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The ESCAPER Study - exploring protective mechanisms against cardiovascular disease in subjects at high risk : Rationale, study protocol, and first results

Ekström, Ola LU ; Arheden, Håkan LU ; Christensson, Anders LU ; Engström, Gunnar LU ; Hedström, Erik LU orcid ; Kennbäck, Cecilia LU ; Laucyte-Cibulskiene, Agne LU orcid ; Lundgren, Simon LU ; Lyssenko, Valeriya LU and Löndahl, Magnus LU , et al. (2025) In Scandinavian cardiovascular journal : SCJ 59(1). p.1-7
Abstract

IntroductionThe ESCAPER project explores cardiovascular resilience in individuals who, despite a high-risk factor burden-longstanding Type 1 Diabetes (T1D), obesity, or kidney failure-avoid or delay macrovascular complications. This suggests underlying protective mechanisms. Initiated in September 2022, this exploratory study aims to uncover and define these mechanisms, potentially leading to novel therapeutic targets in preventive medicine.Research Design and MethodsParticipants from the Skåne region, Southern Sweden, are divided into three subgroups: (1) T1D patients (>30 years duration) without macrovascular complications or macroalbuminuria, (2) obese individuals with normal cardiac function and no cardiovascular medications, and... (More)

IntroductionThe ESCAPER project explores cardiovascular resilience in individuals who, despite a high-risk factor burden-longstanding Type 1 Diabetes (T1D), obesity, or kidney failure-avoid or delay macrovascular complications. This suggests underlying protective mechanisms. Initiated in September 2022, this exploratory study aims to uncover and define these mechanisms, potentially leading to novel therapeutic targets in preventive medicine.Research Design and MethodsParticipants from the Skåne region, Southern Sweden, are divided into three subgroups: (1) T1D patients (>30 years duration) without macrovascular complications or macroalbuminuria, (2) obese individuals with normal cardiac function and no cardiovascular medications, and (3) kidney failure patients awaiting transplantation with no arterial calcification, alongside respective controls. Comprehensive phenotyping includes 24-hour blood pressure, ECG monitoring, vascular ultrasound, cardiac MRI, and ergospirometry (in a subgroup), along with laboratory investigations, including biomarker and omics analyses. Arterial biopsies are collected from kidney failure patients. The study leverages Swedish national medical registries for detailed follow-up of healthcare utilization, diagnoses, and prescriptions, enabling longitudinal outcome assessments.ResultsInitial findings from 90 T1D patients and 31 obese individuals indicate well-managed cardiovascular risk factors. The T1D subgroup shows a mean BMI of 25.6 kg/m
2 and HbA1c of 52 mmol/mol, while the obesity subgroup presents a BMI of 32.9 kg/m
2 with normal glucose levels.ConclusionsESCAPER has the potential to advance understanding of cardiovascular resilience and refine prevention strategies. Its comprehensive methodology and registry-based follow-up provide robust insights into protective mechanisms and long-term outcomes.

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publishing date
type
Contribution to journal
publication status
published
subject
in
Scandinavian cardiovascular journal : SCJ
volume
59
issue
1
pages
1 - 7
publisher
Taylor & Francis
external identifiers
  • pmid:40464525
ISSN
1651-2006
DOI
10.1080/14017431.2025.2513865
language
English
LU publication?
yes
id
be7adb9e-abe5-49da-9df8-5be38b0f2a0a
date added to LUP
2025-06-10 09:25:10
date last changed
2025-06-10 10:49:32
@article{be7adb9e-abe5-49da-9df8-5be38b0f2a0a,
  abstract     = {{<p>IntroductionThe ESCAPER project explores cardiovascular resilience in individuals who, despite a high-risk factor burden-longstanding Type 1 Diabetes (T1D), obesity, or kidney failure-avoid or delay macrovascular complications. This suggests underlying protective mechanisms. Initiated in September 2022, this exploratory study aims to uncover and define these mechanisms, potentially leading to novel therapeutic targets in preventive medicine.Research Design and MethodsParticipants from the Skåne region, Southern Sweden, are divided into three subgroups: (1) T1D patients (&gt;30 years duration) without macrovascular complications or macroalbuminuria, (2) obese individuals with normal cardiac function and no cardiovascular medications, and (3) kidney failure patients awaiting transplantation with no arterial calcification, alongside respective controls. Comprehensive phenotyping includes 24-hour blood pressure, ECG monitoring, vascular ultrasound, cardiac MRI, and ergospirometry (in a subgroup), along with laboratory investigations, including biomarker and omics analyses. Arterial biopsies are collected from kidney failure patients. The study leverages Swedish national medical registries for detailed follow-up of healthcare utilization, diagnoses, and prescriptions, enabling longitudinal outcome assessments.ResultsInitial findings from 90 T1D patients and 31 obese individuals indicate well-managed cardiovascular risk factors. The T1D subgroup shows a mean BMI of 25.6 kg/m<br>
 2 and HbA1c of 52 mmol/mol, while the obesity subgroup presents a BMI of 32.9 kg/m<br>
 2 with normal glucose levels.ConclusionsESCAPER has the potential to advance understanding of cardiovascular resilience and refine prevention strategies. Its comprehensive methodology and registry-based follow-up provide robust insights into protective mechanisms and long-term outcomes.<br>
 </p>}},
  author       = {{Ekström, Ola and Arheden, Håkan and Christensson, Anders and Engström, Gunnar and Hedström, Erik and Kennbäck, Cecilia and Laucyte-Cibulskiene, Agne and Lundgren, Simon and Lyssenko, Valeriya and Löndahl, Magnus and Magnusson, Martin and Nilsson, Peter M and Gottsäter, Anders}},
  issn         = {{1651-2006}},
  language     = {{eng}},
  month        = {{06}},
  number       = {{1}},
  pages        = {{1--7}},
  publisher    = {{Taylor & Francis}},
  series       = {{Scandinavian cardiovascular journal : SCJ}},
  title        = {{The ESCAPER Study - exploring protective mechanisms against cardiovascular disease in subjects at high risk : Rationale, study protocol, and first results}},
  url          = {{http://dx.doi.org/10.1080/14017431.2025.2513865}},
  doi          = {{10.1080/14017431.2025.2513865}},
  volume       = {{59}},
  year         = {{2025}},
}