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. 2023 Oct 27;102(43):e35599. doi: 10.1097/MD.0000000000035599

Hot spots and trends in PCI prognostic research: A bibliometric analysis with CiteSpace

Shuli Guo a,b, Xiandao Luo c, Liu Huang a, Changmin Wang b, Yining Yang d, Lei Yang a,*
PMCID: PMC10615519  PMID: 37904392

Abstract

Background:

The number of patients undergoing percutaneous coronary intervention (PCI) procedures is increasing along with the number of studies involving guidelines, prognostic assessments, and cardiac rehabilitation related to PCI strategies. However, fewer studies have reported the mapping of knowledge structure and hotspot analysis in this field. Our goal was to discuss and analyze the current status, hot spots and developmental trends associated with research into the prognosis of patients undergoing PCI, and to provide reference for PCI-related research.

Methods:

The Web of Science Core Collection and China Knowledge Network were searched for relevant literature from January 2003 to October 2022, and CiteSpace 6.1. R3 software was used to analyze the co-occurrence, clustering, and emerging authors, institutions, and keywords.

Results:

A total of 2666 English and 2010 Chinese publications were included. The number of publications showed a growing trend. The author with the maximum number of articles was Xu Bo. The institutions with high productivity were Peking Union Medical College and Capital Medical University. Although the number of Chinese articles was high, the cooperation between institutions was low and the impact was small. The results of the analysis suggest a shift in the focus of keywords from coronary artery disease and PCI to studies involving the assessment and intervention of risk factors associated with poor prognosis of PCI. Traditional Chinese Medicine and anxiety represent the emerging direction of PCI prognosis. The assessment of major adverse cardiovascular events and cardiac rehabilitation require careful analysis in post-PCI research.

Conclusion:

The findings of this bibliometric study present a comprehensive and systematic overview of the PCI prognosis, based on the analysis of the current status and trends in research, which may facilitate the identification of hot topics and new directions for future research.

Keywords: coronary artery disease, PCI, prognosis, research trends

1. Introduction

Cardiovascular disease is a major public health challenge worldwide, with China reporting the highest mortality rate due to the disease.[1] Percutaneous coronary intervention (PCI) is the main treatment for coronary heart disease. A total of 1.04 million PCI procedures were performed in China in 2019, and the number of cardiac stents implanted were the highest in the world.[2] Although PCI can alleviate symptoms caused by vascular stenosis, postoperative cardiac rehabilitation and outcomes are equally important. The PCI prognostic study refers to the studies investigating the prognosis or likely outcomes of patients who have undergone PCI, including those that affect the success of PCI and patient survival rates, and tracking patients to monitor their health outcomes. Despite extensive research studies investigating the prognostic value of PCI, fewer analyses of research hotspots have been reported in this field. Citespace software can be used to structure the detailed knowledge, visualize the complex relationships, and analyze the key trends based on the knowledge network structure with objectivity, systematicity, and scientific rigor.[3] In this study, we utilized CiteSpace to conduct a bibliometric analysis of relevant literature to visualize the research hotspots in this field, in an effort to provide reference for subsequent prognostic studies involving PCI surgery.

2. Materials and Methods

2.1. Data sources and search strategies

Studies published between January 2003 and October 2022 were searched on November 10th,2022. The Chinese study data were obtained from the journal articles in the China National Knowledge Infrastructure using the search strategy of “Topic = percutaneous coronary intervention OR coronary PCI and Topic = prognosis OR outcome”. Published literature in English language were obtained from the Science Citation Index Expanded of the Web of Science Core Collection (WoSCC) using the search strategy of “Topic = (percutaneous coronary intervention OR PCI) AND Topic = (prognosis OR outcome) AND Topic = (Coronary artery disease OR Coronary heart disease)”. A total of 2131 Chinese and 3117 English publications were retrieved, which were exported in Refworks format in Chinese and in full record plain text format in English. The study records included title, author, institution, keywords, year, and journal. Substandard documents were excluded and then analyzed. To ensure the accuracy of the study data, the search process was conducted independently by 2 researchers by searching, checking, screening, and confirmation. Details of the filtering process are presented in Figure 1.

Figure 1.

Figure 1.

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Flow chart of the literature selection.

2.2. Data analysis

SPSS 26.0 (SPSS Inc, Chicago, IL) was used to create the fitting curve for the number of publications. CiteSpace (version 6.1.R3, Drexel University, Philadelphia, PA, https://citespace.podia.com/download) was used to analyze the publications that contributed to the prognosis of PCI. First, the source terms included author, title, keywords, and abstract, while the node type was set as institution, country, cited journal or keyword. Second, the cosine link reduction method and pathfinder networking scaling were utilized to simplify the network and highlight the important features. Third, we performed a keyword co-occurrence and cluster analysis by combining similar objects to determine related areas of study. We used the log-likelihood ratio algorithm to analyze related terms and keywords associated with PCI prognosis. The number of objects involved in the cluster were determined according to the size, and the largest clusterID 0 (#0) contained the largest number of keywords. The silhouette value (S) reflected the similarity of a term to members in the cluster, with S > 0.7 indicating a high degree of consistency. Fourth, we used the burst detection function to explore the emerging trends during a specific time period. For visualization, rings of different colors in the node represent the node frequency of occurrence in different years. Centrality is an indicator that can be used to evaluate the importance of the item in the network. Generally, the purple outer circle shows the term with centrality ≥ 0.1, indicating the strong interactive significance of the node.

