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Mapping the global landscape of research on immune checkpoint inhibitor-associated cardiotoxicity: A quantitative and
Tiecheng Liu1, Xiangnv Meng2,3, Yongsheng Li2
1Department of Cardiology, Cangzhou People's Hospital, Cangzhou, Hebei, China.
Abstract:
Immune checkpoint inhibitors (ICIs) have transformed oncologic practice, but their expanding use has heightened concern about potentially fatal cardiovascular toxicity. This bibliometric study mapped the global research landscape and temporal evolution of ICI-associated cardiotoxicity from 2016 to 2025. Records were retrieved from the Web of Science Core Collection on January 1, 2026. After excluding letters, conference abstracts, editorials, and other non-research items, 1,127 original articles and reviews were analyzed. A thesaurus file standardized synonyms, abbreviations, spelling variants, and singular-plural forms before keyword co-occurrence analysis. VOSviewer and CiteSpace were used to evaluate publication trends, collaboration networks, citation structures, keyword clusters, temporal patterns, and burst terms. The corpus involved 67 countries, 2,430 institutions, and 8,842 authors. Annual output increased from 9 publications in 2016 to 236 in 2025, representing a 26.2-fold rise and a compound annual growth rate of 43.8%; cumulative publication output was well fitted by a quadratic polynomial model (R2 = 0.9973). China produced the most publications, whereas the United States achieved the highest citation count. The University of Texas MD Anderson Cancer Center, Javid Moslehi, and Frontiers in Oncology were the leading institution, author, and journal, respectively; The New England Journal of Medicine was the most frequently co-cited journal. Keyword mapping delineated three domains: immune-mediated cardiovascular phenotypes, PD-1/PD-L1-related mechanisms, and multidisciplinary risk management. Temporal and burst analyses indicated a shift from toxicity recognition toward mechanistic elucidation, diagnostic standardization, risk stratification, and cardiovascular outcome assessment. Emerging low-frequency but rapidly strengthening terms highlight growing attention to combination-regimen safety, patient-level risk assessment, evidence synthesis, and long-term cardiovascular outcomes.
Insights
Research on cardiotoxicity from immune checkpoint inhibitors (ICIs) has surged globally. Studies now focus on mechanisms, diagnosis, and managing cardiovascular risks, reflecting an evolving research landscape.
Area of Science:
- Cardiology
- Oncology
- Immunology
- Bibliometrics
Background:
- Immune checkpoint inhibitors (ICIs) have revolutionized cancer treatment.
- Expanding ICI use raises concerns about potentially fatal cardiovascular toxicity.
- Understanding the research trends in ICI-associated cardiotoxicity is crucial.
Purpose of the Study:
- To map the global research landscape and temporal evolution of ICI-associated cardiotoxicity from 2016 to 2025.
- To identify key research domains, influential institutions, authors, and journals.
- To analyze shifts in research focus over time.
Main Methods:
- Bibliometric analysis of 1,127 articles and reviews from Web of Science Core Collection (2016-2025).
- Keyword co-occurrence analysis using VOSviewer and CiteSpace for trend and burst term identification.
- Standardization of terms using a thesaurus file.
Main Results:
- Global publications on ICI cardiotoxicity increased 26.2-fold from 2016 to 2025 (43.8% CAGR).
- China led in publications; the US led in citations. Key contributors include The University of Texas MD Anderson Cancer Center, Javid Moslehi, and Frontiers in Oncology.
- Research evolved from toxicity recognition to mechanistic understanding, diagnostics, risk stratification, and outcome assessment, with emerging focus on combination therapies and long-term effects.
Conclusions:
- The field of ICI-associated cardiotoxicity is rapidly expanding and maturing.
- Research is shifting towards understanding mechanisms, improving diagnostics, and managing patient risk.
- Future research will likely emphasize combination therapies, personalized risk assessment, and long-term cardiovascular outcomes.
