In the Netherlands, there is no national approach for early detection of cardiovascular disease, kidney disease and type 2-diabetes in the general population, despite the social and economic impact of these disorders. The Check@Home consortium was founded to fill this gap and aims to lower the morbidity and mortality of cardiovascular disease, chronic kidney disease and type 2 diabetes by 25% in the next ten years, and thereby decrease the burden of these chronic diseases.

The Focus

Due to common risk factors such as high blood pressure, obesity and the aging population, the number of people suffering from cardiovascular disease, chronic kidney disease or type 2-diabetes is expected to increase excessively in 2030. A large proportion of people are not aware of having these diseases, as it is often present without overt symptoms. Fortunately, these chronic conditions can be detected at an early stage, allowing for adequate and early treatment to prevent (the progression of) these conditions and their complications. Check@Home aims to do so by developing a (cost-)effective national program that is accessible to all socio-economic groups and takes place in the citizen's own living environment, making it comfortable for citizens to do. It will also reduce the burden on primary care and contribute to the affordability and sustainability of healthcare. The program is designed and implemented in close collaboration with citizens, patients, and local citizen initiatives, to make sure that this program is a durable solution for all groups of society.

The Research

In total 160,000 people aged 50-75 years and living in Breda, Utrecht, Arnhem and Eindhoven, will be invited to participate in the study with a home-based test using the Check@Home digital platform. In case of early signs of cardiovascular disease, kidney damage or diabetes type 2, a targeted work-up will follow in a regional diagnostic center. If necessary, lifestyle advice and initiation of medication will be provided to relieve regular care as much as possible.

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Contact person:

Dr. Lyanne Kieneker

Principal investigators

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Currently, it is largely unknown to what extent the heart is involved in COVID-19. The aim of this project is to assess the incidence and consequences of cardiac damage in patients who have experienced COVID-19. How often does COVID-19 lead to myocardial damage? What are the short- and long-term consequences of this damage and what can we do to prevent it from occurring? These are the central questions that will be answered within the DEFENCE consortium. The Research The DEFENCE consortium integrates several national studies initiated at the onset of the COVID-19 pandemic, encompassing diverse patient groups as part of the COPP study, ranging from elite athletes (COMMIT study) and individuals recovering at home (COVID@Heart study) to hospitalized patients (CAPACITY-COVID registry and CAPACITY 2 study) and children with post-infection inflammatory syndromes affecting the heart (MIS-C). By harmonizing these initiatives, a unique cohort spanning the entire spectrum of COVID-19 severity has been established. The ongoing studies are extended at multiple levels within the DEFENCE project. This includes: Standardized Healthcare Pathway Implementation: Implementing and evaluating a standardized healthcare pathway to assess cardiac damage occurrence within 6 months post-hospitalization for COVID-19. Serial Cardiac Magnetic Resonance (CMR) Imaging: Performing serial CMR imaging to determine the prevalence and reversibility of myocardial damage, with all scans assessed in a core lab. Evaluation of Cardiovascular Symptoms: Assessing the incidence of cardiovascular symptoms such as chest pain and palpitations in the post-acute phase through patient questionnaires. Linking Data to National Datasets: Linking study data to national datasets at Statistics Netherlands to analyze long-term cardiovascular morbidity and mortality. To evaluate whether cardiovascular disease is a characteristic feature of COVID-19, a comparison with other respiratory tract infections, including seasonal influenza will be made.
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The aim of the LoDoCo2 (Low Dose Colchicine for secondary prevention of cardiovascular disease) trial was to investigate the effect of low dose colchicine (0,5 mg once daily) on the risk of myocardial infarction (fatal or non-fatal), stroke, or the need for coronary bypass or stent placement. While the precise mechanism through which colchicine mitigates major cardiovascular events remains incompletely understood, it is hypothesized that its anti-inflammatory effects contribute to risk reduction among patients with established atherosclerotic disease. LoDoCo2 stands out in several respects. It represents a large-scale randomized clinical trial conducted entirely by a non-academic network of cardiologists and a consortium of pharmaceutical companies with a focus on drug repurposing. This trial underscores the potential value of older, often cost-effective medications in advancing the development of new innovative drugs. The Research Following a median follow-up period of 3 years, the addition of colchicine to standard treatment resulted in a 30% reduction in risk of myocardial infarction (fatal or non-fatal), stroke, or the need for coronary bypass or stent placement. Patients treated with colchicine exhibited similar side effects compared to those receiving a placebo. Furthermore, no interactions were found with other commonly used drugs such as (potent) statins. In 2021, certain international guidelines had already incorporated colchicine into the secondary prevention of atherosclerotic cardiovascular disease (ASCVD). Subsequently, in 2023, the Food and Drug Administration (FDA) approved Lodoco® (colchicine) for reducing the risk of myocardial infarction (MI), stroke, coronary revascularization, and cardiovascular (CV) death in adult patients with established atherosclerotic disease or multiple risk factors for CV disease. This approval was based on published data regarding the effects of colchicine on cardiovascular events, along with insights from the LoDoCo2 trial. The LoDoCo2 investigators anticipate that colchicine will become the standard treatment for patients with coronary artery disease.
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