3. Results

3.1. Distribution of annual publications

A total of 2131 Chinese and 3117 English publications from 2003.1.1 to 2022.10.31 were extracted from China National Knowledge Infrastructure and WoSCC. The search process is shown in Figure 1. The final analysis included 2010 Chinese studies and 2666 English records. Since 2003, the number of publications in Chinese associated with PCI prognosis fluctuated around 100 annually, with a maximum of 326 articles in 2017. The publications in English increased nearly every year since 2003, with a peak of 290 articles published in 2020 (Fig. 2).

Figure 2.

Figure 2.

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Annual number of Publications related to PCI prognosis. PCI = percutaneous coronary intervention.

3.2. Bibliometric analysis of authors, institutions, and countries

The Chinese publications involved 730 authors. Qiao Shubin was the most cited (50 times) Chinese author, followed by Xu Bo. the publications in English involved 864 authors, and the top 2 cited authors were Serruys, Patrick W (37 times) and Xu Bo. The number of authors with 1 publication in Chinese was 270 (37.0%), which was higher than those in English (141 or 16.32%). The author with the most citations in English and Chinese combined was Xu, Bo from Fu Wai Hospital, Chinese Academy of Medical Sciences. According to the author cooperation network relationship map (Fig. 3), Chinese authors formed 736 nodes (N) and 1419 lines (E). Authors in English had relatively close connection (N = 864, E = 2138). Table 1 shows the Top 5 active authors.

Figure 3.

Figure 3.

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Bibliometric analysis of authors related to PCI prognosis research (A) Chinese publications, (B) English publications. PCI = percutaneous coronary intervention.

Table 1.

Top 5 active authors in the research.

Chinese publications English publications
Rank Publications Been Cited Year Author Rank Publications Been Cited Year Author
1 20 37 2003 乔树宾Qiao Shubin 1 34 50 2007 Serruys Patrick W
2 14 32 2015 徐波 Xu Bo 2 25 42 2014 Xu Bo
3 14 30 2014 杨跃进 Yang Yuejin 3 24 39 2014 Stone Gregg W
4 13 18 2015 高润霖 Gao Runlin 4 18 35 2018 Gao Zhan
5 8 18 2011 袁晋青Yuan Jinqing 5 15 34 2008 Daida Hiroyuki
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As showed in Figure 4, the publications in Chinese involved a total of 478 institutions (N = 478, E = 150), and the top 5 institutions in terms of number of publications are shown in Table 2. Articles published in English involved 609 institutions with a stronger network of cooperation (N = 609, E = 1223). The articles in English covered 91 countries. In terms of frequency, the top 3 countries were China, the United States, and Japan (Fig. 5, Table 3). Since 2003, the number of publications in China increased in a nearly linear fashion, with a maximum of 121 publications in 2021.As shown in Figure 5,the larger the node, the more publications is available under that country, The connections or links between nodes/terms represents the number of times terms occur together in the same country, and the width of the connection indicates the degree of cooperation. However, unlike the USA and the Netherlands, China does not have a purple outer ring. The purple outer circle indicates that the node has a high intermediary centrality, >0.1, which plays a bridging role with a relatively significant influence in this area.

Figure 4.

Figure 4.

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Knowledge map of institutions related to PCI prognosis research. (A) Chinese publications, (B) English publications. PCI = percutaneous coronary intervention.

Table 2.

Top 5 institutions contributed to the publications.

Chinese publications English publications
Rank Been cited Year Institution Rank Been cited Year Institution
1 49 2008 北京协和医学院Peking Union Medical College 1 92 2008 Capital Med Univ
2 41 2004 河北医科大学Hebei Medical University 2 61 2003 Erasmus MC
3 26 2006 天津医科大学Tianjin Medical University 3 55 2013 Chinese Acad Med Sci
4 25 2019 北部战区总医院the General Hospital of People’s Liberator Army 4 43 2008 Mayo Clin
5 24 2007 大连医科大学Dalian Medical University 5 42 2005 Columbia Univ
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Figure 5.

Figure 5.

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Knowledge map of countries related to PCI prognosis research. PCI = percutaneous coronary intervention.

Table 3.

Top 10 countries contributed to the publications.

Rank Been cited Centrality Year Country
1 599 0.01 2003 Peoples R China
2 539 0.32 2003 USA
3 294 0.01 2003 Japan
4 194 0.06 2003 Italy
5 153 0.11 2003 Netherlands
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3.3. Bibliometric analysis of co-cited references and top-cited articles

Analysis of the higher co-cited references provides access to the disciplinary research base (Table 4). The 2017 ESC guidelines for the management of patients with acute myocardial infarction with ST-segment elevation were the most frequently cited (119 times in total). The ESC/EACTS guidelines for myocardial remodeling and optimal pharmacotherapy with or without PCI in stable coronary artery disease had a higher mediated centrality of 0.14 and 0.13, respectively, and these 3 articles represent important references for the development of PCI treatment. Some of the literature is closely related and is often cited together with the cited literature, that is, these documents often appear together in multiple documents published later. It also means that these co-cited documents have some similarities in content. From this, further clustering is carried out to explore the common theme of similar literature. Cluster analysis of co-cited literature was conducted and sorted according to the number of members and citations under different classifications. The smaller the cluster ID, the higher the number of members and the greater the influence. Figure 6 revealed 7 main directions of prognostic research focus on coronary PCI at this stage, which lays the foundation for prognostic research on PCI.

Table 4.

Top 10 co-cited references on PCI prognosis.

