EUROASPIRE

Programme of European Surveys of

Secondary and Primary Prevention of Cardiovascular Disease

The main objectives of CVD prevention are to reduce cardiovascular morbidity and mortality, improve quality of life, and increase life expectancy. The European Society of Cardiology together with other partner Societies has engaged in a comprehensive programme of CVD prevention in clinical practice since 1994. Guidelines on this important topic have been developed and updated at regular intervals over the last 18 years: 1994, 1998, 2003, 2007, 2012 and 2016. The aim of the Joint European Societies Guidelines (JES) on cardiovascular disease prevention is to improve the practice of preventive cardiology by encouraging the development of national guidance on cardiovascular disease prevention and its communication, implementation and evaluation through national societies in each country.

            Guideline implementation in Europe was evaluated in five cross-sectional surveys with the acronym EUROASPIRE (European Action on Secondary and Primary Prevention by Intervention to Reduce Events) starting in 1995-96 under the auspices of the Working Group on Epidemiology and Prevention, and this was followed by the second, third, fourth and fifth surveys in 1999-2000, 2006-2007, 2012-2014 and 2016- 2018 through the European Society of Cardiology (ESC) Euro Heart Survey /EURObservational research programmes. The objective of each survey was to determine whether clinical practice in patients with coronary heart disease (CHD) and people at high risk of developing CVD was achieving the standards set in the CVD prevention guidelines and whether there were any changes over time in lifestyle, risk factor and therapeutic management. The methodology used in EUROASPIRE I was duplicated in the second, third, fourth and fifth surveys with standardized interviews and measurements, and a central laboratory for lipid and glucose analyses, so that time trends between surveys could be described. Patients were identified from hospital or general practice medical notes and interviewed and examined at least six months after the recruiting event. The fourth and fifth European survey of Cardiovascular Disease Prevention and Diabetes merged with the EuroHeart Survey on Diabetes Mellitus and incorporated an assessment of dysglycaemia and renal disease in all patients.

    The hospital arm of EUROASPIRE V survey was undertaken at 131 centres in 27 countries. A total of 16,208 medical records were reviewed and 8,261 patients with coronary disease attended the interview. The results showed that a large majority of patients had unhealthy lifestyles in terms of smoking, diet and sedentary behaviour, which adversely impacts major cardiovascular risk factors. One fifth of patients were current smokers, nearly two-fifths were obese, three-fifths were centrally obese. Forty two per cent had a blood pressure ≥140/90 mm Hg (≥140/85 if diabetes), 71% had LDL-cholesterol ≥1.8 mmol/L (≥70 mg/dL) and 29% reported having diabetes. Cardioprotective medication was: anti-platelets 93%, beta-blockers 81%, ACE inhibitors/ARBs 75% and statins 80%.           

The primary care arm of the survey was carried out in 78 centres from 16 European countries. A total of 3,562 medical records were reviewed and 2,759 patients at high risk of developing CVD attended the interview. The risk factor control was poor with one fifth of patients being smokers, more than two-fifths obese and just under two-thirds centrally obese. Less than half of the patients on blood pressure lowering medication reached the target of <140/90 mmHg (<140/85 mmHg in people with self-reported diabetes). Among treated dyslipidaemic patients less than half attained LDL-cholesterol target of <2.6 mmol/L. Among people treated for type 2 diabetes mellitus, two-thirds achieved the HbA1c target of <7.0%.

The results of the EUROASPIRE V survey clearly demonstrate that most of coronary and high CVD risk patients are failing to achieve the lifestyle, blood pressure, lipid and glycaemic targets as defined in the 2016 JES Guidelines on CVD prevention in clinical practice. A wide gap still exists between the evidence-based guidelines and everyday clinical practice. Cardiovascular prevention requires a modern preventive cardiology programme with appropriate adaptation to medical and cultural settings in each country and health care systems that invest in prevention.

Participating countries:

I. Hopsital arm: Belgium, Bosnia & Herzegovina, Bulgaria, Croatia, Czech Republic, Egypt, Finland, Germany, Greece, Ireland, Italy, Kazakhstan, Kyrgyzstan, Latvia, Lithuania, the Netherlands, Poland, Portugal, Romania, Russia, Serbia, Slovenia, Spain, Sweden, Turkey, Ukraine and the United Kingdom.

II. Primary care arm: Bosnia & Herzegovina, Bulgaria, Croatia, the Czech Republic, Egypt, Greece, Kazakhstan, Kyrgyzstan, Lithuania, Poland, Portugal, Romania, Russia, Sweden, Ukraine, and the United Kingdom.

