Stiftungsprofessur für Vaskuläre Prävention

(EVER Neuro Pharma)

1. Research in epidemiology of CVD risk factors and vascular diseases, including studies on cardio-metabolic diseases and cognitive outcomes of CVD risk factors.

Epidemiological research will be carried out to reveal new risk factors and the changing impact of well-established risk factors using data both from existing data from various studies carried out in Austria as well in other countries. The aim is to reveal new findings on the incidence, risk factors and outcomes of these diseases. As the present head of the Center has excellent links to the data bases collected in Finland and several other countries around the world, it has possible to establish formal or informal links with these studies, and in the future these links will be strengthened.

A particular aspect of epidemiological research in this line is related to the evaluation of the role of CVD risk factors on cognitive impairment both before and after stroke. Possibilities for studies on gene-environment interactions will be explored.

In collaboration with the Karolinska Institute Stockholm, Sweden) and Imperial College (London, UK) a European-wide survey on CVD risk factors and diabetes in patients with acute coronary disease. This project is carried out in 25 countries under the auspices of the European Society of Cardiology (ESC). Another project with ESC and the Foundation of Clinical Epidemiology (Madrid, Spain) is the evaluation of the implementation of European Guideline of Diabetes, Prediabetes and Cardiovascular Disease that will be carried out in the same countries.

During the last year 10 peer reviewed scientific articles has been published on these data. It is expected that the rate will even increase in the future.

2. Design, conduct and evaluation of trials on prevention and management of vascular and cardio-metabolic diseases and disorders of cognitive decline, and community studies on chronic disease prevention.

In Austria, very few research activities exist in the primary prevention of vascular and cardio-metabolic disease. Thus, there is a lot of room to develop chronic disease prevention research in the country. This Center has a mission to fill this gap.

We have initiated together with other units at the Department the Austrian Polyintervention Study to Prevent Cognitive Decline after Ischemic Stroke (ASPIS), the first study ever carried out to find out the extent to which cognitive decline after stroke can be prevented by lifestyle intervention consisting of improvement of multiple lifestyle traits (diet, physical activity, cognitive and social support).

In the recent past, we have carried out the EU-funded project Diabetes in Europe - Prevention using Lifestyle, Physical Activity and Nutritional intervention (DE-PLAN) where DUK has been a partner. This is the first attempt to implement primary prevention of type 2 diabetes in Austria. The results of Lower Austrian part of this project are currently being published. The Center will also actively participate in the publication of the results from the collaborative European-wide project.
The main project for the coming years is the Early Prevention of Diabetes Complications in Europe (e-PREDICE). The general objective of ePREDICE is to assess the long-term effects of different therapeutic regimens, both pharmacological and lifestyle interventions, for the early prevention of diabetic complications in people with intermediate hyperglycaemia (IFG or IGT) and screen-detected diabetes (SD-T2D). The project is funded by the EU and coordinated from Madrid, Spain and the head of the Center is the overall PI for the project. DUK is the leader of the Workpackage related to neurological, neuropsychological and quality of life aspects of the project.

The primary objective is to assess the effect of treatment with sitagliptine or metformin or their combination plus lifestyle intervention (diet and exercise), compared to lifestyle intervention alone, for at least 3 years, and up to 5 years, on different microvascular parameters (retinal, renal and neurological), as defined by the primary and secondary endpoints, in adults with hyperglycaemia (IGT, IFG or SD-T2D). Secondary objectives are: to identify among people with hyperglycaemia who are most likely to develop early diabetic complication; to find out which of the early diabetic complications can be best prevented by interventions applied in this study; to determine the extent to which the compliance to the interventions affect the rate of early diabetic complications; to preserve quality of life and neuropsychological functions; to assess the efficacy of treatment with sitagliptine or metformin and both combined added to lifestyle interventions in comparison to lifestyle intervention alone with regard to surrogate parameters of vascular function and structure, and novel biomarkers of microvascular damage in adults with hyperglycaemia (IGT, IFG or SD-T2D).

The recruitment period is 12 months starting January 2013. It uses a parallel-group treatment and clinical follow-up during 36 months, and extended follow-up (epidemiological observation and outcome evaluation without treatment): 24 months (from month 36th to month 60th). The estimated number of study subjects will be 3000 in 16 centres in Europe and Australia.

3. Post-graduate training in science and research in epidemiology, prevention and management of vascular diseases and diabetes.

The Center takes part in research training in its own area of interest, and also participates in other courses organised by DUK (Master course in Stroke Medicine; Evidence-based medicine) and several international postgraduate training courses in diabetes, stroke and CVD. The Center will coordinate the African Training Course on Epidemiology and Public Health Aspects of Diabetes in July in Tanzania.

The head of the Center has delivered approximately 70 invited lectures in international conferences around the world, including various major (World, European, American) congresses in the field of vascular and cardio-metabolic diseases, and also served in many programme committees of these conferences. He is the Co-President in the 7th World Congress on Prevention of Diabetes and Its Complications to be held in Madrid, Spain in November 2012.

The head of the Center has received during the last years highly recognised science awards: The Geoffrey Rose Award on Population Science by the European Society of Cardiology and the Folksam Prize on Epidemiological Research by the Karolinska Institute, Sweden (that also donates the Nobel Prizes).

The head of the Center has a vast experience in research training: 75 PhD fellows have completed their theses, and more than 10 are currently involved in their PhD work at various universities. The aim is to use this experience in developing a strong PhD programme within the Center in the near future.

4. International research collaboration.

Much of the research, both epidemiology and clinical science, is multinational today. The head of the Center has created many multinational research projects and been the leader in several of them. Thus, there is a wide international network in place already.

The research work ongoing and to be carried out in the future will have a significant international dimension, and the plan is to have the work of the Center included in several collaborative EU-funded projects with a significant local input.

5. Personnel

At the moment the Center has limited, part-time personnel: Head, one researcher and a secretary. Given the scope of work and the potential the Center has, there is a need to increase the manpower. In particular, there is a need to recruit 1-2 research fellows and 1-2 post-doctoral fellows. This would create the necessary critical mass for the Center to be able to handle and further develop the research potential the Center already has.