{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T09:09:31Z","timestamp":1789981771040,"version":"4.0.1"},"reference-count":40,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,7,24]],"date-time":"2026-07-24T00:00:00Z","timestamp":1784851200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Pharmacol."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>\n                      Conventional dual antiplatelet therapy (DAPT) post percutaneous coronary intervention (PCI) comprises aspirin and a P2Y\n                      <jats:sub>12<\/jats:sub>\n                      inhibitor. However, aspirin increases gastrointestinal and bleeding risks. Indobufen, a reversible COX-1 inhibitor, may offer a safer alternative.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To evaluate whether replacing aspirin with indobufen in DAPT provides comparable efficacy and improved safety in patients undergoing PCI.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Six databases were systematically searched until 24 February 2026. The primary outcomes were major adverse cardiovascular events (MACE) for efficacy and bleeding events for safety. Subgroup analyses, particularly for acute coronary syndrome (ACS) patients, were conducted.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Twelve studies involving 7,928 patients were included. Indobufen demonstrated comparable efficacy to aspirin in preventing MACE (OR = 0.89, 95% CI 0.73\u20131.10,\n                      <jats:italic>P<\/jats:italic>\n                      = 0.284). Crucially, indobufen significantly reduced bleeding events compared to aspirin (OR = 0.51, 95% CI 0.35\u20130.74,\n                      <jats:italic>P<\/jats:italic>\n                      &amp;lt; 0.001). Subgroup analyses across ACS status and specific P2Y\n                      <jats:sub>12<\/jats:sub>\n                      inhibitors (clopidogrel or ticagrelor) consistently supported these findings.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>For patients undergoing PCI, an indobufen-based DAPT regimen appears to reduce bleeding risk while offering comparable MACE prevention relative to conventional aspirin-based DAPT. However, these findings should be interpreted cautiously due to existing limitations.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fphar.2026.1821883","type":"journal-article","created":{"date-parts":[[2026,7,24]],"date-time":"2026-07-24T04:23:26Z","timestamp":1784867006000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Indobufen-based dual antiplatelet therapy in patients undergoing PCI: a systematic review and meta-analysis"],"prefix":"10.3389","volume":"17","author":[{"given":"Yiheng","family":"Liu","sequence":"first","affiliation":[{"name":"Department of Cardiology, The Second Affiliated Hospital of Chongqing Medical University","place":["Chongqing, China"]},{"name":"Department of Cardiology, West China Hospital, Sichuan University","place":["Chengdu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bin","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Cardiology, The Second Affiliated Hospital of Chongqing Medical University","place":["Chongqing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Weiran","family":"Dai","sequence":"additional","affiliation":[{"name":"Department of Cardiology, The Second Affiliated Hospital of Chongqing Medical University","place":["Chongqing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,7,24]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"1849","DOI":"10.1016\/s0140-6736(09)60503-1","article-title":"Aspirin in the primary and secondary prevention of vascular disease: collaborative meta-analysis of individual participant data from randomised trials","volume":"373","author":"Baigent","year":"2009","journal-title":"Lancet"},{"key":"B2","doi-asserted-by":"publisher","first-page":"183","DOI":"10.3109\/09537104.2012.686072","article-title":"Clopidogrel plus indobufen in acute coronary syndrome patients with hypersensitivity to aspirin undergoing percutaneous coronary intervention","volume":"24","author":"Barilla","year":"2013","journal-title":"Platelets"},{"key":"B3","doi-asserted-by":"publisher","first-page":"754","DOI":"10.1001\/jama.2010.181","article-title":"Comparison of platelet function tests in predicting clinical outcome in patients undergoing coronary stent implantation","volume":"303","author":"Breet","year":"2010","journal-title":"Jama"},{"key":"B4","doi-asserted-by":"publisher","first-page":"3720","DOI":"10.1093\/eurheartj\/ehad191","article-title":"2023 ESC guidelines for the management of acute coronary syndromes","volume":"44","author":"Byrne","year":"2023","journal-title":"Eur. 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