Global landscape and emerging trends in programmable mRNA-based therapeutics for myocardial infarction: a...

Myocardial infarction (MI) remains a leading cause of mortality worldwide. Although current reperfusion-based interventions have significantly improved clinical outcomes, they are insufficient to restore lost cardiomyocytes or repair irreversible myocardial injury. Programmable messenger RNA (mRNA)-based therapeutics have emerged as a cutting-edge strategy for cardiac regenerative repair owing to their advantages of transient and controllable protein expression, high design flexibility, and avoidance of genomic integration. However, the global research landscape, collaborative networks, and evolving scientific priorities in this rapidly expanding field have not yet been systematically characterized.

A comprehensive bibliometric analysis was conducted using publications retrieved from the Web of Science Core Collection (WoSCC) and PubMed databases from 2012 to 2026. After literature screening and deduplication, 814 publications from WoSCC and 4,155 publications from PubMed were included. VOSviewer, CiteSpace, and the R package Bibliometrix were used to conduct parallel analyses of annual publication trends, country- and institutional-collaboration networks, journal and author distributions, reference citation bursts, and keyword-based thematic evolution.

WoSCC analysis revealed a fluctuating but overall increasing publication trajectory, with annual research output peaking at ∼90 publications in 2023. The evolution of this field could be categorized into three stages: an emerging phase (2012-2016), a developmental phase (2017-2021), and an accelerated expansion phase (2022 onward). China and the United States represented the leading contributors, while institutions including Harvard University and the Chinese Academy of Medical Sciences-Peking Union Medical College served as major research hubs. Circulation Research and Circulation occupied central positions within the co-citation network. ZANG, LICHUN was identified as the most productive author, whereas the landmark 2013 study by Zangi L represented the most influential foundational contribution to the field. Parallel analysis of PubMed further validated the identified evolutionary trends and highlighted angiogenesis as a promising yet underexplored research direction.

Research on programmable mRNA therapeutics for MI is rapidly expanding, with the focus shifting from fundamental molecular mechanisms to translational applications that enable precise inflammatory modulation, fibrosis reversal, and revascularization. Future breakthroughs will likely depend on the development of efficient and cardiac-targeted delivery platforms, as well as deeper exploration of epitranscriptomic therapeutic strategies, to accelerate clinical translation.