Carotid artery disease, the primary trigger of ischaemic cerebrovascular events including stroke, causes major morbidity, mortality and healthcare costs worldwide. Still, treatment is based on criteria established in the 90s that do not take into account the molecular evolution we have witnessed since, nor the introduction of new medication, leading to remarkably high unnecessary surgical treatment while missing most patients at risk. TAXINOMISIS will provide novel disease mechanism-based stratification for carotid artery disease patients to address the needs for stratified and personalised therapeutic interventions in the current era. This will be achieved through (1) the dissection of mechanisms mediating carotid artery disease, and identification of susceptibility and protection factors of plaque erosion and/or rupture using longitudinal cohorts and multi-omics, (2) the definition of distinct disease phenotypes and endotypes, and generation of molecular fingerprints of high versus low-risk states through systems medicine, (3) the development of a multilevel risk prediction model of the symptomatic plaque incorporating new biomarkers and advanced imaging, implemented in a software, to assist patient stratification and clinical decision making, (4) the development of novel pharmacogenomics solutions based on lab-on-a-chip technology to support personalized treatment, (5) the evaluation of the new risk prediction model and lab-on-a-chip device in a prospective observational clinical study, and (6) the assessment of regulatory, cost-effectiveness and ethical issues towards the implementation and commercialization of the programme’s outcomes. TAXINOMISIS has therefore the potential to rationally change the current state-of-the-art in the stratification of patients with carotid artery disease by reducing unnecessary operations, refining medical treatment and opening up new avenues for therapeutic intervention, while strengthening the European biotechnology sector.

European Coronary Heart Disease (CHD) burden is unsustainable. Better risk stratification tools and personalized care of patients are needed for reducing morbidity and mortality of CHD and the associated economic burden. To this end we have planned to shape and implement a personalized secondary prevention program for patients with established CHD. This precision strategy will be tested in a prospective trial, the CoroPrevention Trial, a central element of our proposal. We aim to significantly reduce the numbers of coronary events by using outcome risk- and patient characteristics- guided prevention in CHD patients. 1. Prospectively evaluate clinical utility of personalized prevention in CHD 2. Evaluate health economic and social benefits of the personalized prevention in CHD 3. Discover predictive markers of drug treatment response in CHD 4. Improve current ESC guidelines based on RCT validated clinical data 5. Disseminate the refined prevention program to the attention of practitioners, patients, health care payers and policy makers This program will establish a new economically sustainable personalized treatment practice applicable throughout Europe particularly to those regions where CHD prevention needs upgrading. The used protocols and technologies will carefully assessed by NICE using their standard evaluation methods that will allow independent expert opinions for different European authorities and decision makers. These opinion statements will further be supported by full Health Economics analyses of CoroPrevention Trial.