Rank Frequency Centrality Year Cited references
1 119 0.03 2018 2017 ESC Guidelines for the management of acute myocardial infarction in patients presenting with ST-segment elevation.
2 74 0.14 2014 2014 ESC/EACTS Guidelines on myocardial revascularization: The task force on myocardial revascularization of the European Society of Cardiology (ESC) and the European Association for Cardio-Thoracic Surgery (EACTS) developed with the special contribution of the European Association of Percutaneous Cardiovascular Interventions (EAPCI)
3 72 0.09 2016 2015 ESC guidelines for the management of acute coronary syndromes in patients presenting without persistent ST-segment elevation: Task force for the management of acute coronary syndromes in patients presenting without persistent ST-Segment Elevation of the European Society of Cardiology (ESC).
4 61 0.01 2019 2018 ESC/EACTS guidelines on myocardial revascularization.
5 58 0.03 2012 ESC guidelines for the management of acute myocardial infarction in patients presenting with ST-segment elevation.
6 49 0.01 2020 2019 ESC guidelines for the diagnosis and management of chronic coronary syndromes.
7 38 0.05 2019 Fourth universal definition of myocardial infarction (2018).
8 36 0.04 2009 Percutaneous coronary intervention versus coronary artery bypass grafting for severe coronary artery disease.
9 31 0.13 2007 Optimal medical therapy with or without PCI for stable coronary disease.
10 31 0.01 2020 Initial invasive or conservative strategy for stable coronary disease.
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PCI = percutaneous coronary intervention.

Figure 6.

Figure 6.

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Knowledge map of clustering of co-cited references on PCI prognosis. PCI = percutaneous coronary intervention.

3.4. Bibliometric analysis of co-occurring keywords

3.4.1. Co-occurrences, and cluster analysis of keywords.

A keyword is a high overview and summary of an article; the frequency of keywords usually indicates the focus of the field. The knowledge map of Chinese publications contains 476 keywords and English publications contain 637 keywords, Table 5 shows the general consistency of top 20 keywords in Chinese and English. The knowledge map of keyword clusters of PCI prognosis is presented in Figure 7 and Table 6. The Chinese and English publication clusters of keywords were reasonable (Chinese: Modularity = 0.8748, S = 0.979; English: Modularity = 0.742, S = 0.8932), indicating a high degree of consistency among members within each category of clusters, with valid and convincing results. Both English and Chinese publications focused primarily on prognostic studies based on cardiovascular events, diabetes, and antiplatelet therapy. While Traditional Chinese Medicine (TCM) was the focus in Chinese publications, the English publications dwelt primarily on triglyceride-glucose index and optical coherence tomography (OCT)-guided PCI-related research. The keyword timeline plots (Fig. 8) reveal hot keywords in the Chinese and English literature ranging from coronary artery disease and PCI transfer to studies on prognosis, cardiovascular events, risk factors, and interventions.

Table 5.

Top 20 keywords in Chinese and English articles on PCI prognosis.

Rank Chinese publications English publications
Frequency Centrality Keyword Frequency Centrality Keyword
1 681 0.55 预后prognosis 1151 0.02 Percutaneous coronary intervention
2 315 0.34 不良事件Adverse events 787 0.02 Coronary artery disease
3 264 0.31 冠心病Coronary heart disease 555 0.01 Myocardial infarction
4 105 0.21 冠脉支架Coronary stents 542 0 Mortality
5 76 0.16 危险因素Risk factors 460 0.01 Risk factor
6 56 0.1 替罗非班Tirofiban 421 0.01 Glomerular filtration rate
7 55 0.03 心功能Cardiac function 408 0.01 Acute myocardial infarction
8 50 0.03 糖尿病Diabetes 398 0.02 Prognosis
9 48 0.08 氯吡格雷Clopidogrel 387 0.02 Cardiac Rehabilitation
10 41 0.04 预后评估Prognostic evaluation 330 0.01 Major adverse cardiovascular events
11 40 0.04 冠状动脉Coronary artery 313 0.02 Cardiovascular disease
12 39 0.13 介入治疗Interventional therapy 287 0.01 Society
13 37 0.05 健康管理Health management 270 0.03 Risk intervention
14 32 0.02 焦虑 Anxiety 269 0.03 Acute coronary syndrome
15 26 0.02 球囊Balloon 254 0.03 Heart failure
16 23 0.01 血栓抽吸Thrombus aspiration 252 0.02 Triglyceride-glucose index
17 23 0.02 老年人the elderly 218 0.02 Health management
18 21 0 性别Gender 199 0.03 Revascularization
19 21 0.02 心脏康复Cardiac Rehabilitation 178 0.02 Angioplasty
20 19 0.05 中医Traditional Chinese Medicine 171 0.01 Vascular endothelial function
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PCI = percutaneous coronary intervention.

Figure 7.

Figure 7.

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Knowledge map of clustering of keywords on PCI prognosis. (A) Chinese publications, (B) English publications. PCI = percutaneous coronary intervention.

Table 6.

Clustering labels of keywords of Chinese and English publications on PCI prognosis.

