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Position paper

Vascular risk assessment and management

A proposed model of integrated care pathway (ICP) on behalf of the European Society of Vascular Medicine (ESVM)

Published Online:https://doi.org/10.1024/0301-1526/a001026

Summary:Background: Atherosclerotic cardiovascular disease remains the leading cause of morbidity and mortality globally. Methods: the integrated care pathways (ICPs) are tools through which evidence-based guidelines (GLs) on a specific disease or clinical topic can be implemented in a clinical process. Aim: This study aims to facilitate decision making for health professionals in their daily practice. Results: This model, according with the European Society of Cardiology (ESC)/European Atherosclerosis Society (EAS) Guidelines, supports the multifactorial evaluation of global cardiovascular (CV) risk and suggests using algorithms and revised cardiovascular risk stratification, specifically for high- and very-high-risk patients. Conclusions: Multidimensional and integrated actions are aimed at eliminating and/or minimizing the impact of cardiovascular disease, improving the quality and consistency of vascular prevention, and leading to optimal clinical decisions.

References

  • 1 European Heart Network. European Cardiovascular Diseases Statistics 2017. Available from: http://www.ehnheart.org/cvd-statistics.html First citation in articleGoogle Scholar

  • 2 Mach F, Baigent C, Catapano AL, Koskinas KC, Casula M, Badimon L, et al. 2019 ESC/EAS Guidelines for the management of dyslipidaemias: lipid modification to reduce cardiovascular risk: The Task Force for the management of dyslipidaemias of the European Society of Cardiology (ESC) and European Atherosclerosis Society (EAS). Eur Heart J. 2020;41(1):111–88. First citation in articleCrossref MedlineGoogle Scholar

  • 3 Ray KK, Molemans B, Schoonen WM, Giovas P, Bray S, Kiru G, et al. DA VINCI study. EU-wide cross-sectional observational study of lipid-modifying therapy use in secondary and primary care: the DA VINCI study. Eur J Prev Cardiol. 2021;28(11):1279–89. First citation in articleCrossref MedlineGoogle Scholar

  • 4 Bhatt DL, Steg PG, Ohman EM, Hirsch AT, Ikeda Y, Mas JL, et al. REACH Registry Investigators. International prevalence, recognition, and treatment of cardiovascular risk factors in outpatients with atherothrombosis. JAMA. 2006;295(2):180–9. First citation in articleCrossref MedlineGoogle Scholar

  • 5 Sagris M, Katsaros I, Giannopoulos S, Rosenberg RD, Altin SE, Rallidis L, et al. Statins and statin intensity in peripheral artery disease. A systematic review and meta-analysis. Vasa. 2022;51(4):198–211. First citation in articleLinkGoogle Scholar

  • 6 Frank U, Nikol S, Belch J, Boc V, Brodmann M, Carpentier PH, et al. Guidelines on peripheral artery disease. Vasa. 2019;48 Suppl 102:1–79. First citation in articleAbstractGoogle Scholar

  • 7 Belch JJF, Brodmann M, Baumgartner I, Binder CJ, Casula M, Heiss C, et al. Lipid-lowering and anti-thrombotic therapy in patients with peripheral arterial disease, European Atherosclerosis Society/European Society of Vascular Medicine Joint Statement. Vasa. 2021;50(6):401–11. First citation in articleLinkGoogle Scholar

  • 8 Visonà A, Pesavento R, Mazzolai L, Cimminiello C, Pécsvárady Z, Olinic D, et al. ESVM integrated care pathways – a call for action. Vasa. 2019;48(2):113–4. First citation in articleLinkGoogle Scholar

  • 9 Brouwers MC, Kho ME, Browman GP, Burgers JS, Cluzeau F, Feder G, et al. AGREE Next Steps Consortium. AGREE II: advancing guideline development, reporting and evaluation in health care. CMAJ. 2010;182(18):E839–42. First citation in articleCrossref MedlineGoogle Scholar

  • 10 Visseren FLJ, Mach F, Smulders YM, Carballo D, Koskinas KC, Bäck M, et al. ESC Scientific Document Group. 2021 ESC Guidelines on cardiovascular disease prevention in clinical practice. Eur J Prev Cardiol. 2021;1:1–2. First citation in articleGoogle Scholar

  • 11 Arnett DK, Blumenthal RS, Albert MA, Buroker AB, Goldberger ZD, Hahn EJ, et al. 2019 ACC/AHA Guideline on the Primary Prevention of Cardiovascular Disease: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. Circulation. 2020;141(16):e774. First citation in articleMedlineGoogle Scholar

  • 12 Cosentino F, Grant PJ, Aboyans V, Bailey CJ, Ceriello A, Delgado V, et al. 2019 ESC Guidelines on diabetes, pre-diabetes, and cardiovascular diseases developed in collaboration with the EASD: The Task Force for diabetes, pre-diabetes, and cardiovascular diseases of the European Society of Cardiology (ESC) and the European Association for the Study of Diabetes (EASD). Eur Heart J. 2020;41(2):255–323. https://doi.org/10.1093/eurheartj/ehz486 First citation in articleCrossref MedlineGoogle Scholar

  • 13 Williams B, Mancia G, Spiering W, Agabiti Rosei E, Azizi M, Burnier M, et al. Authors/Task Force Members: 2018 ESC/ESH Guidelines for the management of arterial hypertension: The Task Force for the management of arterial hypertension of the European Society of Cardiology and the European Society of Hypertension: The Task Force for the management of arterial hypertension of the European Society of Cardiology and the European Society of Hypertension. J Hypertens. 2018;36(10):1953–2041. First citation in articleCrossref MedlineGoogle Scholar

  • 14 Nordestgaard BG, Chapman MJ, Ray K, Borén J, Andreotti F, Watts GF, et al. European Atherosclerosis Society Consensus Panel. Lipoprotein(a) as a cardiovascular risk factor: current status. Eur Heart J. 2010;31(23):2844–53. First citation in articleCrossref MedlineGoogle Scholar

  • 15 Heiss C, Madaric J, Belch J, Brodmann M, Mazzolai L. The compelling arguments for the need of medical vascular physicians in Europe. Vasa. 2019;48(6):487–91. First citation in articleLinkGoogle Scholar