Global Trends in Guideline-Directed Medical Therapy for Patients With Heart Failure: A Bibliometric and Thematic Analysis of Articles Indexed in Scopus (2013-2025).

Abstract

Heart Failure with reduced Ejection Fraction (HFrEF) is still a major cause of mortality and morbidity all over the world. This study uses bibliometric analysis to trace global publication trends and evaluate the scientific production, citation impact, contributions of authors, institutions and countries, collaboration patterns, and thematic evolution of Guideline-Directed Medical Therapy (GDMT) research in patients with HFrEF. We analyzed the data using Bibliometrix (R package) and VOSviewer v.16.21 to map collaboration networks, citation patterns, and emerging research themes. The analysis indicated a significant increase in academic interest after 2021, with the principal areas of focus being heart failure (HF), HFrEF, chronic kidney disease, Sacubitril/Valsartan, diabetes, and ivabradine; this trend shows that the emphasis is on existing treatments for HF and its major comorbidities. Researchers identified 693 peer-reviewed academic sources authored by 20,686 people. McMurray JJV of the Glasgow had the highest h-index, the most citations, and the most publications. Most top authors in GDMT and HFrEF were affiliated with institutions in the United States and Europe. The United States had the greatest research productivity. Although the United States produced the most research, the European countries showed comparatively higher levels of international collaboration. The European Journal of Heart Failure was the most influential journal, having the highest h-index (59) and highest total citation score (11,795). The results show that research into GDMT-HFrEF is highly concentrated in the major cardiovascular and <i>heart failure journals</i>. The thematic analysis of Authors keywords shows that in 2021 heart failure and HFrEF were still the main topics. Between 2023 and 2024, Sodium-Glucose Cotransporter 2 (SGLT2) inhibitors and mineralocorticoid receptor antagonists became important themes, showing a move towards modern GDMT. By 2025 the subjects of the research had become more diverse and now included HFrEF, SGLT2 inhibitors, Dapagliflozin, pharmacotherapy and other heart failure phenotypes. The results show that research into GDMT-HFrEF is increasingly multidisciplinary and involves greater international cooperation, especially between the United States and Europe. Future studies are expected to concentrate on SGLT2 inhibitors such as dapagliflozin; combination therapies; drug optimization; personalized care; better implementation strategies; and team-based care models.