Rationale and methods of the European Study on Cardiovascular Risk Prevention and Management in Daily Practice (EURIKA)

Fernando Rodríguez-Artalejo, Eliseo Guallar, Claudio Borghi, Jean Dallongeville, Guy De Backer, Julian P Halcox, Ramón Hernández-Vecino, Francisco Javier Jiménez, Elvira L Massó-González, Joep Perk, Philippe Gabriel Steg, José R Banegas, EURIKA Investigators, Fernando Rodríguez-Artalejo, Eliseo Guallar, Claudio Borghi, Jean Dallongeville, Guy De Backer, Julian P Halcox, Ramón Hernández-Vecino, Francisco Javier Jiménez, Elvira L Massó-González, Joep Perk, Philippe Gabriel Steg, José R Banegas, EURIKA Investigators

Abstract

Background: The EURIKA study aims to assess the status of primary prevention of cardiovascular disease (CVD) across Europe. Specifically, it will determine the degree of control of cardiovascular risk factors in current clinical practice in relation to the European guidelines on cardiovascular prevention. It will also assess physicians' knowledge and attitudes about CVD prevention as well as the barriers impeding effective risk factor management in clinical practice.

Methods/design: Cross-sectional study conducted simultaneously in 12 countries across Europe. The study has two components: firstly at the physician level, assessing eight hundred and nine primary care and specialist physicians with a daily practice in CVD prevention. A physician specific questionnaire captures information regarding physician demographics, practice settings, cardiovascular prevention beliefs and management. Secondly at the patient level, including 7641 patients aged 50 years or older, free of clinical CVD and with at least one classical risk factor, enrolled by the participating physicians. A patient-specific questionnaire captures information from clinical records and patient interview regarding sociodemographic data, CVD risk factors, and current medications. Finally, each patient provides a fasting blood sample, which is sent to a central laboratory for measuring serum lipids, apolipoproteins, hemoglobin-A1c, and inflammatory biomarkers.

Discussion: Primary prevention of CVD is an extremely important clinical issue, with preventable circulatory diseases remaining the leading cause of major disease burden. The EURIKA study will provide key information to assess effectiveness of and attitudes toward primary prevention of CVD in Europe. A transnational study creates opportunities for benchmarking good clinical practice across countries and improving outcomes. (ClinicalTrials.gov number, NCT00882336).

Figures

Figure 1
Figure 1
Countries participating in the EURIKA study.

