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EuroCaReD breaks through!

A report from Werner Benzer, EACPR Cardiac Rehabilitation Section

EuroCaReD - the European Cardiac Rehabilitation Database - is a registry to compare outcomes following different cardiac rehabilitation programmes across Europe.


In the year 2008, the Nucleus of the Cardiac Rehabilitation Section of the EACPR proposed to introduce a database for outcome measurements and quality assessment in cardiac rehabilitation across Europe.

As a result the European Cardiac Rehabilitation Database (EuroCaReD) was introduced. In October 2010 the web-based database was first used in clinical practice. About 50 study sites across 9 countries took part in the first edition. First results, describing more than 1.000 patient baseline and follow-up records, could be presented at the “late breaking news” session at the EuroPRevent 2011 congress in Geneva.

The EuroCaReD study group consisting of steering committee members and country delegates (Table 1) could demonstrate that a web-database has the potential to document cardiac rehabilitation services and results in Europe in a way never been achieved before.

EuroCaReD first study results show that patient characteristics correspond to other reports published within the last view years, particularly the underrepresentation of women and the prevalence of ischemic heart disease by any definition as the initiating diagnosis. At the end of the cardiac rehabilitation programme an improvement of exercise capacity, cardiovascular risk burden and health-related quality of life is visible (Table 2 below). But about 30% of the patients dropped out the programme by any reason. Despite of the homogenous patient setting with regard to age, gender, initiating diagnosis and the distribution of risk factors a large deviation of outcomes after cardiac rehabilitation was observed across Europe. This could be brought about the big variation of programme design and length.

But there were also obvious limitations. Because of its wide variety the first data derived from EuroCaReD are not suitable to make any final conclusion about the quality of cardiac rehabilitation programmes across Europe. The main reason was that only view centres in view countries took part in the database.

For representative pictures at least 200 patients per country in at least half of the countries of Europe should be enrolled into the project. Therefore more countries with more institutions and more patients should be motivated to participate in the database. Countries with existing national databases should be motivated to connect with EuroCaReD. Countries with individual institution participation should be summarized in EuroCaReD as a virtual national database.

Following these inferences the EuroCaReD steering committee decided to start a second study of the EuroCaReD project in October 2011. This new edition meets the same basic purposes than the initial study. The only additional purpose is to get more representative results and to end up together with the first study in a representative overall picture of cardiac rehabilitation outcomes across Europe.

The enrolment period of the second study was just completed at the end of last month. At this time another 1.000 patients could be enrolled in 7 old and 4 new countries. Three other countries provided a link between the national and international database. The database now contains more than 2.000 patient records to be analysed for a final report (Figure 1). Further preliminary results will be presented at the EuroPRevent 2012 congress in May in Dublin. The steering committee intends to publish a final report of the EuroCaReD project in the European Journal of Preventive Cardiology at the end of this year.