EuroAspire VI

The EUROASPIRE programme was started following the first Joint European Societies Recommendations on Prevention of Coronary Heart Disease in Clinical Practice in 1994, the very first ESC Clinical Practice Guideline, and the objective of this first survey in nine European countries in 1995-96 was to document the status of secondary prevention practice in the context of these new recommendations.

The EUROASPIRE II (1999-2000) survey of secondary prevention was undertaken in 15 countries. EUROASPIRE III (2007-08) included 22 countries and was expanded to include both secondary prevention (Hospital) and primary prevention (general practice). EUROASPIRE IV (2013-15) was combined with the EuroHeart Survey on Diabetes and encompassed secondary and primary prevention across 24 countries with a special focus on dysglycaemia and diabetes. EUROASPIRE V (2016-18) in 27 countries continued the theme of cardiometabolic disease in secondary and primary prevention.

All of these surveys demonstrated a high prevalence of unhealthy lifestyles, modifiable risk factors and inadequate use of drug therapies to achieve blood pressure, lipid and diabetes goals in patients with established coronary heart disease (CHD) and people at high risk of developing cardiovascular disease. There were wide variations in medical practice between countries in the treatment of these patients.

This sixth EUROASPIRE survey will be expanded to investigate the cardiometabolic and renal continuum in both secondary and primary cardiovascular disease prevention in 2023-2025 under the auspices of the European Society of Cardiology, Global Registries And Surveys Programme (GRASP). As in the previous EUROASPIRE surveys this survey will be focused on hospital patients with CHD, with and without diabetes mellitus, and apparently healthy individuals in primary care at high risk (hypertension, dyslipidaemia, diabetes) of developing cardiovascular disease (CVD).

Objectives

The objectives of EUROASPIRE VI survey of CVD prevention, diabetes and chronic kidney disease are:

1. To determine in patients with established CHD (CHD = acute myocardial infarction (AMI) and acute ischaemia (unstable angina) and patients following revascularisation by a percutaneous coronary intervention (PCI) or coronary artery by-pass graft surgery (CABG)) and in patients at high risk of developing CVD risk, whether the 2021 European guidelines on CVD prevention are being followed.
2. To compare diagnostic and therapeutic strategies in CHD and high-risk patients for hypertension to determine whether the 2018 European guidelines on hypertension are being followed.
3. To compare diagnostic and therapeutic strategies in CHD and high-risk patients for glucose metabolism (impaired fasting glycaemia, impaired glucose tolerance and diabetes) to determine whether the 2019 European guidelines on diabetes, prediabetes and CVD are being followed.
4. To compare diagnostic and therapeutic strategies in CHD and high-risk patients, including those with familial hypercholesterolaemia, for their lipid (total cholesterol, HDL-cholesterol, triglycerides and Lp(a)) management to determine whether the 2019 lipid guidelines are being followed.
5. To compare diagnostic and therapeutic strategies in CHD and high-risk patients for chronic kidney disease (either albuminuria and/or reduced kidney function defined as an eGFR <60 ml/min/1.73 m2) to determine whether the CKD guidelines (ADA/EASD, KDIGO) are being followed.
6. To determine whether organ-protective medications, that protect the heart and the kidneys as recommended in the guidelines, are prescribed (and up-titrated to the correct doses as appropriate) in every day clinical practice.
7. To determine whether the preventive strategies in patients with established CHD in EUROASPIRE VI has improved by comparison with those hospital centres which took part in previous EUROASPIRE surveys and whether the practice of preventive cardiology in patients in primary care at high CVD risk in EUROASPIRE VI has improved by comparison with those centres which took part in EUROASPIRE III, IV and V.
8. To follow-up all coronary patients from EUROASPIRE VI one and five years after the interview for hospitalisations, cardiovascular procedures, cardiovascular events and cardiovascular and all cause mortality to determine the impact of risk factors for CVD and their management and event-free survival.
9. To identify strategies for improving preventive care based on the EUROASPIRE survey results from hospital and general practice, and to make policy and practice recommendations to the European Association for Preventive Cardiology and future ESC Guidelines on CVD Prevention.

Study Organisation

Study Task Force

The study task force is chaired by John William McEvoy and David Wood and composed of Dirk De Bacquer, Kosh Ray, Catriona Sian Jennings, Kornelia Kotseva, Lars Rydén, Per - Henrik Groop, Linda Mellbin, Agnieszka Adamska.

Publications

There are numerous specialist publications to read following the EUROASPIRE registry results over the years (I, II, III, IV and V), available here.