References

    1. Allender S, Scarborough P, Peto V, Rayner M, Leal L, Luengo-Fernandez R, GrayEuropean Cardiovascular Disease Statistics 2008.
    1. Rodríguez-Artalejo F, Guallar-Castillón P, Villar Alvarez F, Banegas JR. Critical review and proposals for improvement of the health information systems on cardiovascular diseases in Spain. Med Clin (Barc) 2008;131:302–311. doi: 10.1016/S0025-7753(08)72264-4.
    1. Allender S, Scarborough P, O'Flaherty M, Capewell S. Patterns of coronary heart disease mortality over the 20th century in England and Wales: Possible plateaus in the rate of decline. BMC Public Health. 2008;8:148. doi: 10.1186/1471-2458-8-148.
    1. Fourth Joint Task Force of the European Society of Cardiology and other societies on cardiovascular disease prevention in clinical practice (constituted by representatives of nine societies and by invited experts) European guidelines on cardiovascular disease prevention in clinical practice: full text. Eur J Cardiovasc Prev Rehabil. 2007;14(Suppl 2):S1–113.
    1. Palmieri L, Bennett K, Giampaoli S, Capewell S. Explaining the Decrease in Coronary Heart Disease Mortality in Italy Between 1980 and 2000. Am J Public Health. 2009. in press .
    1. Björck L, Rosengren A, Bennett K, Lappas G, Capewell S. Modelling the decreasing coronary heart disease mortality in Sweden between 1986 and 2002. Eur Heart J. 2009;30:1046–1056. doi: 10.1093/eurheartj/ehn554.
    1. Hardoon SL, Whincup PH, Lennon LT, Wannamethee SG, Capewell S, Morris RW. How much of the recent decline in the incidence of myocardial infarction in British men can be explained by changes in cardiovascular risk factors? Evidence from a prospective population-based study. Circulation. 2008;117:598–604. doi: 10.1161/CIRCULATIONAHA.107.705947.
    1. Bhatt DL, Steg PG, Ohman EM, Hirsch AT, Ikeda Y, Mas JL, Goto S, Liau CS, Richard AJ, Röther J, Wilson PW. REACH Registry Investigators. International prevalence, recognition, and treatment of cardiovascular risk factors in outpatients with atherothrombosis. JAMA. 2006;295:180–189. doi: 10.1001/jama.295.2.180.
    1. Kotseva K, Wood D, De Backer G, De Bacquer D, Pyörälä K, Keil U. EUROASPIRE Study Group. EUROASPIRE III: a survey on the lifestyle,risk factors and use of cardioprotective drug therapies in coronary patients from 22 European countries. Eur J Cardiovasc Prev Rehabil. 2009;16:121–137. doi: 10.1097/HJR.0b013e3283294b1d.
    1. Kotseva K, Wood D, De Backer G, De Bacquer D, Pyörälä K, Keil U. EUROASPIRE Study Group. Cardiovascular prevention guidelines in daily practice: a comparison of EUROASPIRE I, II, and III surveys in eight European countries. Lancet. 2009;373:929–940. doi: 10.1016/S0140-6736(09)60330-5.
    1. Wensing M, Ludt S, Campbell S, van Lieshout J, Volbracht E, Grol R. on behalf of the EPA Cardio Project Group. European Practice Assessment of Cardiovascular risk management (EPA Cardio): protocol of an international observational study in primary care. Implement Sci. 2009;4(1):3.
    1. Conroy RM, Pyörälä K, Fitzgerald AP, Sans S, Menotti A, De Backer G, De Bacquer D, Ducimetière P, Jousilahti P, Keil U, Njølstad I, Oganov RG, Thomsen T, Tunstall-Pedoe H, Tverdal A, Wedel H, Whincup P, Wilhelmsen L, Graham IM. SCORE project group. Estimation of ten-year risk of fatal cardiovascular disease in Europe: the SCORE project. Eur Heart J. 2003;24:987–1003. doi: 10.1016/S0195-668X(03)00114-3.
    1. Third Joint Task Force of European and Other Societies on Cardiovascular Disease Prevention in Clinical Practice. European guidelines on cardiovascular disease prevention in clinical practice. Eur Heart J. 2003;24:1601–1610. doi: 10.1016/S0195-668X(03)00347-6.
    1. Cabana MD, Rand CS, Powe NR, Wu AW, Wilson MH, Abboud PA, Rubin HR. Why don't physicians follow clinical practice guidelines? A framework for improvement. JAMA. 1999;282:1458–1465. doi: 10.1001/jama.282.15.1458.
    1. Hobbs FD, Erhardt L. Acceptance of guideline recommendations and perceived implementation of coronary heart disease prevention among primary care physicians in five European countries: the Reassessing European Attitudes about Cardiovascular Treatment (REACT) survey. Fam Pract. 2002;19:596–604. doi: 10.1093/fampra/19.6.596.
