The Emerging Risk Factors Collaboration (ERFC) is a CEU-led consortium of >130 prospective studies from >30 countries that has collated and harmonised individual-participant data (IPD) from a total of ~2.5 M participants to study risk factors for cardiovascular diseases and cause-specific mortality in greater detail by IPD meta-analysis. Risk factors studied have included circulating lipid markers, inflammatory markers, glycaemia markers, adiposity markers, diabetes, and cardiometabolic multimorbidity.

 

Analyses concern aetiological hypothesis or risk prediction assessment in subsets of studies/participants with relevant data, with methodological developments occurring in parallel as necessary.

 

Aetiological analyses primarily focus on assessing important features of exposure-outcome associations, including: the shape of dose-response relationships; the magnitude of independent associations with consistent adjustment for confounding factors across studies; correction for regression dilution bias in both exposure and confounders; and assessing potential heterogeneity by individual and study level characteristics.

 

Risk prediction analyses assess and compare the predictive performance of different risk models in the IPD meta-analysis context using measures of discrimination, calibration, and reclassification. Public health modelling approaches are used to help more meaningfully convey inferences, such as estimates of the number of people needed to be screened and treated to prevent 1 cardiovascular event over 10 years with different screening options; or estimates of potential years of life lost due to a risk factor increasing the risk of premature death.

 

The CUORE Project participates in ERFC with the two Italian cohorts, Crevalcore and Montegiorgio, from the prospective FINE study (Finland, Italy, the Netherlands, Elderly). The Crevalcore cohort represented on the baseline (1985) a sample of all men aged 65-84 years who lived in the rural village of Crevalcore, located in northern Italy, in a lowland area where the traditional diet was rich in animal fats; the Montegiorgio cohort represented on the base line a sample of all men aged 65-84 years who lived in the rural village of Montegiorgio, located in central Italy, in an internal hilly area about 30 km from the Adriatic Sea, and which followed a food more similar to the "Mediterranean diet".

 

Resources

• Emerging Risk Factors Collaboration (ERFC) web site