European Heart Survey

European Heart Survey
Name	European Heart Survey
Type	Multicenter clinical registry
Established	1999
Focus	Cardiology, coronary artery disease, acute coronary syndromes
Region	Europe

European Heart Survey

The European Heart Survey was a multinational cardiology registry that collected clinical, procedural, and outcome data across dozens of France, Germany, Italy, Spain, United Kingdom and other European Union member states. Conceived and coordinated by cardiology networks and academic centres including European Society of Cardiology, the project linked tertiary hospitals, national registries, and research consortia to generate evidence relevant to World Health Organization and regional policy agencies. The initiative informed guideline panels such as those convened by the European Society of Cardiology and national bodies in Sweden, Netherlands, and Belgium.

Overview

The survey assembled patient-level data on acute and chronic coronary syndromes from tertiary centres in Austria, Denmark, Finland, Portugal, Greece, Poland, Czech Republic, Hungary, Romania, Bulgaria, Slovakia, Slovenia, Lithuania, Latvia, Estonia, Ireland, Norway, Switzerland, Iceland, Luxembourg, Malta and other European jurisdictions, linking academic cardiology departments, national cardiac societies, and hospital networks such as Charité – Universitätsmedizin Berlin, Hôpital Pitié-Salpêtrière, Ospedale San Raffaele, Hospital Clínic de Barcelona and Guy's and St Thomas' NHS Foundation Trust. Funders and collaborators included pan-European organizations and regional research infrastructures that previously worked with the European Commission and the European Medicines Agency.

Objectives and Design

The primary objectives were to characterise patient demographics, presentation patterns, reperfusion strategies, pharmacotherapy, and outcomes for patients with acute coronary syndromes managed across diverse settings such as academic centres in Cambridge and community hospitals in Marseille, evaluating adherence to contemporary guideline recommendations promulgated by the European Society of Cardiology and national cardiac societies in Germany and Italy. Secondary aims included benchmarking procedure volumes from high-volume centres like Karolinska University Hospital and smaller institutions in Zagreb and understanding temporal trends relevant to trials conducted at sites affiliated with Uppsala Clinical Research Center and the Imperial College London cardiovascular group.

Methodology

The registry used prospective cohort methods, standardised case report forms, and central data coordination often hosted by academic units in Leiden, Edinburgh, Turku, or Leuven. Data elements captured clinical variables, laboratory results, angiographic findings from catheterisation laboratories such as those at Hôpitaux Universitaires de Genève, revascularisation strategies referencing centres like Hôpital Européen Georges-Pompidou, and in-hospital outcomes tracked via linkage with national health institutes in Denmark and regional audits coordinated with the National Institute for Health and Care Excellence. Statistical analysis teams with ties to universities in Oxford, Cambridge, Milan, Barcelona, and Munich performed multivariable modelling and sensitivity analyses.

Key Findings

Analyses highlighted heterogeneity in door-to-balloon times between tertiary referral centres such as Hospital Universitario La Paz and peripheral hospitals in Bucharest, variable use of dual antiplatelet therapy in line with recommendations from the European Society of Cardiology and differences in invasive strategy uptake seen in registries from Lisbon and Riga. The survey documented mortality gradients that prompted comparisons with contemporary randomized trials run by groups in Dublin, Bologna, and Frankfurt am Main and informed meta-analyses conducted by investigators affiliated with Brussels and Helsinki institutions.

Impact on Clinical Practice and Guidelines

Findings from the registry were cited in guideline updates from the European Society of Cardiology, influenced national protocols in Spain and Portugal, and were used by quality-improvement programmes at hospitals such as Ospedale Policlinico Sant'Orsola-Malpighi and University Hospital Basel. Regulators and professional bodies including the European Medicines Agency and national cardiac societies in France and Germany used the evidence to prioritise targets in audits and performance metrics analogous to initiatives run by the National Institute for Health and Care Excellence and the Royal College of Physicians.

Criticisms and Limitations

Critiques noted selection biases because participating centres often resembled high-volume academic hospitals like Charité – Universitätsmedizin Berlin or Karolinska University Hospital, limiting generalisability to rural hospitals in Sardinia or community clinics in Galicia. Methodological limitations were compared with randomized trials from networks such as Clinical Trials Unit, University College London and registry standards promoted by the International Consortium for Health Outcomes Measurement; concerns included incomplete follow-up, variable data quality between sites in Estonia and Bulgaria, and limited capture of long-term patient-reported outcomes used in studies from Aarhus and Mannheim.

Subsequent Studies and Legacy

The registry catalysed subsequent multinational efforts and follow-up registries coordinated with networks like the European Society of Cardiology Research and Innovation and influenced initiatives such as multicentre audits in Norway, collaborative registries in Poland and randomized pragmatic trials conducted by consortia in Switzerland and Belgium. Academic groups at Imperial College London, KU Leuven, University of Milan, University of Amsterdam, King's College London, University of Glasgow, Trinity College Dublin, Université de Montréal (via collaborations), Yale University (via visiting investigators), and numerous national cardiac societies drew on the survey's methods to inform quality metrics, guideline updates, and educational programmes across Europe.

Category:Cardiology research