Vascular risk assessment and management
A proposed model of integrated care pathway (ICP) on behalf of the European Society of Vascular Medicine (ESVM)
Abstract
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 Cardiovascular Diseases Statistics 2017. Available from: http://www.ehnheart.org/cvd-statistics.html
2 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.
3 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.
4 REACH Registry Investigators. International prevalence, recognition, and treatment of cardiovascular risk factors in outpatients with atherothrombosis. JAMA. 2006;295(2):180–9.
5 Statins and statin intensity in peripheral artery disease. A systematic review and meta-analysis. Vasa. 2022;51(4):198–211.
6 Guidelines on peripheral artery disease. Vasa. 2019;48 Suppl 102:1–79.
7 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.
8 ESVM integrated care pathways – a call for action. Vasa. 2019;48(2):113–4.
9 AGREE Next Steps Consortium. AGREE II: advancing guideline development, reporting and evaluation in health care. CMAJ. 2010;182(18):E839–42.
10 ESC Scientific Document Group. 2021 ESC Guidelines on cardiovascular disease prevention in clinical practice. Eur J Prev Cardiol. 2021;1:1–2.
11 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.
12 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
13 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.
14 European Atherosclerosis Society Consensus Panel. Lipoprotein(a) as a cardiovascular risk factor: current status. Eur Heart J. 2010;31(23):2844–53.
15 . The compelling arguments for the need of medical vascular physicians in Europe. Vasa. 2019;48(6):487–91.