Cohort profile: the Utrecht Cardiovascular Cohort–Second Manifestations of Arterial Disease (UCC-SMART) Study–an ongoing prospective cohort study of patients at high cardiovascular risk in the Netherlands
Michiel L Bots,
N Charlotte Onland-Moret,
Pim A de Jong,
L Jaap Kappelle,
Frank L J Visseren,
Folkert W Asselbergs,
Ynte M Ruigrok,
Steven H J Hageman,
Jan Westerink,
Maarten van Smeden,
Gert J de Borst,
Maarten J Cramer,
Jannick A N Dorresteijn,
Marianne C Verhaar,
Mirjam I Geerlings,
Maria C Castelijns,
Marga A G Helmink,
Marielle H Emmelot-Vonk,
Niels P van der Kaaij,
A Titia Lely,
Manon G van der Meer,
Barend M Mol,
Hendrik M Nathoe,
Rutger B van Petersen,
Martin Teraa,
Angela Vandersteen
Affiliations
Michiel L Bots
Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
N Charlotte Onland-Moret
Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
Pim A de Jong
Department of Radiology, University Medical Center Utrecht, Utrecht, The Netherlands
L Jaap Kappelle
Department of Neurology, University Medical Center Utrecht, Utrecht, The Netherlands
Frank L J Visseren
Department of Vascular Medicine, University Medical Center Utrecht, Utrecht, The Netherlands
Folkert W Asselbergs
Department of Cardiology, University Medical Center Utrecht, Utrecht, The Netherlands
Ynte M Ruigrok
Department of Neurology, University Medical Center Utrecht, Utrecht, The Netherlands
Steven H J Hageman
Department of Vascular Medicine, University Medical Center Utrecht, Utrecht, The Netherlands
Jan Westerink
Department of Vascular Medicine, University Medical Center Utrecht, Utrecht, The Netherlands
Maarten van Smeden
Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
Gert J de Borst
Department of Vascular Surgery, University Medical Center Utrecht, Utrecht, The Netherlands
Maarten J Cramer
Department of Cardiology, University Medical Center Utrecht, Utrecht, The Netherlands
Jannick A N Dorresteijn
Department of Vascular Medicine, University Medical Center Utrecht, Utrecht, The Netherlands
Marianne C Verhaar
Department of Nephrology and Hypertension, University Medical Center Utrecht, Utrecht, The Netherlands
Mirjam I Geerlings
Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
Maria C Castelijns
Department of Vascular Medicine, University Medical Center Utrecht, Utrecht, The Netherlands
Marga A G Helmink
Department of Vascular Medicine, University Medical Center Utrecht, Utrecht, The Netherlands
Marielle H Emmelot-Vonk
Department of Geriatrics, University Medical Center Utrecht, Utrecht, The Netherlands
Niels P van der Kaaij
Department of Cardiothoracic Surgery, University Medical Center Utrecht, Utrecht, The Netherlands
A Titia Lely
Department of Gynaecology and Obstetrics, University Medical Center Utrecht, Utrecht, The Netherlands
Manon G van der Meer
Department of Cardiology, University Medical Center Utrecht, Utrecht, The Netherlands
Barend M Mol
Department of Vascular Surgery, University Medical Center Utrecht, Utrecht, The Netherlands
Hendrik M Nathoe
Department of Cardiology, University Medical Center Utrecht, Utrecht, The Netherlands
Rutger B van Petersen
Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
Martin Teraa
Department of Vascular Surgery, University Medical Center Utrecht, Utrecht, The Netherlands
Angela Vandersteen
Department of Vascular Medicine, University Medical Center Utrecht, Utrecht, The Netherlands
Purpose The Utrecht Cardiovascular Cohort–Second Manifestations of Arterial Disease (UCC-SMART) Study is an ongoing prospective single-centre cohort study with the aim to assess important determinants and the prognosis of cardiovascular disease progression. This article provides an update of the rationale, design, included patients, measurements and findings from the start in 1996 to date.Participants The UCC-SMART Study includes patients aged 18–90 years referred to the University Medical Center Utrecht, the Netherlands, for management of cardiovascular disease (CVD) or severe cardiovascular risk factors. Since September 1996, a total of 14 830 patients have been included. Upon inclusion, patients undergo a standardised screening programme, including questionnaires, vital signs, laboratory measurements, an ECG, vascular ultrasound of carotid arteries and aorta, ankle-brachial index and ultrasound measurements of adipose tissue, kidney size and intima–media thickness. Outcomes of interest are collected through annual questionnaires and adjudicated by an endpoint committee.Findings to date By May 2022, the included patients contributed to a total follow-up time of over 134 000 person-years. During follow-up, 2259 patients suffered a vascular endpoint (including non-fatal myocardial infarction, non-fatal stroke and vascular death) and 2794 all-cause deaths, 943 incident cases of diabetes and 2139 incident cases of cancer were observed up until January 2020. The UCC-SMART cohort contributed to over 350 articles published in peer-reviewed journals, including prediction models recommended by the 2021 European Society of Cardiology CVD prevention guidelines.Future plans The UCC-SMART Study guarantees an infrastructure for research in patients at high cardiovascular risk. The cohort will continue to include about 600 patients yearly and follow-up will be ongoing to ensure an up-to-date cohort in accordance with current healthcare and scientific knowledge. In the near future, UCC-SMART will be enriched by echocardiography, and a food frequency questionnaire at baseline enabling the assessment of associations between nutrition and CVD and diabetes.
