Global research trends on exosomes in atherosclerosis: a bibliometric and scientometric analysis (2004–2025)

Background: Exosomes play multifaceted roles in atherosclerosis, contributing to vascular inflammation, immune regulation, and tissue repair. This duality has drawn attention to their potential clinical utility, both as diagnostic indicators and as novel therapeutic avenues. However, despite the rapid expansion of research, a comprehensive scientometric overview of this field remains lacking. Methods: From 2004 to July 29, 2025, publications related to exosomes and atherosclerosis were screened in the Web of Science Core Collection (WoSCC) and Scopus. After deduplication, 1,179 records (964 articles, 215 reviews) were included. Bibliometric analyses were conducted using CiteSpace, VOSviewer, and the bibliometrix R package. Indicators examined included publication trends, global distribution, institutional and author contributions, co-citation patterns, and keyword evolution. Results: Publications on exosomes in atherosclerosis have risen sharply since 2015, consistent with Price's Law. China contributes the largest volume, while the United States shows stronger international collaboration. Central South University, Capital Medical University, and Harvard University rank among the most productive institutions. Key contributors include Elena Aikawa and Lijun Yuan. Major publication venues are the International Journal of Molecular Sciences, Frontiers in Cardiovascular Medicine, and Frontiers in Immunology. Keyword and co-citation mapping revealed three major research axes: RNA-mediated regulation, immune and endothelial interactions, and emerging translational applications such as engineered exosomes and diagnostic biomarkers. Conclusion: This bibliometric analysis characterizes global research development and shows a shift from descriptive studies toward mechanistic insight and translational innovation. These trends may facilitate future efforts in biomarker discovery, standardized exosome workflows, and therapeutic development.