Steering Committee:

I. Executive Committee

Kornelia Kotseva (London, UK, Chair Steering Committee),
Guy De Backer (Ghent, Belgium, Chair Executive Committee)
Dirk De Bacquer (Ghent, Belgium)
Diederick Grobbee (Utrecht, the Netherlands
Arno Hoes (Utrecht, the Netherlands)
Aldo P Maggioni (Florence, Italy)
Pedro Marques-Vidal (Lausanne, Switzerland)
Lars Rydén (Stockholm, Sweden)
David Wood (Principal Investigator, London, UK)
Herve Druais (Nice, France, ex-officio)

II. National Coordinators:

Ana Abreu (Lisbon, Portugal)
Carlos Aguiar (Lisbon, Portugal)
Jolita Badariene (Vilnius, Lithuania)
Jan Bruthans (Prague, Czech Republic)
Almudena Castro Conde (Madrid, Spain)
Renata Cifkova (Prague, Czech Republic)
Jim Crowley (Galway, Ireland)
Kairat Davletov (Almaty, Kazakhstan)
Delphine De Smedt (Ghent, Belgium)
Johan De Sutter (Ghent, Belgium)
Jaap Deckers (Rotterdam, Netherlands)
Mirza Dilic (Sarajevo, Bosnia and Herzegovina)
Maryna Dolzhenko (Kiev, Ukraine)
Vilnis Dzerve (Riga, Latvia)
Andrejs Erglis (Riga, Latvia)
Zlatko Fras (Ljubljana, Slovenia)
Dan Gaita (Timisoara, Romania)
Nina Gotcheva (Sofia, Bulgaria)
Hosam Hasan-Ali (Assiut, Egypt)
Peter Heuschmann (Würzburg, Germany)
Piotr Jankowski (Krakow, Poland)
Nebojsa Lalic (Belgrade, Serbia)
Seppo Lehto (Kuopio, Finland)
Christos Lionis (Crete, Greece),
Dragan Lovic (Nis, Serbia),
Aldo Pietro Maggioni (Florence, Italy)
Silvia Mancas (Timisoara, Romania)
Linda Mellbin (Stockholm, Sweden)
Davor Miličić (Zagreb, Croatia)
Erkin Mirrakhimov (Osh, Kyrgyzstan)
Rafael Oganov (Moscow, Russia)
Nana Pogosova (Moscow, Russia)
Željko Reiner (Zagreb, Croatia)
Lars Rydén (Stockholm, Sweden)
Martin Stagmo (Malmo, Sweden)
Stefan Störk (Würzburg, Germany)
Jouko Sundvall (Helsinki, Finland)
Lale Tokgözoğlu (Ankara, Turkey)
Costas Tsioufis (Athens, Greece)
Dusko Vulic (Banja Luka, Bosnia and Herzegovina)
David Wood (London, UK).

Academic institutions partnering with EUROASPIRE

Coordinating centre
Cardiovascular Medicine, National Heart and Lung Institute, Medical Faculty, Imperial College London, London, UK: David Wood, Kornelia Kotseva, Catriona Jennings, Agnieszka Adamska, Sabina Adamska

Data management centre
EURObservational Research Programme Department, European Heart House, Sophia Antipolis, Nice, France: Herve Druais, Emanuela Fiorucci, Mariam Glemot, Florian Larras, Vivianne Missiamenou, Aldo P Maggioni, Charles Taylor, Thierry Ferreira, K Lemaitre

Statistical analysis centre
Department of Public Health, Ghent University, Belgium: Dirk De Bacquer, Guy De Backer

Diabetes centre
Department of Cardiology, Karolinska University Hospital, Stockholm, Sweden: Lars Rydén, Linda Mellbin, Viveca Gyberg, Jaako Tuomilehto, Oliver Schnell.

Central laboratory
Biochemistry laboratory, Genomics and Biomarkers Unit, National Institute for Health and Welfare, Helsinki, Finland: Laura Raman, Jouko Sundvall

EUROASPIRE V sponsors

Amgen, Eli Lilly, Pfizer, Sanofi, Ferrer and Novo Nordisk

EUROASPIRE Publications

De Smedt D, Kotseva K,  De Backer G,  Wood D, Van Wilder L, De Bacquer D. EQ-5D in coronary patients: what are they suffering from? Results from the ESC EORP European Survey of Cardiovascular Disease Prevention and Diabetes (EUROASPIRE IV) Registry. Quality of Life Research 2019; DOI: 10.1007/s11136-019-02334-2

