Indobufen Dual Antiplatelet Therapy (DAPT) Versus Aspirin Dual Antiplatelet Therapy (DAPT) After Percutaneous Coronary Intervention (PCI): A Systematic Review and Meta‐Analysis

Abstract

BACKGROUND: Dual antiplatelet therapy (DAPT), which combines aspirin with a P2Y12 receptor inhibitor, is considered the standard of care for patients who have had percutaneous coronary intervention (PCI). This study aimed to compare indobufen-based (DAPT) to aspirin-based (DAPT) after PCI. METHODS: This systematic review and meta-analysis analyzed randomized controlled trials (RCTs) and propensity-matched cohort studies comparing indobufen (DAPT) to standard aspirin (DAPT) after PCI. We searched four databases: PubMed, Scopus, Web of Science, and Cochrane through January 2025 and updated the search in September 2025. Dichotomous data were pooled as odds ratios with 95% CIs. RESULTS: Our search identified 403 records; only five studies were included in the analysis. Comparing major adverse cardiac and cerebrovascular events (MACCE) between the indobufen and aspirin groups, no difference was observed (OR 1.12, 95% CI: 0.87-1.46; p = 0.38). Bleeding BARC types 2, 3, 5 were compared between the two groups, showing fewer bleeding events in the indobufen group than in the aspirin group (OR: 0.47, 95% CI: 0.24-0.95; p = 0.03). CONCLUSION: Indobufen-based (DAPT) had a lower incidence of bleeding than aspirin-based (DAPT), with no difference between the two groups for MACCE, myocardial infarction, ischemic stroke, cardiovascular death, repeat vascularization, or stent thrombosis.