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

心血管疾病(CVD)给社会带来的负担是巨大的，欧洲有8500万人受到影响。由于不健康的生活方式和人口老龄化，总的患病率继续增长。心力衰竭(HF)是所有心血管疾病的最终常见途径，尽管治疗取得了重大进展，但5年死亡率仍高达20%-50%。ICARE4CVD旨在通过促进三个基本步骤来改善目前的护理途径，涵盖从早期风险到确定的心衰的所有阶段：1)早期诊断，以识别有心血管疾病风险的患者，并将他们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；以及3)预测每个亚组的治疗反应。这将通过以下步骤实现：临床合作伙伴将为包括&gt；100万名患者在内的一大批患者提供广泛的生物标志物(例如数字、血液、成像)。通过使用区块链支持的联合数据库，将能够匿名访问数据。基于人工智能的建模还考虑了患者的相关因素，将评估风险的变化，并根据患者对治疗的个人反应对患者进行分层。然后，结果将在新的和正在进行的大型队列和试点试验中进行前瞻性验证，以测试治疗反应的预测，方法是使用多个生物标记物，超越当前的风险预测(如分数)，转向个性化治疗。结果将被用来为针对新确定的亚群的每一步提供新的决策工具，并作为未来创新试验的蓝图，以实现个体化预防和治疗。在iCARE4CVD的每个部分(例如，患者咨询委员会)中，患者的参与是关键，以建立患者自我护理的激励框架。该项目汇集了一个欧盟范围的财团，拥有公共和私人方面所需的资源和专业知识，以使iCARE4CVD取得成功。

The burden of cardiovascular disease (CVD) on society is huge with >85 million people affected in Europe. The overall prevalence continues to grow due to unhealthy lifestyles and population aging. Heart failure (HF) is the final common pathway of all CVD and has a 5 year mortality rate of 20-50% despite significant advances in therapy. iCARE4CVD aims to address this burden by contributing to three essential steps to improve the current care pathways, covering all stages from early risk to established HF: 1) early diagnosis to identify patients at risk of CVD and divide them into clinically meaningful subgroups; 2) risk stratification for these subgroups to define the 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-based modeling also considering patient relevant factors will assess changes in risk and stratify patients according to their individual responses to therapy. Results will then be prospectively validated in new and ongoing large cohorts and a pilot trial to test the prediction of treatment response by using multiple biomarkers going beyond current risk prediction (such as SCORE) towards individualized therapy. Results will be used to provide novel decision tools for each step targeting newly identified subgroups and as a blueprint for innovative future trials to individualise prevention and therapy. Patient involvement is key in every part of iCARE4CVD (e.g. patient advisory board) to build a motivational framework for self-care by patients. The project brings together an EU-wide consortium with the needed resources and expertise from the public and private side to bring iCARE4CVD to success.