    1. Graham IM, Stewart M, Hertog MG. Cardiovascular Round Table Task Force. Factors impeding the implementation of cardiovascular prevention guidelines: findings from a survey conducted by the European Society of Cardiology. Eur J Cardiovasc Prev Rehabil. 2006;13:839–845. doi: 10.1097/01.hjr.0000219112.02544.24.
    1. Erhardt LR, Hobbs FD. A global survey of physicians' perceptions on cholesterol management: the From The Heart study. Int J Clin Pract. 2007;61:1078–1085. doi: 10.1111/j.1742-1241.2007.01420.x.
    1. Celentano A, Panico S, Palmieri V, Guillaro B, Brancati C, Di Palma Esposito N, Arezzi E, Setola C, Piccinocchi G, Canfora G, Rubba P, Di Minno G, Mancini M. Citizens and family doctors facing awareness and management of traditional cardiovascular risk factors: results from the Global Cardiovascular Risk Reduction Project (Help Your Heart Stay Young Study) Nutr Metab Cardiovasc Dis. 2003;13:211–217. doi: 10.1016/S0939-4753(03)80013-3.
    1. Mosca L, Linfante AH, Benjamin EJ, Berra K, Hayes SN, Walsh BW, Fabunmi RP, Kwan J, Mills T, Simpson SL. National study of physician awareness and adherence to cardiovascular disease prevention guidelines. Circulation. 2005;111:499–510. doi: 10.1161/01.CIR.0000154568.43333.82.
    1. Doroodchi H, Abdolrasulnia M, Foster JA, Foster E, Turakhia MP, Skelding KA, Sagar K, Casebeer LL. Knowledge and attitudes of primary care physicians in the management of patients at risk for cardiovascular events. BMC Fam Pract. 2008;9:42. doi: 10.1186/1471-2296-9-42.
    1. Ford ES, Ajani UA, Croft JB, Critchley JA, Labarthe DR, Kottke TE, Giles WH, Capewell S. Explaining the decrease in U.S. deaths from coronary disease, 1980-2000. N Engl J Med. 2007;356:2388–2398. doi: 10.1056/NEJMsa053935.
    1. Brunzell JD, Davidson M, Furberg CD, Goldberg RB, Howard BV, Stein JH, Witztum JL. American Diabetes Association; American College of Cardiology Foundation. Lipoprotein management in patients with cardiometabolic risk: consensus statement from the American Diabetes Association and the American College of Cardiology Foundation. Diabetes Care. 2008;31:811–822. doi: 10.2337/dc08-9018.
    1. Gotto AM Jr, Whitney E, Stein EA, Shapiro DR, Clearfield M, Weis S, Jou JY, Langendorfer A, Beere PA, Watson DJ, Downs JR, de Cani JS. Relation between baseline and on-treatment lipid parameters and first acute major coronary events in the Air Force/Texas Coronary Atherosclerosis Prevention Study (AFCAPS/TexCAPS) Circulation. 2000;101:477–484.
    1. Sniderman AD, Furberg CD, Keech A, Van Lennep Roeters JE, Frohlich J, Jungner I, Walldius G. Apolipoproteins versus lipids as indices of coronary risk and as targets for statin treatment. Lancet. 2003;361:777–780. doi: 10.1016/S0140-6736(03)12663-3.
    1. Casas JP, Shah T, Hingorani AD, Danesh J, Pepys MB. C-reactive protein and coronary heart disease: a critical review. J Intern Med. 2008;264:295–314. doi: 10.1111/j.1365-2796.2008.02015.x.
    1. Ridker PM, Danielson E, Fonseca FA, Genest J, Gotto AM Jr, Kastelein JJ, Koenig W, Libby P, Lorenzatti AJ, MacFadyen JG, Nordestgaard BG, Shepherd J, Willerson JT, Glynn RJ. JUPITER Study Group. Rosuvastatin to prevent vascular events in men and women with elevated C-reactive protein. N Engl J Med. 2008;359:2195–2207. doi: 10.1056/NEJMoa0807646.
    1. Waters DD, Brotons C, Chiang CW, Ferrières J, Foody J, Jukema JW, Santos RD, Verdejo J, Messig M, McPherson R, Seung KB, Tarasenko L. Lipid Treatment Assessment Project 2 Investigators. Lipid treatment assessment project 2: a multinational survey to evaluate the proportion of patients achieving low-density lipoprotein cholesterol goals. Circulation. 2009;120:28–34. doi: 10.1161/CIRCULATIONAHA.108.838466.
    1. Hippisley-Cox J, Coupland C, Vinogradova Y, Robson J, Minhas R, Sheikh A, Brindle P. Predicting cardiovascular risk in England and Wales: prospective derivation and validation of QRISK2. BMJ. 2008;336:1475–1482. doi: 10.1136/bmj.39609.449676.25.

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