Abstract
AimsThe ESCAPE-NET project (“European Sudden Cardiac Arrest network– towards Prevention, Education and New Effective Treatments”) aims to study: (1) risk factors and mechanisms for the occurrence of sudden cardiac arrest (SCA) in the population, and (2) risk factors and treatment strategies for survival after SCA on a European scale. MethodsThis is an Horizon2020 funded program of the European Union, performed by a European public-private consortium of 16 partners across 10 EU countries. There are 11 deep-phenotyped SCA cohorts for the study of risk factors and treatment strategies for survival after SCA, and 5 deep-phenotyped observational prospective population cohorts for the study of risk factors for occurrence of SCA. Personalized risk scores for predicting SCA onset and for predicting survival after SCA will be derived and validated. ResultsThe 11 clinical studies with SCA cases comprise 85,790 SCA cases; the 5 observational prospective population cohorts include 53,060 subjects. A total of 15,000 SCA samples will be genotyped for common and rare variants at the Helmholtz Zentrum München (Germany) using the Illumina Global Screening Array which contains > 770,000 SNPs, and after imputation, a database of an estimated > 9 million variants will be available for genome wide association studies. Standardization of risk factors definition and outcomes is ongoing. An Executive Committee has been created along with a Collaboration Policy document. ConclusionESCAPE-NET will complement ongoing efforts on SCA outside Europe and within Europe including the EuReCa project.
Highlights
Despite recent improvements in cardiopulmonary resuscitation and post-resuscitation care, survival after out-of hospital sudden cardiac arrest (SCA) remains as low as 10% on average when considering the whole spectrum of SCA including SCA with no attempts of resuscitation by Emergency Medical Services [1]
Multiple studies have reported on individual risk factors for SCA occurrence including traditional acquired risk factors or comorbidities [2], familial predisposition [3] or neural control of heart rhythm [4] (Fig. 1 left)
Risk stratification algorithms based on findings from epidemiological studies that evaluate traditional risk factors, acquired risk factors, environmental risk factors, and genetic variants in combination may aid in the identification of susceptible individuals and subgroups within the population (Fig. 1 right)
Summary
Despite recent improvements in cardiopulmonary resuscitation and post-resuscitation care, survival after out-of hospital sudden cardiac arrest (SCA) remains as low as 10% on average when considering the whole spectrum of SCA including SCA with no attempts of resuscitation by Emergency Medical Services [1]. In addition to treatment strategies, patient characteristics and organization of care may further impact on survival, these factors are poorly considered simultaneously. This integrative approach has important implications as it may help to identify the respective weights of the determinants of survival after SCA and to prioritize necessary improvements. Accounting for differences in patients characteristics, treatment strategies and organization of care may help to understand and reduce the disparities in SCA incidence and survival rates after SCA across Europe and the world [15,16]. Recognizing risk gene (profiles) is of practical importance in clinical decision making, e.g., when a drug with potential arrhythmia risk (e.g., QT prolonging cardiac or noncardiac drugs) must be prescribed to an individual (pharmacogenetics)
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