перевод в очереди
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Yang Libin, Huang Ben, Chen Zhenhang, Abudupataer Mieradilijiang, Zuo Ziang, Liu Gao, Sun Yongxin, Wang Chunsheng
Аннотация
PURPOSE: To compare the safety and efficacy of indobufen-based versus aspirin-based sequential antiplatelet therapy in septuagenarians undergoing coronary artery bypass grafting (CABG).
PATIENTS AND METHODS: Patients aged 70-79 years who underwent CABG between 2020 and 2022 received either indobufen- or aspirin-based dual antiplatelet therapy (DAPT) (with clopidogrel) for 12 months, followed by monotherapy with their respective baseline agent (indobufen or aspirin) for an additional year. Propensity score matching (1:2, caliper 0.25 SD) balanced the baseline characteristics. The primary outcomes were 2-year major adverse cardiac and cerebrovascular events (MACCE) and Bleeding Academic Research Consortium (BARC) types 2, 3, or 5 bleeding.
RESULTS: Among 296 patients (indobufen, 46; aspirin, 250), 104 (indobufen, 36; aspirin, 68) were well matched. Before matching, indobufen showed similar 2-year MACCE risk to aspirin (6.5% vs 6.8%; subdistribution hazard ratio [sHR] 0.96, 95% CI 0.28-3.28; p = 0.95) and lower BARC type 2, 3, or 5 bleeding (2.2% vs 6.8%; sHR 0.32, 95% CI 0.04-2.38; p = 0.23). After matching, results remained consistent (MACCE 8.3% vs 10.3%; sHR 0.81, 95% CI 0.21-3.10; p = 0.76; bleeding 2.8% vs 11.8%; sHR 0.24, 95% CI 0.03-1.87; p = 0.14). Indobufen reduced clinically relevant bleeding by 9.0% (number needed to treat [NNT] ≈ 11) without compromising ischemic outcomes.
CONCLUSION: Indobufen-based sequential therapy provided ischemic protection similar to that of aspirin, while showing a favorable bleeding profile in septuagenarians undergoing CABG. For individuals with a high bleeding risk or aspirin intolerance, indobufen may represent a practical alternative. Larger prospective studies focusing on geriatric outcomes are warranted.
PATIENTS AND METHODS: Patients aged 70-79 years who underwent CABG between 2020 and 2022 received either indobufen- or aspirin-based dual antiplatelet therapy (DAPT) (with clopidogrel) for 12 months, followed by monotherapy with their respective baseline agent (indobufen or aspirin) for an additional year. Propensity score matching (1:2, caliper 0.25 SD) balanced the baseline characteristics. The primary outcomes were 2-year major adverse cardiac and cerebrovascular events (MACCE) and Bleeding Academic Research Consortium (BARC) types 2, 3, or 5 bleeding.
RESULTS: Among 296 patients (indobufen, 46; aspirin, 250), 104 (indobufen, 36; aspirin, 68) were well matched. Before matching, indobufen showed similar 2-year MACCE risk to aspirin (6.5% vs 6.8%; subdistribution hazard ratio [sHR] 0.96, 95% CI 0.28-3.28; p = 0.95) and lower BARC type 2, 3, or 5 bleeding (2.2% vs 6.8%; sHR 0.32, 95% CI 0.04-2.38; p = 0.23). After matching, results remained consistent (MACCE 8.3% vs 10.3%; sHR 0.81, 95% CI 0.21-3.10; p = 0.76; bleeding 2.8% vs 11.8%; sHR 0.24, 95% CI 0.03-1.87; p = 0.14). Indobufen reduced clinically relevant bleeding by 9.0% (number needed to treat [NNT] ≈ 11) without compromising ischemic outcomes.
CONCLUSION: Indobufen-based sequential therapy provided ischemic protection similar to that of aspirin, while showing a favorable bleeding profile in septuagenarians undergoing CABG. For individuals with a high bleeding risk or aspirin intolerance, indobufen may represent a practical alternative. Larger prospective studies focusing on geriatric outcomes are warranted.