ClusterID Chinese publications English publications
Size Silhouette Label (log-likelihood ratio, p level) Size Silhouette Label (log-likelihood ratio, p level)
0 57 0.864 预后(124.61, 1.0E–4) Prognosis 77 0.762 Prognosis (2867.3, 1.0E–4)
1 57 0.798 心肌梗死 (66.57, 1.0E–4) Myocardial infarction 74 0.819 Percutaneous coronary intervention (1555.72, 1.0E–4)
2 48 0.842 经皮冠状动脉介入治疗 (57.75, 1.0E–4) Percutaneous coronary intervention 61 0.791 Cardiovascular events (1899.78, 1.0E–4)
3 47 0.803 冠心病 (127.77, 1.0E–4) Coronary heart disease 58 0.793 Platelet reactivity (3753.15, 1.0E-4)
4 41 0.881 危险因素 (51.85, 1.0E–4) Risk factors 58 0.77 Triglyceride-glucose index (7666.16, 1.0E–4)
5 31 0.892 糖尿病 (51.68, 1.0E–4) Diabetes 55 0.776 Acute coronary syndrome (2967.22, 1.0E–4)
6 25 0.926 中医(36.49, 1.0E–4) Traditional Chinese Medicine 46 0.741 Diabetes mellitus (5243.12, 1.0E–4)
7 25 0.927 氯吡格雷 (83.89, 1.0E–4) Clopidogrel 43 0.726 Optical coherence tomography (2672.71, 1.0E–4)
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PCI = percutaneous coronary intervention.

Figure 8.

Figure 8.

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Timeline of clustering of keywords on PCI prognosis. (A) Chinese publications, (B) English publications. PCI = percutaneous coronary intervention.

3.4.2. Burst detection of keywords.

Figure 9 presents the 20 keywords and hotspots with citation bursts over the last 20 years. Among the Chinese publications, “myocardial infarction” appeared the earliest and lasted the longest (2003–2015). The strongest burst term was “coronary stent,” while TCM, prognosis, and post-PCI anxiety were emphasized from 2017 to 2020, consistently until 2022, which are the current research hotspots. The longest duration of keywords in English publications was complication (2005–2017) and the strongest burst term was angioplasty. ST-segment elevation myocardial infarction, society, cardiac rehabilitation, major adverse cardiovascular events, prognosis, and stents emerged in the last 6 years and have been consistently reported until 2022, and are the current research hotspots.

Figure 9.

Figure 9.

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TOP 20 keywords with the strongest citation bursts on PCI prognosis. (A) Chinese publications, (B) English publications. PCI = percutaneous coronary intervention.

4. Discussion

More than 11.39 million patients are currently diagnosed with coronary heart disease in China, and the country reports the highest mortality rate worldwide due to this disease.[4] PCI can be used to rapidly open up occluded coronary arteries and restore blood flow and myocardial reperfusion. It is one of the most effective clinical treatments for coronary artery disease. However, PCI does not change the disease pathophysiology. Major adverse cardiovascular events (MACE such as restenosis and death) can still occur after PCI, with an incidence reaching as high as 30.5% at 5 years after PCI.[5] Prognostic assessment and intervention of patients undergoing PCI is important to consolidate the efficacy of surgery and improve patient survival and quality of life. With the increase in the incidence of coronary artery disease, advances in treatment technology, guidelines continue to be introduced and treatment is constantly standardized, improvements in medical coverage, and reduction in the price of stents, more and more people are willing to accept PCI, the number of PCI procedures has increased with a growing emphasis on PCI prognosis.[6] In addition, the aging population in China is an increasingly serious concern, the number of elderly patients with coronary heart disease continues to increase. The relevant knowledge mapping inter-author, inter-institutional, and inter-country linkage (Figs. 3–5) showed that PCI prognosis research has formed a certain cooperative network in China, the citation frequency of the relevant literature (Table 3) also indicates to some extent that Chinese literature has provided a reference for related research in this field and promoted the development of the discipline of cardiac rehabilitation post-PCI.

China has focused increasingly on PCI, with a comprehensive investigation in related fields, independently developing bioresorbable scaffolds, and practicing the concept of “intervention without implantation” for vascular reconstruction.[7] Meanwhile, the National Center for Cardiovascular Quality Improvement and the National Quality Control Center for Coronary Heart Disease have strengthened the quality of cardiovascular disease management and improved the quality and service levels. China’s efforts in the treatment of coronary heart disease using PCI serve as a standard of reference for other countries in improving human health.

In this study, a summary analysis of related articles in the last 20 years revealed a steady upward in the overall number of publications associated with PCI prognosis since 2003.The main reasons include not only extensive PCI procedures performed in China, the PCI-related guidelines have also contributed to the continuous standardization of PCI diagnosis and treatment. For example, the guidelines and expert consensus on ST-segment elevation myocardial infarction/non-ST elevation myocardial infarction, countermeasures for post-PCI bleeding, and management options for complete obstruction have been issued.[8–10] In 2002, China also successively issued PCI-related treatment guidelines, and later released different versions in 2009, 2012, and 2016.[11–14] The peak of Chinese literature in PCI occurred in 2017 immediately afterwards (Fig. 2). These guidelines further promoted the increase in PCI procedures and related research.

A strong cooperative network has been formed among the authors, and a core group of authors associated with PCI prognostic studies has been established. There is less cooperation among Chinese institutions or authors, with the proportion of authors publishing a single article as high as 37%. Most of the research institutions are hospitals or universities, without leading participation at the national or governmental level. They represent single research entity, with no obvious clustering among institutions. China is the country with the highest frequency of publications in this field, indicating increased attention and active exploration in PCI prognosis. However, compared with the United States and The Netherlands, China is less central and less influential. It is necessary to further strengthen the cooperation between institutions and countries to further deepen the research direction, to play a bridging role in studies investigating PCI prognosis.

