Coronary heart disease (CHD) and stroke – the top two leading causes of death and disability in Europe – amount to over EUR 170 billion in healthcare costs. However, tens of thousands of these deaths from cardiovascular disease (CVD) could be prevented.

The increasingly ageing European population makes it imperative to find evidence-based solutions for accurate and early diagnosis, as well as better clinical management of CVD.

The EU-funded project EPIC-CVD (Individualised CVD risk assessment: tailoring targeted and cost-effective approaches to Europe's diverse populations) was established to provide clinicians and policymakers with personalised predictive tools.

The aim of EPIC-CVD was to build upon previous research in CVD risk prediction by using population resources, biomarker technologies, and translational studies. The pan-European multidisciplinary consortium comprised of 28 partners from 10 European countries, who focused their expertise on translational research, epidemiology and diagnostic technology.

Project partners identified 11 000 stroke cases and retrieved their biological samples for testing, making it one of the largest epidemiological studies on stroke. They also assayed most of the 42 000 samples for nutritional biomarkers such as fatty acids, vitamin C, metabolites of vitamin D and carotenoids. Samples from CVD patients as well as controls were used for comparison.

Another area of focus was to identify biomarkers of 'nature' such as genetic variants, telomere length and components in circulating serum. Researchers developed and tested a high-throughput monochrome multiplex quantitative polymerase chain reaction assay specifically for leukocyte telomere length. Pilot testing on 40,000 EPIC-CVD participants demonstrated the efficacy of this assay against Southern blotting, the current ′gold standard′ technique.

One of the project’s key aspects involved ensuring the clinical and public health utility of novel CVD risk scores. Through systematic reviews scientists selected the most promising modifiable risk scores and methodologies for CVD risk prediction. Considerable inroads were made with regard to cost-effectiveness analyses and developing a cardiovascular risk assessment tool.

A major achievement was to successfully obtain ethical approval for the randomised controlled trial – INFORM, which assessed the clinical applicability of the CVD risk scores in 1,000 patients.

The single biggest impact of EPIC-CVD has been to provide clinicians and policymakers with an evidence-based list of options. These are for targeted and cost-effective CVD risk approaches. These options are tailored to the needs of Europe’s diverse populations and will contribute to the health and well-being of citizens, as well as enhancing innovation and research competitiveness within the EU.

Project Partners:

(source: https://cordis.europa.eu/project/id/279233)

VITAS AS, Norway https://www.vitas.no/

University of Utrecht, The Netherlands https://www.umcutrecht.nl/nl

Dept of Surgery, Malmö University Hospital, Lund University, Malmö, Sweden https://www.medicin.lu.se/

Medical Research Council, United Kingdom https://www.ukri.org/councils/mrc/

International Agency for Research on Cancer – IARC, Lyon, France, www.iarc.fr

IIGM Foundation, Italy https://www.iigm.it/site/

Deutsches Institut für Ernährungsforschung Postdam-Rehbruecke, Potsdam, Germany www.dife.de

Imperial College London – ICL, London, UK https://www.imperial.ac.uk/

Escuela Andaluza de Salud Publica SA, Spain https://www.easp.es/

Dept of Epidemiology, Institute of Public Health, Aarhus University, Aarhus, Denmark www.au.dk

Dept of Public Health and Clinical Medicine, University of Umeå, Sweden www.umu.se

National Institute of Public Health and the Environment – RIVM, Bilthoven, The Netherlands www.rivm.nl

The Chancellor, Master and Scholars of the University of Oxford, United Kingdom https://www.ox.ac.uk/

Dipartimento di Medicina Clinica e Sperimentale, Universita di Napoli, Federico II, Naples, Italy https://www.unina.it/-/768586-dipartimento-di-medicina-clinica-e-chirurgia

German Cancer Research Centre, Heidelberg, Germany www.dkfz.de

Department of Predictive and Prevention Medicine, Fondazione, IRCCS Istituto Nazionale dei Tumori, Milan, Italy https://www.istitutotumori.mi.it/

Institute of Community Medicine, University of Tromsø, Norway https://uit.no/startsida

Asosciacion Instituto Biodonstia, Spain https://www.biodonostia.org/

Fundacion Publica Miguel Servet, Spain https://www.navarrabiomed.es/en/navarrabiomed/fundacion-miguel-servet

Department of Epidemiology, Consejería de Sanidad y Consumo, Murcia, Spain http://www.carm.es/web/pagina?IDCONTENIDO=1&IDTIPO=180

Molecular and Nutritional Epidemiology Unit – ISPO, Cancer Prevention and Research Institute, Florence, Italy https://www.ispro.toscana.it/

Consejería de Salud y Servicios Sanitarios de Asturias, Oviedo, Spain https://www.asturias.es/

The University of Auckland https://www.auckland.ac.nz/en.html

Rand Europe Community Interest Company, United Kingdom https://www.rand.org/

Foundation for Genomics and Population Health, United Kingdom https://www.phgfoundation.org/

AIRE ONLUS- Associazione Iblea per la Ricerca Epidemiologica https://www.aireetsragusa.org/

Organismo Autonomo Instituto de Salud Pública y Laboral de Navarra, Gobierno de Navarra, Pamplona, Spain http://www.navarra.es/home_es/Gobierno+de+Navarra/Organigrama/Los+departamentos/Salud/Organigrama/Estructura+Organica/Instituto+Navarro+de+Salud+Publica/portada+ISP.htm

Nightingale Health OYJ, Finland https://nightingalehealth.com/

Funding:

European Commission CORDIS FP7-HEALTH HEALTH.2011.2.4.2-2 - Evaluation and validation studies of clinically useful biomarkers in prevention and management of cardiovascular diseases. Grant agreement ID: 279233