Interview Daniel Engler (UKE)
Daniel Engler
University Heart Center Hamburg
Daniel Engler is the dedicated project manager for the AFFECT-EU project. He has long standing experience in the management of research projects funded by the European Union. A health scientist as well as project manager, he has been actively engaged in public health research and cardiovascular health projects.
Daniel graduated from Furtwangen University, the University of Maastricht and the University of Applied Sciences Hamburg. He received BSc and MSc degrees in health sciences and European public health. His management tasks included the submission and implementation of European and national grants since 2015 at the Research and Transfer Centre HAW Hamburg (FTZ-ALS) and University Medical Centre Hamburg-Eppendorf (UKE).
UKE is one of the most modern hospitals in Europe, with more than 80 highly specialized clinics and research institutes. UKE represents a combination of state-of-the-art medical treatment, research, science, and education with international reputation. The UKE is currently participating as coordinator or partner in 58 EU projects.
What is AFFECT-EU?
AFFECT-EU is an international consortium consisting of 26 partners from scientific, patient representatives and industry sections. Our major goal is to develop a risk-based, accurate, and ready for implementation atrial fibrillation (AF) screening algorithm, using digital devices, for early AF detection in the community.
How can AFFECT-EU contribute to improving citizens’ lives?
The prevalence of AF as the most common sustained arrhythmia is expected to increase to 3.5% (18 million individuals) in Europe by the year 2060. Thus, there is a high potential of AFFECT-EU for public health gain in AF screening to prevent the sequelae of undiagnosed and untreated AF in the aging European society and make a direct contribution to the EU policy on active aging (no. 17468/12).
How will AFFECT-EU improve screening for AF?
To improve AF screening, we are using well-powered, large-scale clinical trial information as it becomes available to define the currently best AF screening strategy for implementation. We will also integrate results from multiple smaller trials/studies across Europe. Furthermore, we are searching for markers for risk stratification in the population. Nt-proBNP is currently the most promising biomarker for risk refinement, we will measure it in all studies with available blood samples. In an orchestrated approach, we will thus combine the abundance of locally existing data from high quality cohorts and trials with the aim to maximise access and jointly explore data to achieve exclusively robust results
How do patients benefit from AF screening in AFFECT-EU?
AFFECT-EU’s comprehensive dissemination and communication activities will raise awareness across a broad range of stakeholders, including healthcare providers, patients, policymakers and the general public. This in itself is a huge step forward in a still largely underestimated health threat. Better awareness of AF-related risks in the aging European population will pave the way to disease prevention, thereby improving healthy and independent aging.
What are the AF screening knowledge gaps according to AFFECT-EU?
At present, there are no sufficiently robust data, which address the question of stroke and systemic embolism (SE) risk related to screen detected AF in the general population. Currently, we assume that the benefit of stroke and SE risk reduction outweighs the relatively infrequent major, rarely life-threatening bleeding events caused by AF therapy. We need information on significant harms that arise from treatment with oral anticoagulants (intracerebral haemorrhage, gastrointestinal and other bleeding) in screening detected AF. If a benefit can be proven by high quality data from different sources as assembled in AFFECT-EU, screening can be recommended.
How does the risk-based AF screening approach function in AFFECT-EU?
AFFECT-EU fills in the knowledge gaps by integrating information from independent studies entering the project. These data will be used to implement a risk-based AF screening approach and to provide evidence on the superiority of AF screening using a robust community screening strategy for reducing AF-related morbidity and mortality.