By clustering the co-cited literature and an in-depth analysis of important literature, we found that the current focus of prognostic studies involving PCI in coronary artery disease is 3-fold: Consensus or guidelines related to ST-segment elevation myocardial infarction and coronary revascularization. The guidelines based on clinical effectiveness trials have clarified the criteria for the selection of revascularization strategies, the intraoperative operation of PCI and the prevention and treatment of major complications of PCI, the antithrombotic treatment in the perioperative period of PCI and the postoperative management;[15–18] The population benefiting from PCI is still not clearly identified. Further studies are needed to confirm the incidence of poor cardiovascular events after PCI compared with those before PCI. PCI and pharmacotherapy are the best treatment options for stable coronary artery disease, and the classification of patients with myocardial infarction needs to be further optimized;[19–21] Studies related to the prognosis of MACE after PCI. The main focus is on the risk factors associated with the occurrence of MACE (including cardiac-caused death, all-cause death, in-stent thrombosis, restenosis, and revascularization) after PCI, and the effectiveness of different interventions to improve the prognosis.[22,23]

Based on cluster analysis of keywords, we found that TCM emerged in Chinese publications, while English publications focused on triglyceride-glucose index and OCT-guided PCI-related research. PCI treatment for coronary heart disease was adopted early in foreign countries, and surgical techniques are constantly improving. OCT for the management of complex bifurcation lesions has advantages in guiding accurate PCI treatment.[24] Cardiac rehabilitation has been carried out early in foreign countries with medical insurance support, and sufficient attention has been paid to the study of PCI prognosis. The “metabolic comorbidity problem” can significantly affect the prognosis of PCI and is also a treatment difficulty, making it a research hotspot.[25] TCM provides a systematic diagnosis and treatment of coronary heart disease. In recent years, evidence-based medicine has been continuously developed, and research has shown that TCM and other factors can affect the prognosis of PCI. Further, Baduanjin and others have reported strong results in cardiac rehabilitation after PCI, laying the foundation for the study of TCM in the prognosis of PCI.[26,27]

Based on keyword frequency, centrality, clustering labels, keyword emergence time and intensity and comparison with foreign countries, we analyzed the 3 main directions of PCI prognosis research in China: Immediate, intermediate and long-term prognostic assessment of patients with PCI. Risk assessment models and risk scores are often used for prognostic assessment of PCI.[28–30] The main risk factors include age, gender, history of diabetes, treatment modality (thrombolysis, OCT guidance),[31,32] platelet activity,[33] triglyceride-glucose index,[34] lesion vascular condition and other indicators[35]; Cardiac rehabilitation (CR) and health management of patients after PCI. CR significantly reduces cardiovascular death and all-cause mortality, improves exercise tolerance, and benefits almost all patients with coronary artery disease. It is an important adjunct to PCI treatment. The CR referral rate for patients after PCI has reached about 60% in USA, with dedicated CR facilities and relatively mature procedures that are covered by health insurance.[36] CR is based on exercise in a variety of forms, and is traditionally used mostly in medical institutions and family-centered exercise interventions. Community-based and information technologies such as AI-guided CR have proven effective.[37–40] Behavioral management of patients undergoing PCI using diet and exercise has significantly improved patients quality of life;[41,42] Management of risk factors after PCI. Anxiety and depression occur in approximately 21.5% of patients 24 hours after PCI,[43] which can affect the long-term survival of patients and the incidence of MACE after PCI.[44–46] Studies have used psychological counseling and other methods to alleviate patients anxiety and depression and improve disease prognosis.[47,48] Treatment using TCM-based interventions emerged in 2017 to 2019 alone or in conjunction with Western medicine, to facilitate “double heart recovery,” relieve anxiety and reduce the occurrence of MACE.[49–52] In addition, TCM exercises such as Tai Chi Chuan and Ba Duan Jin have also been shown to improve PCI prognosis. Further evidence is expected to support the role of TCM in improving the prognosis of PCI.[27,53,54]

In conclusion, compared with foreign countries, China has made multi-faceted exploration in the field of PCI prognosis, with concrete achievements. The future further depends on several factors. First, based on the current scenario, research at each institution is relatively independent and scattered, but the cooperation and communication between research subjects has increased. Second, to focus on hot spots, the research content needs to be deepened, and a sound and standard prognostic assessment system for PCI needs to be established. Third, interdisciplinary cross-fertilization is required to build a personalized health management program for patients post-PCI. Fourth, the randomized controlled studies of PCI prognostic interventions should be conducted to lay the foundation for the development of guidelines related to PCI prognosis.

5. Conclusion

We conducted a systematic review and bibliometric analysis of studies related to PCI prognosis from 2003 to 2022, which provided important insights into research trends, hotspots, and future directions. An overall upward exists in the number of publications reporting PCI prognosis. China has published a limited number of articles in this research area. However, there is a need to strengthen cooperation, deepen the research content, and improve the impact. In addition, the research frontiers and trends in PCI prognosis may focus on MACE assessment, CR, and risk factor intervention. This bibliometric analysis summarizes and distinguishes the research hotspots and frontiers as well as the corresponding directions, provides effective strategies and enlightenment for future studies on PCI prognosis.

6. Strengths and limitations

The analysis of Chinese and English publications involving PCI prognosis in the past 20 years has practical implications in helping investigators in China to comprehend the research hotspots and the latest progress in this field, establish the direction of scientific research, and improve the quality and impact of research.

Only a limited number of articles and reviews published in English were included in the WoSCC database, which may lead to inaccurate and biased results. However, the overall scientific merit of the study results and conclusions is not affected.

Acknowledgments

We would like to thank ChaoMei Chen from Drexel University, USA, for developing the CiteSpace software and making it available online for free.

Author contributions

Conceptualization: Changmin Wang, Lei yang.

Data curation: Liu Huang.

Formal analysis: Yining Yang.

Writing – original draft: Shuli Guo.

