The Prospective Studies of Atherosclerosis (Proof-ATHERO) Consortium: Design and Rationale
Authors: Tschiderer Lena , Seekircher Lisa , Klingenschmid Gerhard , Izzo Raffaele , Baldassarre Damiano , Iglseder Bernhard , Calabresi Laura , Liu Jing , Price Jackie F. , Bae Jang-Ho , Brouwers Frank P. , de Groot Eric , Schmidt Caroline , Bergström Göran , Aşçi Gülay , Gresele Paolo , Okazaki Shuhei , Kapellas Kostas , Landecho Manuel F. , Sattar Naveed , Agewall Stefan , Zou Zhi-Yong , Byrne Christopher D. , Nanayakkara Prabath W.B. , Papagianni Aikaterini , Witham Miles D. , Bernal Enrique , Ekart Robert , van Agtmael Michiel A. , Neves Mario F. , Sato Eiichi , Ezhov Marat , Walters Matthew , Olsen Michael H. , Stolić Radojica , Zozulińska-Ziółkiewicz Dorota A. , Hanefeld Markolf , Staub Daniel , Nagai Michiaki , Nieuwkerk Pythia T. , Huisman Menno V. , Kato Akihiko , Honda Hirokazu , Parraga Grace , Magliano Dianna , Gabriel Rafael , Rundek Tatjana , Espeland Mark A. , Kiechl Stefan , Willeit Johann , Lind Lars , Empana Jean Philippe , Lonn Eva , Tuomainen Tomi-Pekka , Catapano Alberico , Chien Kuo-Liong , Sander Dirk , Kavousi Maryam , Beulens Joline W.J. , Bots Michiel L. , Sweeting Michael J. , Lorenz Matthias W. , Willeit Peter ,   Proof-ATHERO Study Group
Published: July 2020

Atherosclerosis – the pathophysiological mechanism shared by most cardiovascular diseases – can be directly or indirectly assessed by a variety of clinical tests including measurement of carotid intima-media thickness, carotid plaque, ­ankle-brachial index, pulse wave velocity, and coronary ­artery calcium. The Prospective Studies of Atherosclerosis ­(Proof-ATHERO) consortium (https://clinicalepi.i-med.ac.at/research/proof-athero/) collates de-identified individual-participant data of studies with information on atherosclerosis measures, risk factors for cardiovascular disease, and incidence of cardiovascular diseases. It currently comprises 74 studies that involve 106,846 participants from 25 countries and over 40 cities. In summary, 21 studies recruited participants from the general population (<i>n</i> = 67,784), 16 from high-risk populations (<i>n</i> = 22,677), and 37 as part of clinical trials (<i>n</i> = 16,385). Baseline years of contributing studies range from April 1980 to July 2014; the latest follow-up was until June 2019. Mean age at baseline was 59 years (standard deviation: 10) and 50% were female. Over a total of 830,619 person-years of follow-up, 17,270 incident cardiovascular events (including coronary heart disease and stroke) and 13,270 deaths were recorded, corresponding to cumulative incidences of 2.1% and 1.6% per annum, respectively. The consortium is coordinated by the Clinical Epidemiology Team at the Medical University of Innsbruck, Austria. Contributing studies undergo a detailed data cleaning and harmonisation procedure before being incorporated in the Proof-ATHERO central database. Statistical analyses are being conducted according to pre-defined analysis plans and use established methods for individual-participant data meta-analysis. Capitalising on its large sample size, the multi-institutional collaborative Proof-ATHERO consortium aims to better characterise, understand, and predict the development of atherosclerosis and its clinical consequences.