Work

Estimation of lifetime benefits from the optimization of secondary prevention in patients with established atherosclerotic cardiovascular disease

Year: 2026

Type: article

Abstract: AIMS: Cardiovascular disease causes almost four million deaths in Europe, costing the EU €282 billion/annum. Future mortality rate improvements will be gained through improving secondary prevention of atherosclerotic cardiovascular disease (ASCVD) events. Wide gaps exist between ASCVD prevention/treatment guidelines and their implementation across Europe. We aim to estimate lifetime benefits available via optimized secondary prevention in patients with ASCVD in Denmark, France, Germany, Italy, Poland, Spain, and the UK. METHODS: A literature review identified ASCVD risk factor prevalence in ASCVD populations in seven countries. The simulation used an analytical framework and the SMART-REACH survival model to derive event probabilities over 1 year, associated with being 'at-risk' and 'risk-free'. The effect of modifying four risk factors in the SMART-REACH model-hypertension, hypercholesterolaemia, diabetes, and tobacco smoking-was examined. The impact of improving treatment coverage and smoking cessation from (estimated) 43 to 70% (i.e. 70% of patients reach treatment targets/cease smoking) was analysed. RESULTS: Over 94 359 cardiovascular-event-free life-years could be gained/year across seven countries by improving secondary ASCVD prevention: 25 333 years in Germany, 21 144 in Italy, 14 584 in France, 13 324 in the UK, 9393 in Spain, 9369 in Poland, and 1212 in Denmark. CONCLUSIONS: This is a step in better quantifying the impact of improved secondary ASCVD prevention, giving an indication of the potential of EU and national cardiovascular health plans in cardiovascular survival gains. Countries should incentivize proactive identification of patients at risk and ensure subsequent, timely treatment according to guidelines. Future work should utilize updated data and modelling integrating additional cardiometabolic risk factors.

Source: European Journal of Preventive Cardiology

DOI: 10.1093/eurjpc/zwag027