Writing – review & editing: Xiandao Luo.

Abbreviations:

CR
cardiac rehabilitation
E
Lines
MACE
major adverse cardiovascular events
N
Nodes
OCT
optical coherence tomography
PCI
percutaneous coronary intervention
S
Silhouette
TCM
Traditional Chinese Medicine
WoSCC
Web of Science Core Collection

SG and XL contributed equally to this work.

This article is a review and analysis of published literature and does not require ethical review.

The study was supported byAutonomous Region Health and Young Medical Science and Technology Talents Special Project (WJWY-202321).

The datasets generated during and/or analyzed during the current study are publicly available.

The authors have no funding and conflicts of interest to disclose.

How to cite this article: Guo S, Luo X, Huang L, Wang C, Yang Y, Yang L. Hot spots and trends in PCI prognostic research: A bibliometric analysis with CiteSpace. Medicine 2023;102:43(e35599).

Contributor Information

Shuli Guo, Email: 2020011012014@stu.hznu.edu.cn.

Xiandao Luo, Email: 1466932284@qq.com.

Liu Huang, Email: 2016012012001@stu.hznu.edu.cn.

Changmin Wang, Email: wcm224@126.com.

Yining Yang, Email: yanglei62@hznu.edu.cn.

References

  • [1].Roth GA, Mensah GA, Fuster V. The global burden of cardiovascular diseases and risks: a compass for global action. J Am Coll Cardiol. 2020;76:2980–1. [DOI] [PubMed] [Google Scholar]
  • [2].National Center for Cardiovascular Diseases. China Cardiovascular Health and Disease Report 2019. J Cardiopulm Vasc Dis. 2020;39:1145–56. [Google Scholar]
  • [3].Chen CM. CiteSpace II: detecting and visualizing emerging trends and transient patterns in scientific literature. J Am Soc Inf Sci Tec. 2006;57:359–77. [Google Scholar]
  • [4].Writing committee of the report on cardiovascular health and diseases in China. Report on cardiovascular health and diseases in China 2021: an updated summary. Biomed Environ Sci. 2022;35:573–603. [DOI] [PubMed] [Google Scholar]
  • [5].Matsumoto I, Moriya S, Kurozumi M, et al. Relationship between serum uric acid levels and the incidence of cardiovascular events after percutaneous coronary intervention. J Cardiol. 2021;78:550–7. [DOI] [PubMed] [Google Scholar]
  • [6].Yuan S, Liu Y, Li N, et al. Impacts of health insurance benefit design on percutaneous coronary intervention use and inpatient costs among patients with acute myocardial infarction in Shanghai, China. PharmacoEcon. 2014;32:265–75. [DOI] [PubMed] [Google Scholar]
  • [7].Wu Y, Shen L, Yin J, et al. 5 years of serial intravascular imaging outcomes of XINSORB sirolimus-eluting bioresorbable vascular scaffold. JACC Cardiovasc Interv. 2019;12:602–3. [DOI] [PubMed] [Google Scholar]
  • [8].Smith SC, Jr, Feldman TE, Hirshfeld JW, Jr, et al. ACC/AHA/SCAI writing committee to update 2001 guidelines for percutaneous coronary intervention ACC/AHA/SCAI 2005 guideline update for percutaneous coronary intervention: a report of the American College of Cardiology/American Heart association task force on practice guidelines (ACC/AHA/SCAI writing committee to update 2001 guidelines for percutaneous coronary intervention). Circulation. 2006;113:e166–286. [DOI] [PubMed] [Google Scholar]
  • [9].Levine GN, Bates ER, Blankenship JC, et al. 2011 ACCF/AHA/SCAI guideline for percutaneous coronary intervention: a report of the American College of Cardiology Foundation/American Heart Association task force on practice guidelines and the society for cardiovascular angiography and interventions. Circulation. 2011;124:e574–651. [DOI] [PubMed] [Google Scholar]
  • [10].Levine GN, Bates ER, Blankenship JC, et al. 2015 ACC/AHA/SCAI focused update on primary percutaneous coronary intervention for patients with ST-elevation myocardial infarction: an update of the 2011 ACCF/AHA/SCAI guideline for percutaneous coronary intervention and the 2013 ACCF/AHA guideline for the management of ST-elevation myocardial infarction: a report of the American College of Cardiology/American Heart Association task force on clinical practice guidelines and the society for cardiovascular angiography and interventions. Circulation. 2016;133:1135–47. [DOI] [PubMed] [Google Scholar]
  • [11].Runlin G, Bing L. Guidelines for percutaneous coronary interventions. Chin J Cardiol. 2002;12:6–17. [Google Scholar]
  • [12].Cardiology Branch of Chinese Medical Association, Editorial Committee of Chinese Journal of Cardiology. Guidelines for percutaneous coronary interventions (2009). Chin J Cardiol. 2009;37:4–25. [Google Scholar]
  • [13].Yaling H. Chinese guidelines for percutaneous coronary interventions 2012 (Simplified version). Chin J Front Med Sci (Electronic Version). 2012;4:50–9. [Google Scholar]
  • [14].Interventional Cardiology Group of Cardiovascular Branch of Chinese Medical Association, Professional Committee of Thrombosis Prevention and Treatment of Cardiovascular Physicians Branch of Chinese Medical Doctor Association, Editorial Committee of Chinese Journal of Cardiovascular Diseases. Chinese guidelines for percutaneous coronary interventions (2016). Chin J Cardiol. 2016;44:382–400. [Google Scholar]
  • [15].Ibanez B, James S, Agewall S, et al. 2017 ESC Guidelines for the management of acute myocardial infarction in patients presenting with ST-segment elevation. Kardiol Pol. 2018;76:229–313. [DOI] [PubMed] [Google Scholar]
