Effect of indobufen combined with clopidogrel on efficacy and blood TGF-β and IL-6 expression after percutaneous transluminal angioplasty of arteriovenous fistula

This study aimed to investigate the effect of indobufen combined with clopidogrel compared with clopidogrel alone on the efficacy and serum inflammatory factors (transforming growth factor-beta [TGF-β], interkeukin [IL]-6) in patients after percutaneous transluminal angioplasty (PTA) for arteriovenous fistula (AVF). A retrospective cohort study was conducted, enrolling 120 patients after AVF-PTA. Patients were divided into the combination therapy group (indobufen + clopidogrel) and the conventional therapy group (clopidogrel alone) by propensity score matching, with 60 patients in each group. The clinical efficacy at 7 days postoperatively, changes in AVF blood flow volume/velocity, changes in serum TGF-β/IL-6 levels, and restenosis rates at 3 and 6 months postoperatively were compared between the 2 groups. The total clinical effective rate at 7 days postoperatively was significantly higher in the combination therapy group (91.7% vs 76.7%, P = .024), with more significant improvements in AVF blood flow volume and velocity (both P < .001). The combination therapy group showed greater reductions in serum TGF-β and IL-6 levels postoperatively (both P < .01). The restenosis rates were significantly lower in the combination group at 3 months (6.7% vs 20.0%, P = .038) and 6 months (15.0% vs 36.7%, P = .006) postoperatively, with higher primary patency rates (P = .004). Indobufen combined with clopidogrel can more effectively improve early postoperative efficacy and AVF function after AVF-PTA, significantly suppress the expression of inflammatory factors, and reduce the risk of short- to medium-term restenosis. Its mechanism may be related to synergistic antiplatelet and anti-inflammatory effects.