Carotid atherosclerosis biomarkers in cardiovascular diseases prevention: A systematic review and bibliometric analysis.

PURPOSE: While carotid atherosclerosis (CA) biomarkers are valuable surrogates for cardiovascular events, their inadequate utility is highlighted by clinical practice. We performed an interdisciplinary systematic review and bibliometric analysis to identify the knowledge gaps and offer directions for future research.

METHODS

We applied a comprehensive search strategy to construct a representative dataset of the bibliographic records of CA from 1997 to 2018. A total of 31,793 retrieved articles and 407,473 cited references were included in the analysis. The co-word network and co-citation network were derived to describe the major disciplines and topics of CA research. Milestones detected by burst analysis were reviewed to delineate the evolutionary patterns and emerging trends of research on CA biomarkers.

RESULTS

CA is a multidisciplinary field of study which could be divided into 3 communities: the primary prevention of CVD, the secondary prevention of CVD and imaging techniques to characterize carotid atherosclerosis. The evolution of a CA biomarker may go through 3 stages: the conceptualization stage, the validation stage and the reclassification stage. Measurements that include different CA plaque features, rather than separately, have shown greater value for cardiovascular risk or clinical decision-making.

CONCLUSIONS

Although wide variability exists in the evolutionary stages of CA biomarkers, combined evaluation of CA plaque imaging features shows potential value to improve risk prediction and clinical decision-making for CVD prevention.