  • [16].Windecker S, Kolh P, Alfonso F, et al. 2014 ESC/EACTS Guidelines on myocardial revascularization: the task force on myocardial revascularization of the European Society of Cardiology (ESC) and the European Association for Cardio-Thoracic Surgery (EACTS) developed with the special contribution of the European Association of percutaneous cardiovascular interventions (EAPCI). Eur Heart J. 2014;35:2541–619. [DOI] [PubMed] [Google Scholar]
  • [17].Roffi M, Patrono C, Collet JP, et al. 2015 ESC Guidelines for the management of acute coronary syndromes in patients presenting without persistent ST-segment elevation: task force for the management of acute coronary syndromes in patients presenting without persistent ST-segment elevation of the European Society of Cardiology (ESC). Eur Heart J. 2016;37:267–315. [DOI] [PubMed] [Google Scholar]
  • [18].Neumann FJ, Sousa-Uva M, Ahlsson A, et al. 2018 ESC/EACTS Guidelines on myocardial revascularization. Eur Heart J. 2019;40:87–165. [DOI] [PubMed] [Google Scholar]
  • [19].Boden WE, O’Rourke RA, Teo KK, et al. Optimal medical therapy with or without PCI for stable coronary disease. N Engl J Med. 2007;356:1503–16. [DOI] [PubMed] [Google Scholar]
  • [20].Frelinger AL, Li Y, Linden MD, et al. Aspirin “resistance”: role of pre-existent platelet reactivity and correlation between tests. J Thromb Haemost. 2008;6:2035–44. [DOI] [PubMed] [Google Scholar]
  • [21].Teo KK, Sedlis SP, Boden WE, et al. Optimal medical therapy with or without percutaneous coronary intervention in older patients with stable coronary disease: a pre-specified subset analysis of the COURAGE (clinical outcomes utilizing revascularization and aggressive druG evaluation) trial. J Am Coll Cardiol. 2009;54:1303–8. [DOI] [PubMed] [Google Scholar]
  • [22].Zhao X, Liu C, Zhou P, et al. Estimation of major adverse cardiovascular events in patients with myocardial infarction undergoing primary percutaneous coronary intervention: a risk prediction score model from a derivation and validation study. Front Cardiovasc Med. 2020;7:603621. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • [23].Sarli B, Akpek M, Baktir AO, et al. Impact of D-dimer level on postinterventional coronary flow and in-hospital MACE in ST-segment elevation myocardial infarction. Herz. 2015;40:507–13. [DOI] [PubMed] [Google Scholar]
  • [24].Shlofmitz E, Shlofmitz RA, Galougahi KK, et al. Algorithmic approach for optical coherence tomography-guided stent implantation during percutaneous coronary intervention. Interv Cardiol Clin. 2018;7:329–44. [DOI] [PubMed] [Google Scholar]
  • [25].Gursoy E, Baydar O. The triglyceride-glucose index and contrast-induced nephropathy in non-ST elevation myocardial infarction patients undergoing percutaneous coronary intervention. Medicine (Baltim). 2023;102:e32629. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • [26].Gao ZY, Xu H, Shi DZ, et al. Analysis on outcome of 5284 patients with coronary artery disease: the role of integrative medicine. J Ethnopharmacol. 2012;141:578–83. [DOI] [PubMed] [Google Scholar]
  • [27].Li XX, Fan ZJ, Cui J, et al. Cardiac rehabilitation of Baduanjin exercise in coronary heart disease after PCI: a protocol for systematic review and meta-analysis of randomized controlled trials. Medicine (Baltim). 2021;100:e25501. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • [28].Ikeno F, Brooks MM, Nakagawa K, et al. SYNTAX score and long-term outcomes: the BARI-2D trial. J Am Coll Cardiol. 2017;69:395–403. [DOI] [PubMed] [Google Scholar]
  • [29].Bulluck H, Carberry J, Carrick D, et al. A noncontrast CMR risk score for long-term risk stratification in reperfused ST-segment elevation myocardial infarction. JACC Cardiovasc Imaging. 2022;15:431–40. [DOI] [PubMed] [Google Scholar]
  • [30].Gurm HS, Seth M, Kooiman J, et al. A novel tool for reliable and accurate prediction of renal complications in patients undergoing percutaneous coronary intervention. J Am Coll Cardiol. 2013;61:2242–8. [DOI] [PubMed] [Google Scholar]
  • [31].Danchin N, Puymirat E, Steg PG, et al. Five–year survival in patients with ST–segment–elevation myocardial infarction according to modalities of reperfusion therapy: the French registry on acute ST–elevation and non–ST– elevation myocardial infarction (FAST–MI) 2005 Cohort. Circulation. 2014;129:1629–36. [DOI] [PubMed] [Google Scholar]
  • [32].Baumbach A, Lansky AJ, Onuma Y, et al. Optical coherence tomography substudy of a prospective multicentre randomised post-market trial to assess the safety and effectiveness of the Firehawk cobalt-chromium coronary stent (rapamycin target-eluting) system for the treatment of atherosclerotic lesions: TARGET All Comers. EuroIntervention. 2018;14:1121–8. [DOI] [PubMed] [Google Scholar]
  • [33].Pedersen OB, Hvas AM, Ommen HB, et al. Lower antiplatelet effect of aspirin in essential thrombocythemia than in coronary artery disease. TH Open. 2021;5:e230–8. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • [34].Zhu Y, Liu K, Chen M, et al. Triglyceride-glucose index is associated with in-stent restenosis in patients with acute coronary syndrome after percutaneous coronary intervention with drug-eluting stents. Cardiovasc Diabetol. 2021;20:137. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • [35].McPherson JA, Maehara A, Weisz G, et al. Residual plaque burden in patients with acute coronary syndromes after successful percutaneous coronary intervention. JACC Cardiovasc Imaging. 2012;5(3 Suppl):S76–85. [DOI] [PubMed] [Google Scholar]