De Smedt D, De Backer T, Petrovic M, De Backer G, Wood D, Kotseva K, De Bacquer D. Chronic medication intake in patients with stable coronary heart disease across Europe: Evidence from the daily clinical practice. Results from the ESC EORP European Survey of Cardiovascular Disease Prevention and Diabetes (EUROASPIRE IV) Registry. Int J Cardiology 2019; https://doi.org/10.1016/j.ijcard.2019.09.015

De Bacquer D, De Smedt D, Reiner Ž, Tokgözoğlu L, Clays E, Kotseva K, Rydén L, Wood D, De Backer G. Percentage LDL-C response to a given statin dose is not fixed across the pre-treatment range: real world evidence from clinical practice. Data from the ESC-EORP EUROASPIRE V Study. Eur J Prev Cardiol 2019; DOI: 10.1177/2047487319874898

KotsevaK, De BackerG, De BacquerD, Ryden L, Hoes A, Grobbee D, MaggioniA, et al, on behalf of the EUROASPIRE Investigators. Lifestyles and impact on cardiovascular risk factor control in coronary patients across 27 countries: results from the European Society of Cardiology EUROASPIRE V survey. Eur J Prev Cardiol 2019; Published online Feb 2019. doi: 10.1177/2047487318825350

Cífková R, Lánská V, Bruthans J, Mayer O, Kotseva K, Wood D, Lovic D, De Sutter J, Reiner Z, Fras Z, Deckers J, Gotcheva N, Georgiev B, De Bacquer D, on behalf of EUROASPIRE IV investigators. Blood pressure distribution and control in coronary patients from 24 European countries in the European Society of Cardiology EURoObservational Research Programme European survey of cardiovascular disease prevention and diabetes. EUROASPIRE IV Registry. J Hypertension; June 24, 2019 Published Ahead of Print, doi: 10.1097/HJH.0000000000002130

Van de Cauter J, De Bacquer D, Clays E, De Smedt D, Kotseva K, Braeckman L. Return to work and associations with psychosocial well-being and health-related quality of life in coronary heart disease patients: Results from EUROASPIRE IV. Eur J Prev Cardiology 2019, DOI: 10.1177/2047487319843079

De Backer G, Jankowski P, Kotseva K, Mirrakhimov E, Reiner Ž, Ryden L, Tokg.zoğlu L, Wood D, De Bacquer D, on behalf of the EUROASPIRE V collaborators. Management of dyslipidaemia in patients with coronary heart disease: Results from the ESC-EORP EUROASPIRE V survey in 27 countries.  Atherosclerosis 2019; 285:135–146

Tiffe T, Morbach C, Malsch C, GelbrichG, Wahl V, Wagner M, Kotseva K, Wood D, Leyh R, Ertl G, Karmann W, Störk S and Heuschmann P, on behalf of the STAAB Consortium. Physicians’ lifestyle advice on primary and secondary cardiovascular disease prevention in Germany: A comparison between the STAAB cohort study and the German subset of EUROASPIRE IV. Eur J Prev Cardiol 2019; Published online March 2019. doi: 10.1177/2047487319838218

De Bacquer D, De Smedt D, Kotseva K, Jennings C, Wood D, Rydèn L, Gyberg V, Shahim B, et al. Incidence of cardiovascular events in patients with stabilized coronary heart disease: the EUROASPIRE IV follow-up study. Eur J Epidemiology October 2018 https://doi.org/10.1007/s10654-018-0454-0  

De Smedt D, Annemans L, De Backer G, Kotseva K, Rydèn L, Wood D, Amouyel P, Bruthans J, Cifkova R, De Sutter J, Dolzhenko M, Erglis A, Gotcheva N, Gyberg V, Laucevicius A, Lovic D, Oganov R, Pajak A, Pogosova N, Reiner Z, Stagmo M, De Bacquer D. Cost-effectiveness of optimized adherence to prevention guidelines in European patients with coronary heart disease: Results from the EUROASPIRE IV survey. Int J Cardiol June 2018, doi:10.1016/j.ijcard.2018.06.104

Kotseva K, Wood D, De Bacquer D. Determinants of participation and risk factor control according to attendance in cardiac rehabilitation programmes in coronary patients in Europe: EUROASPIRE IV survey. Eur J Prev Cardiology June 2018,  DOI: 10.1177/2047487318781359

Shahim B, Gyberg V, De Bacquer D, Kotseva K, De Backer G, Schnell O, Tuomilehto J, Wood D, Rydén L. Undetected dysglycaemia common in primary care patients treated for hypertension and/or dyslipidaemia: on the need for a screening strategy in clinical practice. A report from EUROASPIRE IV a registry from the EuroObservational Research Programme of the European Society of Cardiology. Cardiovascualar Diabetology 2018 17:21 https://doi.org/10.1186/s12933-018-0665-4

