{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T09:23:46Z","timestamp":1787822626649,"version":"build-2784847793"},"reference-count":90,"publisher":"MDPI AG","issue":"17","license":[{"start":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T00:00:00Z","timestamp":1787788800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J. Clin. Med.","JCM"],"abstract":"<jats:p>Cardiovascular disease remains Europe\u2019s leading cause of death and disability despite mature evidence for prevention, acute and chronic treatment, rehabilitation, and secondary prevention. This structured critical narrative review evaluates whether the European Safe Hearts Plan can convert this evidence into coordinated, measurable, and accountable cardiovascular pathways. We appraise the plan\u2019s ten flagship actions by evidence maturity and implementation readiness; distinguish shared system functions from disease-specific delivery for acute coronary syndromes, heart failure, and atrial fibrillation; compare selected European Society of Cardiology and American Heart Association\/American College of Cardiology recommendations; and propose a core indicator set and staged Cyprus pilot. Guideline-supported interventions should be standardised and audited, whereas screening technologies, digital health, artificial intelligence, and novel phenotyping require governed implementation and prospective assessment of patient outcomes, costs, equity, and unintended consequences. Cyprus is presented as a bounded implementation setting rather than a directly generalisable European model. The plan should be judged through a limited set of clinical, implementation, and equity indicators, including premature cardiovascular mortality, risk factor control, guideline-directed therapy, rehabilitation participation, registry completeness, reach, and fidelity.<\/jats:p>","DOI":"10.3390\/jcm15176614","type":"journal-article","created":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T09:00:35Z","timestamp":1787821235000},"page":"6614","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Closing Europe\u2019s Cardiovascular Implementation Gap: A Critical Review of the Safe Hearts Plan and the Cyprus Test Case"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-1667-3172","authenticated-orcid":false,"given":"Georgios P.","family":"Georghiou","sequence":"first","affiliation":[{"name":"Department of Surgery, Gray Faculty of Medical & Health Sciences, Tel Aviv University, Tel Aviv 6997801, Israel"},{"name":"School of Medicine, European University Cyprus, Nicosia 2404, Cyprus"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2259-5004","authenticated-orcid":false,"given":"Sotiris","family":"Kyriakou","sequence":"additional","affiliation":[{"name":"Barts and The London School of Medicine and Dentistry, Queen Mary University of London (QMUL), London E1 4NS, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7523-9786","authenticated-orcid":false,"given":"Panos","family":"Georghiou","sequence":"additional","affiliation":[{"name":"Barts and The London School of Medicine and Dentistry, Queen Mary University of London (QMUL), London E1 4NS, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amalia","family":"Georgiou","sequence":"additional","affiliation":[{"name":"Krankenhaus Maria-Hilf, 47805 Krefeld, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-5114-7020","authenticated-orcid":false,"given":"Nikolas","family":"Iosif","sequence":"additional","affiliation":[{"name":"Klinik f\u00fcr Gastroenterologie, Hepatologie, Endokrinologie, Diabetologie, Helios Universit\u00e4tsklinikum Wuppertal, 42283 Wuppertal, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Konstantinos","family":"Toutouzas","sequence":"additional","affiliation":[{"name":"School of Medicine, European University Cyprus, Nicosia 2404, Cyprus"},{"name":"First Department of Cardiology, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9439-3946","authenticated-orcid":false,"given":"Andrew","family":"Xanthopoulos","sequence":"additional","affiliation":[{"name":"School of Medicine, European University Cyprus, Nicosia 2404, Cyprus"},{"name":"Department of Cardiology, Faculty of Medicine, University of Thessaly, 41110 Larissa, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Konstantinos","family":"Lampropoulos","sequence":"additional","affiliation":[{"name":"School of Medicine, European University Cyprus, Nicosia 2404, Cyprus"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-7531-9580","authenticated-orcid":false,"given":"Argyris","family":"Kyriakou","sequence":"additional","affiliation":[{"name":"Barking, Havering and Redbridge University Hospitals NHS Trust, London RM7 0AG, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6433-4016","authenticated-orcid":false,"given":"Filippos","family":"Triposkiadis","sequence":"additional","affiliation":[{"name":"School of Medicine, European University Cyprus, Nicosia 2404, Cyprus"},{"name":"Department of Cardiology, Faculty of Medicine, University of Thessaly, 41110 Larissa, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,8,27]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"716","DOI":"10.1093\/eurheartj\/ehab892","article-title":"European Society of Cardiology: Cardiovascular disease statistics 2021","volume":"43","author":"Timmis","year":"2022","journal-title":"Eur. 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