  • [36].Aragam KG, Dai D, Neely ML, et al. Gaps in referral to cardiac rehabilitation of patients undergoing percutaneous coronary intervention in the United States. J Am Coll Cardiol. 2015;65:2079–88. [DOI] [PubMed] [Google Scholar]
  • [37].Olgoye AM, Samadi A, Jamalian SA. Effects of a home based exercise intervention on cardiac biomarkers, liver enzymes, and cardiometabolic outcomes in CABG and PCI patients. J Res Med Sci. 2021;26:5. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • [38].Zhang Y, Cao H, Jiang P, et al. Cardiac rehabilitation in acute myocardial infarction patients after percutaneous coronary intervention: a community-based study. Medicine (Baltim). 2018;97:e9785. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • [39].Widmer RJ, Allison TG, Lennon R, et al. Digital health intervention during cardiac rehabilitation: a randomized controlled trial. Am Heart J. 2017;188:65–72. [DOI] [PubMed] [Google Scholar]
  • [40].Brewer LC, Kaihoi B, Zarling KK, et al. The use of virtual world-based cardiac rehabilitation to encourage healthy lifestyle choices among cardiac patients: intervention development and pilot study protocol. JMIR Res Protoc. 2015;4:e39. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • [41].Wu Q, Zhang D, Zhao Q, et al. Effects of transitional health management on adherence and prognosis in elderly patients with acute myocardial infarction in percutaneous coronary intervention: a cluster randomized controlled trial. PLoS One. 2019;14:e0217535. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • [42].Xu M, Yang X, Liu L, et al. Effect of the WeChat platform health management and refined continuous nursing model on life quality of patients with acute myocardial infarction after PCI. J Healthc Eng. 2021;2021:5034269. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • [43].Kala P, Hudakova N, Jurajda M, et al. Depression and anxiety after acute myocardial infarction treated by primary PCI. PLoS One. 2016;11:e0152367. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • [44].Meyer T, Hussein S, Lange HW, et al. Anxiety is associated with a reduction in both mortality and major adverse cardiovascular events five years after coronary stenting. Eur J Prev Cardiol. 2015;22:75–82. [DOI] [PubMed] [Google Scholar]
  • [45].de Jager TAJ, Dulfer K, Radhoe S, et al. Predictive value of depression and anxiety for long-term mortality: differences in outcome between acute coronary syndrome and stable angina pectoris. Int J Cardiol. 2018;250:43–8. [DOI] [PubMed] [Google Scholar]
  • [46].Denollet J, Pedersen SS, Daemen J, et al. Reduced positive affect (anhedonia) predicts major clinical events following implantation of coronary-artery stents. J Intern Med. 2008;263:203–11. [DOI] [PubMed] [Google Scholar]
  • [47].Shen X, Zhu X, Wu Y, et al. Effects of a psychological intervention programme on mental stress, coping style and immune function in percutaneous coronary intervention patients. PLoS One. 2018;13:e0187745. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • [48].Lee J, Song Y, Lindquist R, et al. Nontraditional Cardiac Rehabilitation in Korean patients with coronary artery disease. Rehabil Nurs. 2017;42:191–8. [DOI] [PubMed] [Google Scholar]
  • [49].Wu J, Zhao L, Lin K, et al. Chinese herbal medicines for restenosis after percutaneous coronary intervention: a meta-analysis of randomized controlled trials. J Altern Complement Med. 2019;25:983–92. [DOI] [PubMed] [Google Scholar]
  • [50].Li X, Zhang Y, Liu HX, et al. A randomized, placebo-controlled, double-blind trial to evaluate efficacy and safety of Shen-Yuan-Dan capsules, a traditional Chinese medicine, for treatment of peri-procedure myocardial injury following percutaneous coronary intervention. Complement Ther Med. 2022;69:102841. [DOI] [PubMed] [Google Scholar]
  • [51].Zhang C, Huang C, Wang M, et al. Correlation analysis between Traditional Chinese medicine syndromes and gastrointestinal bleeding after percutaneous coronary intervention. Evid Based Complement Alternat Med. 2018;2018:7356546. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • [52].Li Y, Hong M, Liu G. Changes in the quality of life, psychological status, medication compliance, and prognosis of patients with acute myocardial infarction after PCI by applying PDCA cycle management model. Evid Based Complement Alternat Med. 2021;2021:7318653. [DOI] [PMC free article] [PubMed] [Google Scholar] [Retracted]
  • [53].Luo C, Wen J, Sun W, et al. Effects of traditional Chinese exercise on cardiac rehabilitation after percutaneous coronary intervention: study protocol for network meta-analysis of randomised controlled trials. BMJ Open. 2019;9:e023096. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • [54].Liu J, Yu P, Lv W, et al. The 24-Form Tai Chi improves anxiety and depression and upregulates miR-17-92 in Coronary Heart Disease Patients after percutaneous coronary intervention. Front Physiol. 2020;11:149. [DOI] [PMC free article] [PubMed] [Google Scholar]

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