Snaterse M, Deckers J W, Lenzen M G, Jorstad H T, De Bacquer D, Peters R J G, Jennings C, Kotseva K, Scholte op Reimer W J M, for the EUROASPIRE Investigators Smoking cessation in European patients with coronary heart disease. Results from the EUROASPIRE IV survey: A registry from the EuropeanSociety of Cardiology. Int Journal Cardiology 2018; 258:1–6

Wagner M, Wanner C, Schich M, Kotseva K, Wood D, Hartmann K, Fette G, Rucker V, Oezkur M, Störk S, Heuschmann P U. Patient’s and physician’s awareness of kidney disease in coronary heart disease patients – a cross-sectional analysis of the German subset of the EUROASPIRE IV survey. BMC nephrology 2017:18(1), pp.321. https://doi.org/10.1186/s12882-017-0730-3.

Shahim B, De Bacquer D, De Backer G, Gyberg V, Kotseva K, Mellbin L, Schnell O, Tuomilehto J, Wood D, Rydén L. The prognostic value of fasting plasma glucose, two-hour post load glucose, and HbA1c in patients with coronary artery disease: a report from EUROASPIRE IV. Diabetes care 2017 40(9),1233-1240.

Kotseva K. The EUROASPIRE surveys: lessons learned in cardiovascular disease prevention. Cardiovasc Diagnosis Therapy 2017. 12/2017; 7(6):633-639 doi: 10.21037/cdt.2017.04.06

Pogosova N, Kotseva K, De Bacquer D, von Känel R, De Smedt D, Bruthans J, Dolzhenko M,  Psychosocial risk factors in relation to other cardiovascular risk factors in coronary heart disease: Results from the EUROASPIRE IV survey. A registry from the European Society of Cardiology, on behalf of the EUROASPIRE Investigators. Eur J Prev Cardiol, First Published 23 May 2017. DOI: 10.1177/2047487317711334

Wagner M, Wanner C, Kotseva K, Wood D, De Bacquer D, Ryden L, Störk S, Heuschmann P, behalf of the EUROASPIRE IV investigators. Prevalence of chronic kidney disease and its determinants in coronary heart disease patients in 24 European countries: Insights from the EUROASPIRE IV survey of the European Society of Cardiology. Eur J Prev Cardiol 2017 First Published May 15, 2017. DOI: 10.1177/2047487317708891

Wagner M, Gelbrich G, Kircher J, Kotseva K, Wood D, Morbach C, Leyh R, Ert G, Karmann W, Störk S, Heuschmann P. Secondary Prevention in Younger vs. Older Coronary Heart Disease Patients—Insights from the German Subset of the EUROASPIRE IV Survey. Int J Behav Med First published online 30 October 2017. https://doi.org/10.1007/s12529-017-9691-y

Morbach C, Wagner M, Güntner S, Malsch C, Oezkur M, Wood D, Kotseva K,  Leyh R, Ertl G, Karmann W, Heuschmann P, Störk S. Heart failure in patients with coronary heart disease: Prevalence, characteristics and guideline implementation – Results from the German EuroAspire IV cohort. BMC Cardiovasc Disord. 2017; 17: 108. Published online 2017 May 5. doi:  10.1186/s12872-017-0543-0

Gyberg V, De Bacquer D, Kotseva K, De Backer G, Schnell O, Tuomilehto J, Wood D, Rydén L  on behalf of EUROASPIRE IV Investigators. A time saving algorithm limiting the use of a 2 hour oral glucose tolerance test when screening for diabetes in patients with coronary artery disease. A report from EUROASPIRE IV a registry from European Society of Cardiology. BMJ Open 2016;6:e013835. doi:10.1136/bmjopen-2016-013835

De Smedt D, Clays E, Prugger C, De Sutter J, Fras Z, De Backer G, Kotseva K, De Bacquer D. Physical activity status in patients with coronary heart disease: results from the cross-sectional EUROASPIRE surveys. J Physical Activity Health 2016;13:1378 -1384. DOI: 10.1123/jpah.2016-0088

KotsevaK, De Bacquer D, Jennings C, Gyberg V, De Backer G, Rydén, Amouyel P, Bruthans J, Cifkova R, Deckers JW, De Sutter J, Fras Z, Graham I, Keber I, Lehto S,  Moore D, Pajak A, Simon J, Wood D, on behalf of EUROASPIRE Investigators. Time trends in lifestyle, risk factor control and use of cardioprotective drug therapies in patients with coronary heart disease in Europe: results from three EUROASPIRE surveys, 1999 – 2013, of the European Society of Cardiology. Global Heart 2016; http://dx.doi.org/10.1016/j.gheart.2015.11.003; December 2017; 12(4):315-322

