ArticleClinical interventions in aging2026
Indobufen versus Aspirin After CABG in Septuagenarians: A Propensity Score-Matched Cohort Study.
Article in Clinical interventions in aging, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
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.
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