Our History

Despite significant advances in education, technology, and therapy over the past thirty years, ischemic heart disease remains the leading cause of death worldwide. A critical issue that persists is the presence of inequalities in access to and outcomes of cardiovascular care, which continue to affect women, the elderly, vulnerable populations, and ethnic minorities. These groups are often excluded or underrepresented in major clinical trials, with serious consequences on the quality of care they receive.

The Laboratory of Epidemiology and Clinical Cardiology was founded under the guidance of Prof. Raffaele Bugiardini and Prof. Olivia Manfrini with the aim of identifying and analyzing such disparities, understanding their causes, and developing targeted solutions.

The group’s work is based on the awareness of the importance of Big Data in clinical research. Since its early stages, the laboratory has recognized the potential of large-scale analyses to understand and address clinically relevant issues. In line with this vision, one of the first and main activities of the Laboratory was the creation and launch of the ISACS (International Survey of Acute Coronary Syndromes) registry (NCT01218776). This international, multicenter observational study was designed to collect data on acute coronary syndromes (ACS) in Eastern European countries, providing a solid foundation for the analysis of cardiovascular inequalities.

Over the years, our group has incorporated advanced statistical techniques and Machine Learning in collaboration with specialized centers. These tools have enabled in-depth investigations into crucial topics, including:

  • Sex and gender differences in the presentation, treatment, and outcomes of ACS
  • The impact of clinical management on the prognosis of elderly and frail patients
  • Inequalities linked to disadvantaged socio-economic conditions
  • The care of complex patients, such as those undergoing chemotherapy or affected by SARS-CoV-2

Currently, the group coordinates and processes data from over 100,000 patients enrolled across centers in Serbia, North Macedonia, Croatia, Romania, Kosovo, Bosnia-Herzegovina, Italy, and Montenegro. The global perspective that has always guided our project has led to the establishment of a solid international collaborative network rooted in research passion, ethical commitment, and data rigor. This effort has also enabled numerous collaborative studies with other registries, including the UK-based EMMACE registry.