De Smedt D, De Bacquer D, De Sutter J, Dallongeville J, Gevaert S, De Backer G, Bruthans J, Kotseva K, Reiner Ž, Tokgozoglu L, Clays E. The gender gap in risk factor control: Effects of age and education on the control of cardiovascular risk factors in male and female coronary patients. The EUROASPIRE IV study by the European Society of Cardiology. Int J Cardiology 2016; 209:284–90 doi: 10.1016/j.ijcard.2016.02.015

De Backer G, De Bacquer D, Rydén L, Kotseva K, Georgiev B, Gotcheva N, Mancas S,  Milicic D, Reiner Z, Pająk  A, Gaita D, Wood D, on behalf of  the EUROASPIRE investigators. Lifestyle and risk factor management in people at high cardiovascular risk: comparison between the EUROASPIRE III and IV primary care surveys of the European Society of Cardiology. Eur J Prev Cardiology 2016, DOI: 10.1177/2047487316645474

Kotseva K, De Bacquer D, De Backer G, Rydén L, Jennings C, Gyberg V, Abreu A, Aguiar C, Castro Conde A, Davletov K, Dilic M, Dolzhenko M, Gaita D, Georgiev B, Gotcheva N, Lalic N, Laucevicius A, Lovic D, Mancas S, Miličić D, Oganov R, Pajak A, Pogosova N, Reiner Z, Vulic D, Wood D, on behalf of the EUROASPIRE Investigators. Lifestyle and risk factor management in people at high risk of cardiovascular disease. A report from the European Society of Cardiology EUROASPIRE IV cross-sectional survey in fourteen European regions. Eur J Prev Cardiology 2016 DOI: 10.1177/2047487316667784

Kotseva K, Wood D, De Bacquer D, De Backer G, Rydén L, Jennings C, Gyberg V, Amouyel P, Bruthans J, Castro Conde A, Cífková R, Deckers JW, De Sutter J, Dilic M, Dolzhenko M, Erglis A, Fras Z, Gaita D, Gotcheva N, Goudevenos J, Heuschmann P, Laucevicius A, Lehto S, Lovic D, Miličić D, Moore D, Nicolaides E, Oganov R, Pajak A, Pogosova N, Reiner Z, Stagmo M, Störk S, Tokgözoğlu L, Vulic D, on behalf of the EUROASPIRE Investigators. EUROASPIRE IV:  A European Society of Cardiology survey on the lifestyle, risk factor and therapeutic management of coronary patients from twenty four European countries. Eur J Prev Cardiology 2016; 23: 636–648, doi:10.1177/2047487315569401.

Reiner Z, De Backer G, Fras Z, Kotseva K, Tokgözoglu L, Wood D, De Bacquer D. Lipid lowering drug therapy in patients with coronary heart disease from 24 European countries – findings from the EUROASPIRE IV survey. Atherosclerosis 2016 doi: 10.1016/j.atherosclerosis.2016.01.018.

Prugger C, Wellmann J, Heidrich J, De Bacquer D, De Smedt D, De Backer G, Reiner Z, Empana J-P, Fras Z, Gaita D, Jennings C, Kotseva K, Wood D, Keil U, on behalf of the EUROASPIRE Study Group. Regular exercise behaviour and intention and symptoms of anxiety and depression in coronary heart disease patients across Europe: Results from the EUROASPIRE III survey. Eur J Prev Cardiol 2016, doi: 10.1177/2047487316667781

De Smedt D, Clays E, Höfer S, Oldridge N, Kotseva K, Maggioni AP, Janssen B, De Bacquer D on behalf of the EUROASPIRE Investigators. The use of HeartQoL in patients with coronary heart disease: Association with risk factors and European reference values. The EUROASPIRE IV study of the European Society of Cardiology. Eur J Prev Cardiol 2016;23:1174-86. First published February  9, 2016 doi: 10.1177/2047487316631400

Kotseva K, De Bacquer D, Jennings C, Gyberg V, De Backer G, Rydén L, Amouyel P, Bruthans J, Cifkova R, Deckers JW, De Sutter J, Fras Z, Graham I, Keber I, Lehto S,  Moore D, Pajak A, Simon J, Wood D, on behalf of EUROASPIRE Investigators. Adverse lifestyle trends counter improvements in cardiovascular risk factor management in coronary patients: results from three EUROASPIRE cross sectional surveys 1999 – 2013 of the European Society of Cardiology. JACC 6 October 2015;66(14):1633-40. DOI: 10.1016/j.jacc.2015.07.061

