Inflammation across the spectrum of cardiovascular disease: healthcare physician perceptions and practices in six European countries.

Background: There is growing evidence that inflammation is associated with development and progression of cardiovascular disease (CVD). The extent of physician awareness of this evidence, and its impact on clinical care, is unknown. Therefore, our aim was to investigate and characterize the perceptions and clinical practices of HCPs with respect to inflammation when treating patients with atherosclerotic CVD (ASCVD) + chronic kidney disease (CKD) stage 3-4 or heart failure (HF). Methods: This was a qualitative research study involving semi-structured, 1-hour Zoom interviews (including open- and close-ended questions) conducted from February-April 2024. Eligible HCPs were cardiologists, nephrologists, or general practitioners with ≥5 and ≤30 years of post-graduate clinical experience; working in France, Denmark, the Netherlands, Spain, Sweden, and Switzerland; who had managed ≥10 patients with ASCVD + CKD or HF in the previous 3 months. Results: Most of the 62 HCPs included in the study (84%) acknowledged the theoretical importance of inflammation in progression of ASCVD + CKD or HF. However, only 17 (27% of the 62) routinely tested for high-sensitivity C-reactive protein (hsCRP) due to limited awareness of the clinical implications of inflammation in CVD and the lack of consistently proven interventions. If hsCRP is assessed, HCPs cannot alter their patient management in response to the findings due to a lack of treatment options. Conclusion: This study presents the perceptions and practices of a sample of HCPs. Because of limited evidence for the efficacy of interventions and the incomplete understanding of the role of inflammation in CVD, inflammation remains a neglected treatment target in clinical practice.