Bridging Europe and EuroAsia: advancing cardiovascular policy and practice through the ESC EuroAsia Task Force

The ESC EuroAsia Task Force was created with a clear mandate to ensure integrated work between ESC leadership and states with disparate healthcare systems, economic capacities, and policy frameworks.1 Its purpose is not to reproduce Western European models uncritically, but to translate evidence-based medicine into effective, locally adapted strategies, ensuring that patients throughout the region receive support for cardiovascular science advancements. The EuroAsia region is among the most affected areas in terms of the global burden of cardiovascular disease. EuroAsia accounts for a substantial share of the worldwide burden of cardiovascular.2 Yet access to advanced cardiovascular therapies, organized prevention programmes, and integrated-care pathways remains uneven. Each country’s constraints are similarly complex, including limited healthcare budgets, enormous out-of-pocket expenditures, centralized healthcare systems, and competing public health priorities.3–5 The task force recognizes that these challenges exist between communities rather than individuals and that working together to address them creates unique opportunities. The task force may serve as an interface between clinicians and policymakerstranslating clinical evidence into economic and organizational arguments. The session in Madrid aimed to move beyond abstract discussion toward practical implementation. Led by Robert Gil (Warsaw, Poland) and Erkin Mirrakhimov (Bishkek, Kyrgyzstan), the session brought together attendees from all countries in the EuroAsia region (Armenia, Azerbaijan, Georgia, Kazakhstan, Turkmenistan, and Uzbekistan) to share data-informed perspectives on cardiovascular care across the field. In the first presentation, Marine Sargsyan (Yerevan, Armenia) outlined demographic and epidemiologic trends and access to coronary revascularization in the region. Her analysis highlighted wide variability in access to timely percutaneous coronary intervention (PCI), driven not by clinical knowledge but by infrastructure allocation, reimbursement policy, and regional referral pathways. Khurshid Fozilov (Tashkent, Uzbekistan) concluded that there is a need for systematic solutions aligned with ESC Guidelines to make PCIs more effective. In conclusion, it was said that the region should focus on national planning, staff training, and performance measurement, rather than specific growth in procedures. Extending Influence Across Key Areas A core part of the session focused on implantable cardioverter-defibrillator (ICD) therapy as a basis for evaluating overall health system performance. Ulvi Mirzoyev (Baku, Azerbaijan) presented regional data on device implantation, highlighting massive disparities across countries and differences relative to Western Europe. The discussion stressed that a lack of understanding of guidelines or physician expertise does not primarily drive these differences. ICD implantation rates reflect policy decisions, reimbursement architectures, and system readiness. When national programmes and devices are publicly financed, access improves, but when patients pay for treatment, therapy remains limited. Bahram Kadyrov (Ashgabat, Turkmenistan) extended the discussion, suggesting pragmatic measures to improve accessibility—such as phased reimbursement models as well as national referral pathways—and to integrate device therapy into broader cardiovascular strategies. The session also examined atrial fibrillation (AF) ablation as another example of evidence–practice divergence. Ayan Abdrakhmanov (Astana, Kazakhstan) presented regional data, including Kazakhstan’s experience with regionalizing AF systems and establishing regional research. In the final AF presentation, Kakhaber Etsadashvili (Tbilisi, Georgia) raised a thought-provoking question: Is the real barrier money, or a lack of long-term planning? The conclusions were clearcost matters, but so do predictable policy frameworks and institutional resolve: shared difficulties, shared solutions. The panel discussion, chaired by Hamlet Hayrapetyan (Yerevan) and Zviad Kereselidze (Tbilisi), underscored a central theme that most of the challenges facing the region are surprisingly similar. Cross-border challenges, such as fragmented funding, centralized expertise, and insufficient registers for follow-up systems, also persist. The idea of joint initiatives—harmonized data collection, good training programmes, and coordinated advocacy—was proposed to optimize potential support from the ESC. The Madrid meeting was a milestone, but it is not the end. The ESC EuroAsia Task Force is now poised to extend its influence across key areas: Policy advocacy using regional data to support reimbursement and system reform; Accelerating research through collaborative registries and multicenter studies; Benchmarking to enable countries to evaluate progress against European standards; Education and training to address gaps in next-level cardiovascular care; and Closing the evidence-practice gap by aligning guidelines with real-world constraints. Perhaps most importantly, the initiative is a step toward elevating the profile of cardiovascular science in the region—showing that high-quality data, rigorous analysis, and constructive dialogue can influence policy under such conditions. Nothing to declare.