De Smedt D, Clays E, Höfer S, Oldridge N, Kotseva K, Maggioni AP, Janssen B, De Bacquer D on behalf of the EUROASPIRE Investigators. Validity and reliability of the HeartQoL questionnaire in a large sample of stable coronary patients: The EUROASPIRE IV Study of the European Society of Cardiology. Eur J Prev Cardiology 2015 DOI: 10.1177/2047487315604837

Kotseva K, Rydén L, De Backer G, De Bacquer D, Wood D. EURObservational Research Programme: EUROASPIRE survey of cardiovascular prevention and diabetes in 24 countries in Europe. Eur Heart J 2015 2015; 36, 950-955  doi:10.1093/eurheartj/ehv047

Gyberg V, De Bacquer D, De Backer G, Jennings C, Kotseva K, Mellbin L, Schnell O, TuomilehtoJ, Wood D, Rydén L, Amouyel P, Bruthans J, Castro Conde A, Cífková R, Deckers JW, De Sutter J, Dilic M, Dolzhenko M, Erglis A, Fras Z, Gaita D, Gotcheva N, Goudevenos J, Heuschmann P, Laucevicius A, Lehto S, Lovic D, Miličić D, Moore D, Nicolaides E, Oganov R, Pajak A, Pogosova N, Reiner Z, Stagmo M, Störk S, Tokgözoğlu L, Vulic D, on behalf of EUROASPIRE Investigators. Patients with coronary heart disease and diabetes need improved management. A report from EUROASPIRE IV. Cardiovascualar Diabetology 2015; 14:133 DOI 10.1186/s12933-015-0296-y

Gyberg V, De Bacquer D, Kotseva K, De Backer G, Schnell O, Sundvall J, Tuomilehto J, Wood D, Rydén L on behalf of EUROASPIRE Investigators. Screening for dysglycemia in patients with coronary artery disease as reflected by fasting glucose, oral glucose tolerance test and HbA1c. A report from EUROASPIRE IV. Eur Heart J 2015 doi:10.1093/eurheartj/ehv008

De Backer G, Besseling J, Chapman J, Hovingh G K, Kastelein J, Kotseva K, Ray K, Reiner Z, Wood D, De Bacquer D,on behalf of the EUROASPIRE Investigators. Prevalence and management of familial hypercholesterolaemia in coronary patients: An analysis of EUROASPIRE IV, a study of the European Society of Cardiology.  Atherosclerosis 2015;241:169-175

Bruthans J, Mayer Jr O,  De Bacquer D, De Smedt D, Reiner Ž, Kotseva K, Cífková R on behalf of the EUROASPIRE IV Investigators. Educational level, risk profile and risk factor control in patients with established CHD. Eur J Prev Cardiology July 2015, e publication ahead print, DOI: 10.1177/2047487315601078. 2016; 23(8): 881-890.

Prugger C, Wellmann J, Heidrich J, De Bacquer D, De Backer G, Périer MC, Empana JP, Reiner Z, Fras Z, Jennings C, Kotseva K, Wood D, Keil U; on behalf of the EUROASPIRE Study Group. Readiness for smoking cessation in coronary heart disease patients across Europe: Results from the EUROASPIRE III survey. Eur J Prev Cardiol 2014;22: 1212-19 First published Dec 16 2014. pii: 2047487314564728.

Gyberg V, Kotseva K, Dallongeville J, De Backer G, Mellbin L, Rydén L, Wood D,

De Bacquer D. Does pharmacologic treatment in patients with established coronary artery disease and diabetes fulfill guideline recommended targets? Eur J Prev Card 2014, published online 1 April 2014, DOI: 10.1177/2047487314529353

Prugger C, WellmannJ, Heidrich J, De Bacquer D, Périer M-C, Empana J-P, Reiner Z, Fras Z, JenningsC, Kotseva K, Wood D, Keil U, on behalf of the EUROASPIRE Study Group. Passive smoking and smoking cessation among patients with coronary heart disease across Europe: Results from the EUROASPIRE III survey. Eur Heart J 2014;35(9):590-8. doi: 10.1093/eurheartj/eht538. Epub 2013 Dec 13.

De Smedt D, Clays E, Annemans L, Pardaens S, Kotseva K, De Bacquer D. Self-reported health status in coronary heart disease patients: a comparison with the general population. Eur J Cardiovasc Nurs, published online 15 January 2014; 2015;14:117–25, DOI: 10.1177/1474515113519930 .

