Ischaemic heart disease (IHD) affects around 126 million individuals yearly (1.72% of the world’s population) causing nine million deaths globally (1). In Europe, IHD is responsible for 1.7 million deaths per year (2). Acute myocardial infarction (AMI) is often the first manifestation of IHD (3) and is associated with a mortality rate of about 30%, with 50% of deaths occurring prior to arrival at the hospital. At least 5%-10% of survivors die within the first 12 months after the MI, and approximately half of the patients need hospitalisation within a year’s follow-up. Prognosis is highly variable and largely depends on early reperfusion (4).
Importantly, outcomes of AMI vary between and within countries (5). While guidelines show a consensus on optimal treatment strategy, the practical application remains incomplete and therefore treatment goals are insufficiently achieved. The high variability of disease-adjusted life years (DALYs) for CVD and stroke among European countries could be resolved by a new strategy focusing on the uniform implementation of current guidelines by education and dissemination.
The European Association of Preventive Cardiology (EAPC) is conducting a comprehensive programme to design an optimal post-MI pathway for patients’ follow-up and treatment and improve long-term care in secondary prevention.
- Project definition and gaps analysis: Assessment of the current management of post-MI patients in different regions in Europe (online survey, workshops with key national stakeholders).
- Development of Post-MI roadmap and scientific output including the following documents:
- Systematic review paper on the feasibility and effectiveness of introducing digital technology
- Quality Indicators manuscript on chronic/long-term follow-up and lifelong treatment post-MI
- Consensus document reviewing existing situations (best practices, gaps) and outlining a clear process for the optimal detection and management of high / very high-risk patients post-MI
- ESC/EAPC Clinical Statement on the optimal lifelong pathway post-MI
- Implementation and evaluation: dissemination of resources, roadmap translation for broader implementation, qualitative and quantitative evaluation of the roadmap’s impact in selected countries.
Emeline van Craenenbroeck
This multidisciplinary programme involves experts in the field of primary care, acute cardiovascular care, secondary prevention and rehabilitation, cardiovascular nursing, digital health and patients to ensure a multi-disciplinary approach.