Global Research Topics and Trends of Myocardial Infarction with Nonobstructive Coronary Arteries: A Bibliometric Analysis

Tuko  Srimulyo; Antonius  Dwi Saputra; Arga  Setyo Adji; Intan  Komalasari; Atiyatum  Billah; Diski  Saisa; Yudi  Her Oktaviano

doi:10.18502/jthc.v20i4.20746

Tuko Srimulyo Department of Cardiology and Vascular Medicine, Dr Soetomo Academic Hospital, Surabaya, Indonesia.
Antonius Dwi Saputra Faculty of Medicine, University of Jember, Jember, Indonesia.
Arga Setyo Adji Faculty of Medicine, Hang Tuah University, Surabaya, Indonesia.
Intan Komalasari Department of Cardiology and Vascular Medicine, Dr Soetomo Academic Hospital, Surabaya, Indonesia.
Atiyatum Billah Faculty of Medicine, University of Jember, Jember, Indonesia.
Diski Saisa Faculty of Medicine, University of Indonesia, Jakarta, Indonesia.
Yudi Her Oktaviano Department of Cardiology and Vascular Medicine, Dr Soetomo Academic Hospital, Surabaya, Indonesia.

DOI: https://doi.org/10.18502/jthc.v20i4.20746

Keywords: MINOCA; Myocardial Infarction; Nonobstructive Coronary Artery Disease; Acute Coronary Syndrome; Bibliometric Analysis

Abstract

Background: Myocardial infarction with nonobstructive coronary arteries (MINOCA) is a heterogeneous clinical entity characterized by evidence of myocardial infarction (MI) in the absence of obstructive coronary artery disease (CAD) on angiography. This study aimed to explore and visualize the global research trends and hotspots of MINOCA using bibliometric approaches.

Methods: The search was performed on October 1, 2025, using the keyword “MINOCA” and its synonyms. Data were obtained from the Scopus, Web of Science, and PubMed databases and analyzed using RStudio (version 4.5.0), employing the Bibliometrix package (via Biblioshiny) alongside VOSviewer (version 1.6.20) for bibliometric visualization.

Results: A total of 1,562 publications related to MINOCA were identified, showing a marked increase in output over the past decade. The mean number of citations per article was 19.21, with the highest citation count occurring in 2018. International Journal of Cardiology published the most articles, while F. Crea was the most contributing author. The United States, Italy, and China emerged as leading contributors. High-impact articles primarily focused on the pathophysiology, diagnostic algorithms, and prognosis of MINOCA. Keyword analysis revealed evolving research hotspots, including pathophysiology, imaging diagnostics, prognosis, therapy, and sex differences, indicating a growing focus on precision diagnostics and patient-tailored management strategies in MINOCA research.

Conclusion: The research landscape of MINOCA has expanded substantially, with growing attention to its underlying mechanisms and diagnostic challenges. Future studies should prioritize the development of standardized diagnostic criteria and the implementation of tailored therapeutic approaches. This bibliometric analysis provides a valuable framework for clinicians and researchers to navigate the evolving field of MINOCA.