De Smedt D, Clays E, Annemans L, Boudrez H, De Sutter J, Doyle F, Jennings C, Kotseva K, Pająk A, Pardaens S, Prugger C, Wood D, De Bacquer D. The association between self-reported Lifestyle changes on and health-related quality of life in coronary patients: the EUROASPIRE III survey. Eur J Prev Cardiology 2014; 21 (7): 796-805. DOI: 10.1177/2047487312473846.

De Smedt D,  Clays E,  Annemans L, Pardaens S, Kotseva K, De Bacquer D. Risk factor awareness in a coronary population and the association with health-related quality of life outcomes. Int J Public Health 2014;59(3):475-83, doi: 10.1007/s00038-014-0551-0.

Reiner Z, De Bacquer D, Kotseva K, Prugger C, De Backer G, Wood D, on behalf of The EUROASPIRE III Study Group. Treatment potential for dyslipidaemia management in patients with coronary heart disease across Europe: Findings from the EUROASPIRE

III survey. Atherosclerosis 2013; 231: 300-307, doi: 10.1016/j.atherosclerosis.2013.09.020.

De Smedt D, Clays E, Annemans L, Doyle F, Kotseva K, Pająk A, Prugger C, Jennings C, Wood D, De Bacquer D. Health related quality of life in coronary patients and Its association with their cardiovascular risk profile: Results from the EUROASPIRE III survey. Int J Cardiology 2013;168(2):898-903.

De Bacquer D, Dallongeville J, Kotseva K, Cooney MT, Pajak A, Deckers J, Mayer O, Vanuzzo D, Lehto S, Fras Z, Östor E, Ambrosio GB, De Backer G, Wood D, Keil U, Sans S, Graham I, Pyörälä K. Residual risk of cardiovascular mortality in patients with coronary heart disease:  The EUROASPIRE Risk Categories. Int J Cardiology 2013; 168 (2):910-914.

De Smedt D, Kotseva K, De Bacquer D, Wood D, De Backer G, Dallongeville J, Seppo L, Pajak A, Reiner Z, Vanuzzo D, Georgiev B, Gotcheva N, Annemans L. Cost-effectiveness of optimizing prevention in patients with coronary heart disease: the EUROASPIRE III health economics project. Eur Heart J. 2012 Nov;33(22):2865-72. doi: 10.1093/eurheartj/ehs210.

Kotseva K, Wood D, De Backer G, De Bacquer D. Use and effects of cardiac rehabilitation in patients with coronary heart disease: results from the EUROASPIRE III survey.Eur J Prev Cardiology2013; 20(5):817-826, doi: 10.1177/2047487312449591. Epub 2012 Jun 19.

De Smedt D, Clays E, Doyle F, Kotseva K, Prugger C, Pająk A, Jennings C, Wood D, De Bacquer  D, on behalf of the EUROASPIRE Study Group. Validity and reliability of three commonly used quality of life measures in a large European population of coronary heart disease patients. Int J Cardiology 2013;167(5):2294-9. doi: 10.1016/j.ijcard.2012.06.025.

Cooney MT, Kotseva K, Dudina A, De Backer G, Wood D, Graham I. Determinants of risk factor control in subjects with coronary heart disease: a report from the EUROASPIRE III investigators. Eur J Prev Cardiology 2013; 20: 686-691.doi: 10.1177/2047487312445562. Epub 2012 Apr 18.

Pajak A, Jankowski P, Kotseva K, Heidrich J, De Smedt D, De Bacquer D. Depression, anxiety, and risk factor control in patients after hospitalization for coronary heart disease: the EUROASPIRE III Study.Eur J Prev Cardiology 2013; 20: 331-340. doi: 10.1177/2047487312441724.

Prugger C, Keil U, Wellmann J, De Bacquer D, De Backer G, Ambrosio G, Reiner Z,  Gaita D, Wood D, Kotseva K, Heidrich J, for the EUROASPIRE Study Group. Blood pressure control and knowledge of target blood pressure in coronary patients across Europe: Results from the EUROASPIRE III Study. J Hypertension 2011; 29:1641-1648.

doi: 10.1097/HJH.0b013e328348efa7.

Kotseva K, Wood D, De Backer G, De Bacquer D,Pyorala K, Keil U, on behalf of EUROASPIRE study Group. EUROASPIRE III. Management of cardiovascular risk factors in asymptomatic high risk subjects in general practice: cross-sectional survey in 12 European countries. Europ J Cardiovasc Prev Rehabilitation 2010; 17: 530-40. doi: 10.1097/HJR.0b013e3283383f30.

