Research trends in lipid-lowering therapies for coronary heart disease combined with hyperlipidemia: a bibliometric study and visual analysis

Abstract

Background: Cardiovascular disease (CVD) poses a significant global health and economic challenge, with atherosclerosis being a primary cause. Over the past 40 years, substantial research has been conducted into the prevention and reversal of atherosclerosis, resulting in the development of lipid-lowering agents such as statins and fibrates. Despite the extensive literature and formulation of numerous therapeutic guidelines in this domain, a comprehensive bibliometric analysis of the current research landscape and trends has not been performed. This study aimed to elucidate the evolution and milestones of research into lipid-lowering treatments for coronary heart disease (CHD) in conjunction with hyperlipidemia through bibliometric analysis, offering insights into future directions for treatment strategies.

Methods: This study examined publications from 1986 to 2023 retrieved from the Web of Science database (Core Collection). Utilizing tools such as VOSviewer, Pajek, and CiteSpace, we analyzed publication and citation numbers, H-indexes, contributions by countries and institutions, authorship, journal sources, and keyword usage to uncover research trajectories and areas of focus.

Results: Our analysis of 587 publications revealed a recent surge in research output, particularly post-2003. The American Journal of Cardiology published the highest number of studies, with 40 articles, whereas Circulation received the highest number of citations (6,266). Key contributors included the United States, Japan, and China, with the United States leading in citation numbers and the H-index. Harvard University and Leiden University emerged as pivotal institutions, and Professors J. Wouter Jukema and Robert P. Giugliano were identified as leading experts. Keyword analysis disclosed five thematic clusters, indicating a shift in research towards new drug combinations and strategies, signaling future research directions.

Conclusion: The last 4 decades have seen a notable rise in publications on lipid-lowering therapies for CHD and hyperlipidemia, with the United States retaining world-leading status. The increase in international collaboration aids the shift towards research into innovative lipid-lowering agents and therapeutic approaches. PCSK9 inhibitors and innovative combination therapies, including antisense oligonucleotides and angiopoietin-like protein 3 inhibitors, provide avenues for future research, intending to maximize the safety and efficacy of treatment approaches.

Keywords: CiteSpace; VOSviewer; coronary heart disease; hyperlipidemia; lipid-lowering therapy; visualization analysis.

FIGURE 1

Global cardiovascular disease prevalence and associated deaths as a percentage from 1990 to 2019. (A) Prevalence rate of cardiovascular diseases; (B) The proportion of deaths attributable to cardiovascular diseases out of the total number of deaths; (C) The proportion of deaths attributable to ischemic heart disease out of the total number of deaths; (D) The proportion of deaths affected by abnormalities in high-density lipoprotein cholesterol and low-density lipoprotein cholesterol relative to the total number of deaths (Data sources: IHME, Global Burden of Disease Study (2019)—processed by Our World in Data).

FIGURE 2

Process of including and excluding relevant publications from research in the field.

FIGURE 3

Global trends in publications, citations, and publication H-index in the field of lipid-lowering therapy for CHD combined with hyperlipidemia (1991–2023).

FIGURE 4

The dual-map overlay of journals.

FIGURE 5

(A) Visualization of the number of the top 10 countries in terms of cumulative number of publications; (B) Cooperation networks in countries/regions all over the world.

FIGURE 6

Collaborative network of universities/institutions all over the world.

FIGURE 7

Collaborative network of authors all over the world.

FIGURE 8

Analyzing reference co-citation through CiteSpace. (A) View of reference co-citations; (B) Cluster view of reference co-citation; (C) Timeline view of reference co-citation. Nodes closer to the right indicate a newer year of citation; (D) Top 25 references with the strongest citation bursts. Red bars indicate high citation frequency, blue bars indicate lower citation frequency.

FIGURE 9

Visualization maps related to studies of lipid-lowering therapy for CHD combined with hyperlipidemia from 1991 to 2023. (A) The cooperation network of keywords in the field. The selected keywords can be broadly categorized into five clusters representing different types of lipid-lowering drugs and their combination applications; (B) Keyword clustering analysis in this field. Different colors represent different clusters, the smaller the count, the more keywords are in the cluster; (C) Timeline view of keywords in the field. The position of a node on the horizontal axis indicates the moment when it first appears, and its size is related to the number of references; (D) The top 25 keywords with the strongest citation bursts. The blue bar indicates the time period in which the keyword appeared, and the red bar indicates the start year, end year, and duration of the burst.

FIGURE 10

Mainstream drugs that can be used for lipid-lowering treatment. These include (A) statins, (B) ezetimibe, (C) fibrates, (D) ω-3 fatty acids, (E) niacin, (F) bile acid sequestrant, (G) antioxidant and (H) PCSK9 inhibitors. Among them, statins mainly reduce LDL-C levels; ezetimibe, bile acid sequestrants and antioxidants mainly reduce TC and LDL-C levels; fibrates and niacin mainly reduce TG levels, but fibrates also It has the effect of increasing HDL-C; ω-3 fatty acids can increase HDL-C levels and reduce LDL-C levels; PCSK9 inhibitors can significantly reduce LDL-C levels (Created with BioRender.com).