Indobufen is a new generation of anti-platelet aggregation drug, but studies were not sufficient on its anticoagulant effects. In the present study, the anticoagulant activity of indobufen was determined by monitoring the activated partial thromboplastin time (APTT), prothrombin time (PT), and thrombin time (TT) in rabbit plasma. We evaluated the anticoagulant mechanisms on the content of the platelet factor 3,4 (PF3,4), and the coagulation factor 1, 2, 5, 8, 10 (FI, II, V, VIII, X) in rabbits, as well as the in vivo bleeding time and clotting time in mice. The pharmacodynamic differences between indobufen and warfarin sodium, rivaroxaban, and dabigatran were further studied on thrombus formation and the content of FII and FX in rats. Animal experiments showed that intragastric-administrated indobufen can significantly reduce the APTT, PT, TT, PF3, FI, II, V, VIII, and X plasma contents. Its inhibitory effect on plasma FII was better than thrombin inhibitor dabigatran with effect on FX better than FXa inhibitor rivaroxaban. These results suggest that indobufen has some anticoagulant effects as strong as some conventional anticoagulants. The mechanism may be related to both exogenous and endogenous coagulation system.

Clinically, indobufen is widely used for the treatment of antiplatelet aggregation and anticoagulation. Prior studies have discovered that abnormal platelet function can be promptly restored to normal when the drug is stopped. Herein, through the study of the enzyme reaction kinetics, we demonstrated that the inhibitory effect of indobufen on cyclooxygenase-1 (COX-1) was reversible and non-competitive. Specifically, the cyclooxygenase inhibition experiment showed that the level of 6-keto-PGF1α in the gastric mucosa of the indobufen-treated groups was significantly higher than that of the aspirin group (^###p < 0.001), indicating a higher level of PGI₂ in and a better physiological state of the gastric mucosa. Moreover, the rat gastric ulcer index and mucosal section experiments further confirmed the relief of gastrointestinal irritation and the adverse reaction rate of the indobufen-treated group compared to those of the aspirin group. Furthermore, indobufen was verified to exert reversible inhibitory activity on the heme group of COX-1 and thus reversibly inhibit COX-1 activity. In general, compared with aspirin, the long-term oral administration of indobufen yields a lower risk of gastrointestinal symptoms, such as ulcers.

Background: Patients with supraventricular tachycardia (SVT) often experience multiple clinical symptoms that require emergency treatment. This study utilized BioMedGPT-LM-7B, an artificial intelligence (AI) model, to comprehensively evaluate the efficacy and adverse effects of adenosine/adenosine triphosphate (ATP) versus calcium channel blockers (CCBs) in SVT treatment. Methods: This study conducted a comprehensive search of multiple medical databases, as well as major trial registries up to December 2024. We performed dual screening and assessment using BioMedGPT-LM-7B and the traditional Cochrane bias risk tool. The primary outcomes were the rate of sinus rhythm restoration and major adverse events, while secondary outcomes included time to restoration, relapse to SVT post-reversion, and any minor adverse events. Outcome measurements were based on odds ratios (OR) and Mean Difference (MD), with the quality of primary outcomes assessed using the GRADE method. Results: This study included 10 RCTs with a total of 960 SVT patients admitted to the emergency department. Comparing BioMedGPT-LM-7B with the traditional Cochrane bias risk tool, we found no significant differences in random sequence generation and selective reporting. Moderate evidence showed no difference between adenosine/ATP and CCBs in restoring sinus rhythm (OR = 1.44, 95% CI [0.89,2.34]), but adenosine/ATP had a shorter time to reversion (MD = 423,24, 95% CI [293.54, 552.93]). However, the research findings show a lower level of evidence regarding differences in side effects among the drugs mentioned above. Three cases of hypotension were reported in the CCB group, whereas none were reported in the adenosine group. Conclusion: Adenosine/ATP and CCBs have similar efficacy in treating SVT, but adenosine/ATP has a shorter conversion time and no reported cases of hypotension. Clinical studies indicate that adenosine has a higher success rate and faster conversion time in restoring sinus rhythm compared to ATP, with milder side effects. However, further prospective studies are needed to evaluate patient experience and potential adverse events, ensuring a more comprehensive understanding of treatment safety and efficacy. Additionally, this study showcases BioMedGPT-LM-7B’s potential for medical data analysis and future meta-analyses.

Background: Adenosine administration can improve coronary blood flow in patients undergoing primary percutaneous coronary intervention (PCI); however, the therapeutic effects of adenosine on ST resolution and major adverse cardiovascular events (MACEs) after PCI remain unclear. This study aimed to assess the therapeutic effects of adjunctive adenosine administration on patients with acute myocardial infarction (AMI) undergoing PCI using a meta-analytic approach. Methods: We conducted a systematic search across PubMed, Embase, and the Cochrane Library to identify eligible randomized controlled trials (RCTs) published from inception through to March 2024. Primary outcomes included ST resolution and MACEs. The pooled analyses were all conducted using the random-effects model. Additionally, exploratory analyses were carried out through the application of sensitivity and subgroup analyses. Results: Twenty-one RCTs involving 2467 patients with AMI were selected for the meta-analysis. Adenosine significantly increased the incidence of ST resolution (relative risk [RR]: 1.30; 95% confidence interval [CI]: 1.15–1.46; p < 0.001), while it significantly reduced the risk of MACEs (RR: 0.67; 95% CI: 0.51–0.87; p = 0.003). Moreover, the use of adenosine was associated with reduced incidences of no reflow (RR: 0.35; 95% CI: 0.24–0.52; p < 0.001) and myocardial blush grade (MBG) 0 to 1 (RR: 0.75; 95% CI: 0.58–0.99; p = 0.041). Furthermore, adenosine significantly reduced the risk of heart failure (RR: 0.66; 95% CI: 0.44–0.99; p = 0.044). Finally, adenosine use was associated with a lower creatine kinase-MB (CK-MB) peak value (weighted mean difference: –36.94; 95% CI: –73.76– –0.11; p = 0.049). Conclusions: This study revealed that adenosine use was associated with an increased incidence of ST resolution, and reduced risk of MACEs. The INPLASY registration: INPLASY202510051, https://inplasy.com/inplasy-2025-1-0051/.