De Bacquer D, Dallongeville J, Heidrich J, Kotseva K, Reiner Z, Gaita D, Prugger C, Wellmann J,  Wood D, De Backer G, Keil U, on behalf of the EUROASPIRE III Study Group. Management of overweight and obese patients with coronary heart disease in Europe. Europ J Cardiovasc Prev Rehabilitation 2010; 17:447-454. doi: 10.1097/HJR.0b013e328336a05f.

Dallongeville J, De Bacquer D, Heidrich J, De Backer G, Prugger C, Kotseva K, Montaye M, Amouyel P. Gender differences in the implementation of cardiovascular prevention measures after an acute coronary event. Heart 2010;96:1744-1749. doi: 10.1136/hrt.2010.196170.

Kotseva K, Wood D, De Backer G, De Bacquer D,Pyorala K, Keil U, on behalf of EUROASPIRE study Group. Cardiovascular prevention guidelines – the clinical reality: a comparison of EUROASPIRE I, II and III surveys in 8 European countries. Lancet 2009;373(9667):929-40. doi: 10.1016/S0140-6736(09)60330-5.

Kotseva K, Wood D, De Backer G, De Bacquer D, Pyorala K, Keil U, on behalf of EUROASPIRE study Group. EUROASPIRE III: A survey on the lifestyle, risk factors and use of cardioprotective drug therapies in coronary patients from twenty two European countries.  EUROASPIRE Study Group. Europ J Cardiovasc Prev Rehabilitation

2009;16(2):121-37. doi: 10.1097/HJR.0b013e3283294b1d.

Kotseva K, Stagmo M, De Bacquer D, De Backer G, Wood D, on behalf of EUROASPIRE II Study Group. Treatment Potential for Cholesterol Management in Patients with Coronary Heart Disease in 15 European Countries: Findings from the EUROASPIRE II Survey. Atherosclerosis 2008;197:710-7.

Scholte op Reimer W, de Swart E, De Bacquer D, Pyorala K, Keil U, Heidrich J, Deckers J, Kotseva K, Boersma E, for the EUROASPIRE investigators. Smoking behaviour in European patients with established coronary heart disease. Eur Heart J 2005; 27: 35-41.

Kotseva K, Wood DA, De Bacquer D, Heidrich J, De Backer G, on behalf of the EUROASPIRE II Study Group. Cardiac rehabilitation for coronary patients: lifestyle, risk factor and therapeutic management. Results from the EUROASPIRE II survey. Eur Heart J 2004; 6 (Supplement J): J17-J26.

De Sutter J, De Backer D, Kotseva K, Sans S, Pyorala K, Wood D, De Backer G on behalf of the EUROASPIRE II study group. Screening of family members of patients with premature coronary disease. Results from the EUROASPIRE II family survey. Eur Heart J 2003, 24: 249-257.

Boersma E, Keil U, De Bacquer D,  De Backer G, Pyorala K, Poldermans D, Leprotti C, Pilotto L, de Swart E, Deckers JW, Heidrich J, Sans S, Kotseva K, Wood D, Ambrosio GB, for the EUROASPIRE I and II study groups. Blood pressure is insufficiently controlled in European patients with established coronary heart disease. J Hypertension2003; 21: 1831-1840.

De Bacquer D, De Backer G, Ostor E, Simon J, Pyorala K, on behalf of the EUROASPIRE I Study Group. Predictive value of classical risk factors and their control in coronary patients: a follow-up of the EUROASPIRE I cohort. Eur J Cardiovasc Prevention Rehab 2003; 10: 289-295.

De Bacquer D, De Backer G, Cokkinos D, Keil U, Montaye M, Ostor E, Pyorala K, Sans S, for the EUROASPIRE II Study Group. Overweight and obesity in patients with established coronary heart disease: Are we meeting the challenge? Eur Heart J 2004; 25: 121-28.

Mayer Jr O, Simon J, Heidrich J, Cokkinos DV, De Backer D on behalf of EUROASPIRE II study group. Educational level and risk profile of cardiac patients in the EUROASPIRE II substudy. J Epidemiol Community Health 2004; 58: 47-52.

EUROASPIRE study group. Lifestyle and risk factor management and use of drug therapies in coronary patients from fifteen countries. Principal results from EUROASPIRE II. Eur Heart J 2001; 22: 554-572.

EUROASPIRE study group. Clinical reality of coronary prevention guidelines: a comparison of EUROASPIRE I and II in nine countries. Lancet 2001; 357: 995-1001.

EUROASPIRE Study Group. EUROASPIRE. A European Society of Cardiology survey of secondary prevention of coronary heart disease: Principal results. Eur Heart J1997;18;1569-82