The European Research Area Network (ERA-NET) focusing on cardiovascular disease research, (ERA-CVD), was created in 2015 and is supported through Horizon 2020 and 24 funding organizations from 19 countries (https://era-cvd.eu). Within ERA-CVD, multinational cardiovascular research activities have been organized through themed calls, resulting in several cutting-edge consortia, and mobilizing the young research community. In addition to funding cardiovascular research, ERA-CVD has developed a Strategic Research Agenda (SRA). This document was recently released and, in its conclusions, calls for actions to enhance the quality of future cardiovascular research in Europe and to address unmet needs (https://www.era-cvd.eu/396.php). This editorial presents a summary and conclusions of the document. We encourage all readers to view the SRA and to provide feedback that will strengthen the priorities it identifies for future research. Amongst the main conclusions, the SRA emphasizes that an ageing population, improved survival from heart attacks and congenital disease, and a growing incidence of cardiovascular complications of other diseases, such as diabetes, cancer, and kidney disease, combine into an emerging epidemic of chronic cardiovascular disease, with a different presentation from 40 years ago. Chronic disease, disability, and comorbidities challenge the healthcare system and require increased efforts for research and innovation at all levels. A strategic investment in cardiovascular research, including regional development, networking within Europe and beyond, and expanding cross-sectoral partnerships is needed to improve translation, innovation, and patient care, and to increase cardiovascular health. A large body of guidelines for prevention and better treatment exists, but these lack full implementation and evaluation of efficacy. Europe has the capacity for generating large population-based data and needs to invest in proper studies for evaluation of outcome and optimization of prevention and treatment. The SRA also makes it clear that although implementation of existing knowledge is essential, it is not sufficient. Approaches for early disease detection should take advantage, from large datasets at population and cohort level, new multidisciplinary strategies taking advantage of the advances in big data analytics, as well as insights into disease mechanisms generated in basic discovery research. New treatments are needed. Interactive and cross-sector research programmes must complement the traditional bench-to-bedside development cycle. The SRA document has identified areas where increased investment is needed, based on insights from the research and healthcare professional community, from funders and different stakeholder organizations. These areas for investment match the evolution and novel presentation of cardiovascular disease. Several guiding principles for implementation were identified: Collaborative and transnational research can enhance impact at all levels, from discovery to implementation, and outcome studies. Partnerships, multidisciplinary efforts, and co-design of research with patients and citizens are essential for success. A supportive regulatory framework will facilitate innovation and economic wealth within Europe. Inequality within Europe in cardiovascular health requires dedicated, research-guided programmes. Setting a strategic agenda implies choices for priority investment, as presented in the document. Yet, innovation relies on bright ideas. Therefore, bottom-up, discovery research must be supported and should be part of strategic efforts and funding. Implementation of the proposed agenda will require action from ministries, funding bodies, healthcare administrators, and the private sector, at European Union (EU) and national level. Furthermore, beyond the research agenda presented by ERA-CVD, public and private decision-makers providing healthcare must develop novel models for care, ensure equal access to treatment and implement digital health that will, in turn, support research for better cardiovascular health. The SRA lists a series of potential priority areas for future research identified from ERA-CVD stakeholders meetings. We want further input from a wide variety of sources to contribute to ranking these priorities by completing an online survey, the results from which will be published as an appendix to the SRA, to guide policy makers and funders. The survey remains accessible until 1 August 2019. ERA-CVD welcomes as many responses as possible to this survey, which is simple to complete, and accessed from https://tinyurl.com/surveycvd or by contacting Deborah Zyss at deborah.zyss@agencerecherche.fr. A special ESC session, dedicated to the strategic research priorities in cardiovascular diseases, will be held during the ESC Congress in Paris on 2 September 2019 (Monday, Global Exchange Room 1, 12:30 – 13:30), and it will include a first public disclosure of the results