The Prospective Studies of Atherosclerosis (Proof-ATHERO) Consortium: Design and Rationale

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

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review


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 ( 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 (n = 67,784), 16 from high-risk populations (n = 22,677), and 37 as part of clinical trials (n = 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.

Original languageEnglish
Pages (from-to)447-459
Number of pages13
Issue number5
Publication statusPublished - 1 Sep 2020
Externally publishedYes

Bibliographical note

Funding Information:
L. Tschiderer reports grants from the Dr.-Johannes-and-Hertha-Tuba Foundation during the conduct of the study and nonfinancial support from Sanofi outside the submitted work. L. Seekircher reports non-financial support from Sanofi outside the submitted work. G. Klingenschmid reports non-financial support from Sanofi and Pfizer outside the submitted work. N. Sattar reports personal fees from Amgen, AstraZeneca, Boehringer Ingel-heim, Eli-Lilly, Novo Nordisk, Sanofi, and Pfizer and grants from Boehringer Ingelheim outside the submitted work. S.E. Kjeldsen reports personal fees from Merck Darmstadt, MSD Whitehouse Station, Sanofi Paris, and Takeda Chicago outside the submitted work. S. Kiechl reports grants from Austrian Promotion Agency FFG outside the submitted work. G.D. Norata reports grants from Pfizer and Amgen and personal fees from Sanofi, Amgen, Alnyl-am, and Novartis outside the submitted work. P. Willeit reports grants from the Dr.-Johannes-and-Hertha-Tuba Foundation and the Austrian Science Fund FWF during the conduct of the study. Other authors have no conflicts of interest.

Funding Information:
This work was funded by the Austrian Science Fund (FWF) (P 32488) and the Dr.-Johannes-and-Hertha-Tuba Foundation. Funders of individual studies contributing to the present analysis arelistedon the Proof-ATHERO webpage(https://clinicalepi.i-med.

Publisher Copyright:
© 2020 The Author(s) Published by S. Karger AG, Basel.


  • Atherosclerosis
  • Cardiovascular disease
  • Consortium
  • Individual-participant data
  • Prospective studies
  • Repeat measurements


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