Role of Indobufen in coronary artery disease: the story of a neglected drug. A systematic review.

The management of antiplatelet therapy in coronary artery disease (CAD) is one of the most debated topics in cardiology. In some clinical scenarios, such as acute coronary syndromes (ACS) and/or percutaneous coronary interventions (PCI), a dual antiplatelet therapy (DAPT) based on the association of a thromboxane A2 (TXA2) pathway inhibitor and a P2Y12 inhibitor is required. Nevertheless, the recent research has been largely focused on the P2Y12 inhibitors, while few data are available on the TXA2 pathway inhibitors, besides aspirin. This gap in the evidence can have relevant clinical implications when aspirin is contraindicated. After years of empirical use, recent clinical studies have shed some light on the efficacy/safety profile of indobufen when compared to aspirin in low-risk CAD patients. However, also encouraged by promising pharmacodynamic data on platelet inhibition, further clinical investigations are strongly advocated.