Mapping publication trends in oral anticoagulation in atrial fibrillation: A bibliometric and thematic analysis of 11,039 publications (2006-2025).

OBJECTIVE

This study aimed to systematically map the intellectual evolution, thematic development, and collaborative patterns of oral anticoagulation research in atrial fibrillation (AF) from 2006 to 2025.

METHODS

This bibliometric study analyzed 11,039 documents indexed in the Web of Science Core Collection (2006-2025) using the Bibliometrix R package (version 4.x) within the R statistical environment (version 4.3.1) for comprehensive science mapping. The analytical workflow comprised descriptive performance analysis, collaboration network analysis, keyword co-occurrence analysis, strategic thematic mapping, and latent Dirichlet allocation (LDA) topic modeling.

RESULTS

Publication output increased exponentially from 2 articles per year (2006) to a peak of 960 per year (2021), with subsequent stabilization that may reflect consolidation of the field. The United States produced the highest number of publications (3636; 32.9%). The RE-LY trial received the most citations (n=8788). Thematic mapping revealed two main research clusters: Motor themes (141 keywords), representing direct oral anticoagulant agents, stroke prevention, and clinical outcomes; and emerging/declining themes (43 keywords), including venous thromboembolism and pharmacokinetics. LDA topic modeling identified nine distinct research domains encompassing real-world data, safety reporting, and implementation guidelines.

CONCLUSION

The bibliometric patterns observed are consistent with a maturing research field, characterized by a gradual shift from efficacy-focused randomized trials toward real-world effectiveness studies, implementation science, and personalized anticoagulation strategies. Future research may benefit from increased emphasis on long-term adherence, health-economic outcomes, and personalized approaches integrating genetic, clinical, and patient-centered factors.