of the ERA-CVD survey. Mark your calendar - and come to learn and share your opinion. The text of this editorial is based on the document that was developed by the ERA-CVD writing group with the support of many experts and stakeholders. W.H.v.G. is chairman of the External Advisory Board to ERA-CVD; J.P. and K.R.S. are members of the External Advisory Board; and P.M. is a member of the ESC Research and Grants Committee. Conflict of interest: none declared. Biography: Jeremy Pearson is Associate Medical Director for Research at the British Heart Foundation, with particular responsibility for managing research partnerships with other funders. He joined the BHF part-time in 2002 and has been full time since 2010. His post-doctoral research career, working first at The Babraham Institute and then the MRC Clinical Research Centre in Harrow before moving to King’s College London in 1991, was as an endothelial cell biologist, and he became the UK’s first Professor of Vascular Biology on his move to KCL where he still holds an Emeritus chair. He was elected as a fellow of the UK Academy of Medical Sciences in 2004 and as an Honorary Fellow of the Royal College of Physicians in 2006. Biography: Karin Sipido is Professor of Medicine and Head of Experimental Cardiology at the KU Leuven, the University of Leuven, Belgium. She holds an MD degree, trained in Internal Medicine and Cardiology and holds a PhD in Physiology. Her academic research focuses on cellular mechanisms of heart failure and arrhythmias. With collaborators in cardiac imaging and clinical electrophysiology, the research receives a broader clinical perspective. She is editorial board member of several leading cardiovascular journals; she was Associate Editor of the European Heart Journal and Editor-in-Chief of Cardiovascular Research from 2013 to 2017. She was elected member of the Academia Europaea, Fellow of the European Society of Cardiology, Fellow of the American Heart Association, and Fellow of the International Society for Heart Research. She assumed several tasks within the European Society of Cardiology. She was founding member and President of the Alliance for Biomedical Research Europe 2013–15. Currently, she chairs the Scientific Panel for Health under the provision of the European Commission H2020 programme. Within the KU Leuven, she chairs the Council for Research Policy. Biography: Piotr Musialek, Jagiellonian University Professor of Cardiovascular Medicine in Krakow, Poland, is a clinician-scientist. After obtaining his MD and initial clinical training in Krakow he moved to research in experimental cardiology at the University of Oxford (British Foreign Office Scholar, Joan Mott Cardiovascular Research Fellow) where he identified a fundamental mechanism in cardiac pacemaking, leading to dissecting out a novel signal transduction pathway (the NO-If pathway; British Cardiac Society Young Investigator Award 1997, best PhD in biomedical sciences at Oxford 2000, ESC Featured Research 2000). In parallel to research, he then continued his clinical track up to the consultant level in cardiology and vascular medicine (angiology). He is a high-volume cardiovascular operator and a key opinion leader in novel endovascular technologies. His research activity has been focused primarily on the interface of basic and clinical science, and has involved first-in-man investigations as well as investigator-initiated randomized trials and clinical problem-focused all-comer studies. Current main research areas include atherosclerotic plaque imaging and vulnerability, recurrent vascular stenosis, stroke mechanisms and prevention, and cardiovascular regeneration. Recently, to address some fundamental gaps in knowledge and/or clinical decision-making evidence, he set up a series of investigator-initiated studies that he executed effectively (Late-Breaking Clinical Trials at EuroPCR and Transcatheter Cardiovascular Therapeutics, TCT Invention/Innovation, TCT Featured Research, TCT Top 10, ESC Outstanding Scientific Research). He is Polish Cardiac Society Board Envoy for Stroke and Vascular Interventions. Serves on the ESC Research and Grants Committee, ESC Congress Programme Committee, and EuroPCR VITAL. Committed to resolving gaps between basic and clinical science. Highly involved in training and education, actively promotes the next generation of clinician-scientists. Biography: Wiek van Gilst, FESC, is pharmacologist by training. His top 10 most cited publications (Total: 536) include both basic research as reports of clinical trials he has led as principal investigator (h-index: 82). He was appointed Professor of Cardiovascular and Clinical Pharmacology in 1995 and was head of Experimental Cardiology (7 Years) and Director of the Netherlands Heart Institute (10 years). At present he is, apart from his academic position at University Medical Center Groningen, scientific counselor of the Dutch Heart Foundation.
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