Hypercoagulability in Rheumatoid Arthritis: A Bibliometric Analysis and Retrospective Data Mining Study.

Background: Rheumatoid arthritis (RA) is an autoimmune disease characterized by chronic systemic inflammation, leading to joint deformities and functional loss. RA progression is accompanied by abnormalities in the coagulation-fibrinolysis system, clinically manifested as a hypercoagulable state. However, there are currently no bibliometrics or visualization analysis in this field.

Objective: The present study aims to reveal the knowledge structure, research status, and research trends related to hypercoagulability in RA through bibliometric analysis and to evaluate the utility of inflammatory and coagulation markers in RA disease activity through retrospective data mining.

Methods: English articles and reviews on RA hypercoagulability published from 2010 to 2023 were extracted from the Web of Science Core Collection (WoSCC) database on March 1, 2023. VOSviewer and CiteSpace software were used for knowledge mapping analysis of the included papers in terms of countries/regions, institutions, journals, authors, keywords, research hotspots, and frontiers. A retrospective analysis was conducted on the general information on RA patients. The demographic and clinical indicators of all participants were collected to determine the correlation of inflammatory and coagulation markers with the Chinese patient-reported activity index for rheumatoid arthritis (CPRI-RA).

Results: A total of 957 papers were retrieved. The United States was the most productive country in this field and had the highest h-index, and the most prolific institution was the Karolinska Institute. The Annals of the Rheumatic Diseases was the journal with the most publications, and KLARESKOG L. was the most productive author. From keyword analysis, it could be seen that "inflammation", "activation", "disease-activity", and "risk" had long been the focuses of RA hypercoagulability research. "Criteria", "validation", "coagulation", "target", and "anemia" were the latest popular keywords in the past 5 years. Retrospective data mining revealed that the levels of inflammation (RF, ESR, and CRP) and coagulation (PLT and DD) were significantly increased in RA patients. FBG, CRP, and ESR were significantly correlated with CPRI-RA. Additionally, ESR, CRP, and FBG were identified as independent risk factors for CPRI-RA.

Conclusion: The mechanism and application of hypercoagulability in RA have been research hotspots in recent years. Inflammation and coagulation markers are independent risk factors for CPRI-RA.