Inflammatie als risicofactor krijgt onvoldoende ruimte in de ASCVD- en CKD-praktijk — SPARK-CVD

BACKGROUND AND AIMS: Cardiovascular disease (CVD) remains a leading cause of death in China. Systemic inflammation (SI) is an emerging risk factor in atherosclerotic CVD (ASCVD) and chronic kidney disease (CKD). High-sensitivity C-reactive protein (hsCRP) is increasingly recognised for prognostication. The SPARK-CVD China survey assessed Chinese cardiologists' and nephrologists' awareness and perceptions of SI and hsCRP in patients with both ASCVD and CKD. METHODS: A nationwide cross-sectional survey was conducted (September to December 2024) across 31 provinces in China mainland among physicians with ≥3 years of clinical experience and managing ≥20 adult patients with both ASCVD and CKD per month. Descriptive and comparative statistics were used. RESULTS: Among 1500 respondents, SI was used more to aid treatment than diagnosis (65.2% vs 45.5%). Although 73.3% viewed SI as a key determinant of cardiovascular events, only 35.2% discussed SI as a risk factor with patients. Non-testers cited no expected impact on decisions (71.3%), lack of guideline direction (44.0%), and limited treatments (37.2%). A knowledge-practice gap for hsCRP was observed: 29.7% identified hsCRP unprompted versus 87.7% when prompted; perceived diagnostic thresholds varied widely. Fewer than 1/4 of ASCVD and/or CKD patients would be prescribed colchicine; barriers included limited experience (55.2%), potential contraindications (54.1%), and side effects (47.1%). Cardiorenal benefits of GLP-1 receptor agonists were widely recognised (97.9%), with 76.5% attributing benefits partly to anti-inflammatory effects. CONCLUSION: SI is acknowledged but inconsistently operationalised domestically. Targeted professional education, explicit guideline recommendations, and further evidence for risk-stratified, inflammation-guided care may help refine treatment pathways for ASCVD with CKD.