iCARE4CVD - INDIVIDUALISED CARE FROM EARLY RISK OF CARDIOVASCULAR DISEASE TO ESTABLISHED HEART FAILURE

心血管疾病（CVD）对社会的负担是巨大的，在欧洲有超过8500万人受到影响。由于不健康的生活方式和人口老龄化，总体发病率继续上升。心力衰竭（HF）是所有CVD的最终共同途径，尽管治疗取得了显著进展，但15年死亡率仍高达20-50%。iCARE 4CVD旨在通过促进三个基本步骤来改善当前的护理途径来解决这一负担，涵盖从早期风险到确定HF的所有阶段：1）早期诊断以识别具有CVD风险的患者并将其分为具有临床意义的亚组; 2）对这些亚组进行风险分层以确定干预的紧迫性; 3）预测每个亚组的治疗反应。这将通过以下步骤实现：临床合作伙伴将提供一个大型队列集，包括> 1，000，000名具有广泛生物标志物（例如数字，血液，成像）的患者。匿名访问数据将通过使用区块链支持的联邦数据库来实现。基于人工智能的建模也考虑了患者相关因素，将评估风险的变化，并根据患者对治疗的个体反应对患者进行分层。结果将在新的和正在进行的大型队列中进行前瞻性验证，并进行一项试点试验，通过使用超越当前风险预测（如SCORE）的多种生物标志物进行个体化治疗来测试治疗反应的预测。结果将用于为针对新确定的亚组的每一步提供新的决策工具，并作为创新的未来试验的蓝图，以个性化预防和治疗。患者参与在iCARE 4CVD的每个部分（例如患者咨询委员会）都是关键，以建立患者自我护理的激励框架。该项目汇集了来自公共和私营部门的所需资源和专业知识，使iCARE 4CVD取得成功

The burden of cardiovascular disease (CVD) on society is huge with >85 million people affected in Europe. The overall prevalencecontinues to grow due to unhealthy lifestyles and population aging. Heart failure (HF) is the final common pathway of all CVD and hasa 5 year mortality rate of 20-50% despite significant advances in therapy. iCARE4CVD aims to address this burden by contributing tothree essential steps to improve the current care pathways, covering all stages from early risk to established HF: 1) early diagnosis toidentify patients at risk of CVD and divide them into clinically meaningful subgroups; 2) risk stratification for these subgroups to definethe urgency for intervention; and 3) prediction of treatment response for each subgroup. This will be achieved by the following steps:clinical partners will provide a large set of cohorts including >1,000,000 patients with a wide range of biomarkers (e.g. digital, blood,imaging). Anonymous access to data will be enabled by using a blockchain-supported federated database. Artificial intelligence-basedmodeling also considering patient relevant factors will assess changes in risk and stratify patients according to their individual responsesto therapy. Results will then be prospectively validated in new and ongoing large cohorts and a pilot trial to test the prediction of treatmentresponse by using multiple biomarkers going beyond current risk prediction (such as SCORE) towards individualized therapy. Resultswill be used to provide novel decision tools for each step targeting newly identified subgroups and as a blueprint for innovative futuretrials to individualise prevention and therapy. Patient involvement is key in every part of iCARE4CVD (e.g. patient advisory board) tobuild a motivational framework for self-care by patients. The project brings together an EU-wide consortium with the needed resourcesand expertise from the public and private side to bring iCARE4CVD to success