Abstract
A large volume of literature has become available to practitioners prescribing anticoagulants.
The aim of this study was to analyze the bibliometric characteristics of the top 100
most cited articles related to anticoagulation over the past 25 years, with special
consideration to impact of direct or “nonvitamin K antagonist” oral anticoagulants
(NOACs) compared with vitamin K antagonists. A bibliometric analysis of the 100 most
cited journal articles related to anticoagulants published between 1994 and 2019 was
performed in April 2019. The top 100 articles by citation count were analyzed to extract
bibliometric data related to journal title, impact factor, year of publication, place
of publication, anticoagulant studied, indication for anticoagulation, study design,
and conflicts of interest. The median (interquartile range) number of citations per
article was 806 (621–1,085). The anticoagulant most frequently researched was warfarin
(37%). NOAC publications (21%) grew at a relative rate of 3.4 times faster compared
with all publications. The indication most commonly researched was venous thromboembolism
(26%). Eighty articles constituted level I or II evidence, with randomized controlled
trials the most common type of study (74). A financial conflict of interest was declared
in 87% of articles with private, for-profit organizations the most common source of
funding (26%). In summary, top research related to anticoagulation is highly impactful
but may be at risk of sponsorship bias. High-level evidence for NOACs continues to
expand across a range of indications with citation metrics likely to soon approach
or surpass that of older drugs.
Keywords
anticoagulation - NOAC - bibliometric - citation analysis
