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Risk Or Benefit IN Screening for CArdiovascular Disease (ROBINSCA): the rationale and study design of a population-based randomised-controlled screening trial for cardiovascular disease

Session Poster Session 2

Speaker Carlijn Van der Aalst

Congress : ESC Preventive Cardiology (Formerly EuroPrevent) 2019

  • Topic : preventive cardiology
  • Sub-topic : Secondary Prevention
  • Session type : Poster Session
  • FP Number : P545

Authors : C M Van Der Aalst (Rotterdam,NL), M Vonder (Groningen,NL), J-W Gratama (Apeldoorn,NL), H Adriaansen (Apeldoorn,NL), D Kuijpers (The Hague,NL), S Denissen (Rotterdam,NL), P Van Der Harst (Groningen,NL), RL Braam (Apeldoorn,NL), PRM Van Dijkman (The Hague,NL), M Oudkerk (Groningen,NL), HJ De Koning (Rotterdam,NL)

Authors:
C M Van Der Aalst1 , M Vonder2 , J-W Gratama3 , H Adriaansen4 , D Kuijpers5 , S Denissen1 , P Van Der Harst6 , RL Braam7 , PRM Van Dijkman8 , M Oudkerk2 , HJ De Koning1 , 1Erasmus Medical Center, Public Health - Rotterdam - Netherlands (The) , 2University Medical Center Groningen, Radiology - Groningen - Netherlands (The) , 3Gelre Hospital of Apeldoorn, Radiology - Apeldoorn - Netherlands (The) , 4Gelre Hospital of Apeldoorn, Clinical Chemistry and Laboratory Medicine - Apeldoorn - Netherlands (The) , 5Bronovo Hospital, radiology - The Hague - Netherlands (The) , 6University Medical Center Groningen, Cardiology - Groningen - Netherlands (The) , 7Gelre Hospital of Apeldoorn, cardiology - Apeldoorn - Netherlands (The) , 8Bronovo Hospital, cardiology - The Hague - Netherlands (The) ,

Citation:

Background

Coronary Heart Disease (CHD) remains a major cause of morbidity and mortality worldwide. The aim is to describe the rationale, study design, and first results of the Dutch Risk Or Benefit IN Screening for CArdiovascular disease (ROBINSCA) trial, the first population-based randomised-controlled Computed-Tomography screening trial for cardiovascular disease, powered to detect a benefit of 15% reduced CHD-morbidity and mortality.

Methods

Addresses of men (aged 45-74 years) and women (aged 55-74 years) were obtained (n=394,058) from the population registry. All received a mailing with an information brochure, a questionnaire and waist measurement tape and an informed consent form. Asymptomatic people with an expected high-risk for developing CHD were randomised (1:1:1) to one of the study arms: intervention arm A (screening by traditional risk factors), intervention arm B (screening by Coronary Artery Calcium scoring only) or the control arm (usual care).

Results

A total of 87,866 (22.3%) people responded to the questionnaire, of which 43,447 (49.4%) were randomised to intervention arm A (n=14,478 (33.3%)), intervention arm B (n=14,450 (33.3%)), or the control arm (n=14,519 (33.4%)). Screening was completed in August 2018. In intervention arm A, 12,184 (84.2%) were screened and in 54.9% risk reducing treatment by the general practitioner was advised. In intervention arm B, 12,950 (89.6%) were screened and only 24% were advised to receive risk reducing treatment.

Conclusion

CHD-related morbidity and mortality will be measured at 5-year of follow-up. Evidence for net-effectiveness of population-based screening for cardiovascular risk in an asymptomatic population will possibly enable large health gains.



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