Clinical analysis of drug treatment trends for coronary heart disease in China.

BACKGROUND

Coronary heart disease (CHD) is the leading cause of mortality in China, yet the alignment between pharmaceutical research investment and clinical therapeutic priorities remains uncharacterized.

METHODS

We conducted a dual-stream analysis. Stream A (Bibliometric): systematic searches of PubMed, Embase, Scopus, and Web of Science yielded 12,032 records; after deduplication and screening, 3,339 publications met inclusion criteria. Stream B (Clinical Trials): searches of CDCTP and ChiCTR identified 1,433 interventional drug trials after deduplication and quality control. Drugs were standardized to the WHO ATC classification; TCM ingredients to TCMID 2.0.

RESULTS

CHD research output expanded exponentially: Publications increased from 41 (2006) to 353 (2020; 760% increase), with 265 in 2025 (546% increase from baseline). Strikingly, 76.4% of trials were bioequivalence studies, with chemical pharmaceuticals dominating (78.6%) over traditional Chinese medicine (21.4%); calcium channel blockers comprised the largest drug category (45.9%. Notably, Critical gaps emerged: genomic research concentrated on inflammatory biomarkers (CRP, IL6, TNF; 25.8% of gene associations) while lipid metabolism targets were underrepresented (12.4%) despite statin therapeutic dominance; publication venue prestige demonstrated inverse volume-impact correlation (19.7% Q1 vs. 33.6% Q3 journals). Thus, quantitative expansion (compound annual growth rate (CAGR) 10.4%) coexisted with qualitative ceiling effects and target-drug mismatches between research investment and clinical guideline priorities.

CONCLUSION

China's CHD research landscape is policy-driven rather than clinically aligned: generic bioequivalence validation dominates (76.4%) while innovative therapeutic development and high-impact dissemination lag. Strategic rebalancing toward lipid metabolism genomic discovery, Phase II-III novel drug trials, and Q1 journal publication is imperative to bridge the research-clinical practice gap and align with global cardiovascular science standards.