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一家专业的心脏代谢诊所在管理2型糖尿病和动脉粥样硬化性心血管疾病高危患者中的作用和影响。

Role and impact of a specialized cardiometabolic clinic in managing high-risk patients with type 2 diabetes and atherosclerotic cardiovascular disease.

作者信息

Modarressi Taher

机构信息

Advocare Princeton Cardiometabolic Health, 21 Route 31N, Ste B6, Pennington, NJ 08534, United States.

出版信息

Am J Prev Cardiol. 2024 Jul 1;19:100706. doi: 10.1016/j.ajpc.2024.100706. eCollection 2024 Sep.

DOI:10.1016/j.ajpc.2024.100706
PMID:39070023
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11278552/
Abstract

BACKGROUND

Lipid-related risk and residual cardiovascular risk remain high in patients with type 2 diabetes (T2D) and atherosclerotic cardiovascular disease (ASCVD). Significant treatment gaps exist in implementation of pluripotent and effective therapies that reduce these risks.

OBJECTIVE

This study evaluates the efficacy and impact of a dedicated, standalone cardiometabolic clinic designed to address treatment gaps through streamlined management and optimization of treatment strategies.

METHODS

We retrospectively collected data from the first 400 patients with T2D and ASCVD who underwent treatment at the clinic and presented for at least one follow-up visit. These patients were primarily managed for their cardiometabolic risks and received intensified lipid-lowering therapies, including adjunct non-statin therapies.

RESULTS

Significant findings included increased use of glucagon-like peptide-1 receptor agonists (GLP1RA) and sodium-glucose cotransporter 2 inhibitors (SGLT2i) to 84 % and 65 %, respectively, with 94 % of patients eventually on one therapy and 55 % on dual therapy. Increases in lipid-lowering therapies led to 89 % of patients achieving low-density lipoprotein cholesterol levels below patient-specific thresholds for intensification.

CONCLUSION

This care model effectively manages high-risk patient needs, achieving significant intensification of lipid-lowering therapies and broad use of cardiometabolic drugs, and highlights the clinic's potential to serve as a model for similar high-risk populations.

摘要

背景

2型糖尿病(T2D)和动脉粥样硬化性心血管疾病(ASCVD)患者的血脂相关风险和残余心血管风险仍然很高。在实施降低这些风险的多能有效疗法方面存在显著的治疗差距。

目的

本研究评估了一个专门的独立心脏代谢诊所的疗效和影响,该诊所旨在通过简化管理和优化治疗策略来解决治疗差距。

方法

我们回顾性收集了在该诊所接受治疗并至少进行了一次随访的前400例T2D和ASCVD患者的数据。这些患者主要针对其心脏代谢风险进行管理,并接受了强化降脂治疗,包括辅助非他汀类治疗。

结果

显著发现包括胰高血糖素样肽-1受体激动剂(GLP1RA)和钠-葡萄糖协同转运蛋白2抑制剂(SGLT2i)的使用分别增加到84%和65%,94%的患者最终接受一种治疗,55%的患者接受双重治疗。降脂治疗的增加导致89%的患者低密度脂蛋白胆固醇水平低于患者特定的强化阈值。

结论

这种护理模式有效地满足了高危患者的需求,实现了降脂治疗的显著强化和心脏代谢药物的广泛使用,并突出了该诊所作为类似高危人群模型的潜力。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/462a/11278552/aabba6401cb9/gr1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/462a/11278552/aabba6401cb9/gr1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/462a/11278552/aabba6401cb9/gr1.jpg

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