Abstract 12563: Is Cardiometabolic Risk Reduction Sustainable in Routine Practice?

Abstract

Introduction: Sustained cardiometabolic risk reduction is elusive in routine practice. Hypothesis: A multidisciplinary (endocrinology, cardiology, nutrition, diabetes technology/education, and exercise physiology) preventive cardiology center focused on the cardiometabolic-based chronic disease (CMBCD) model can exert long-term risk reduction in patients with and without cardiometabolic presentations. Methods: Yearly attainment of guideline-directed medical therapy targets of the metabolic driver at the most advanced stage in patients from the Center for Clinical Cardiovascular Health at Mount Sinai Heart with adiposity-, dysglycemia-, hypertension-, and lipid-based chronic disease with predisease, disease, or complications was measured. The main outcome was sustainability rate. Results: A total of 270 patients with a mean follow-up of 4.0±1.2 years were included. Sustainability, defined as target attainment in the year in question and in any other previous year(s), was observed in 93/127 (73%), 81/116 (70%), 55/80 (69%), 40/54 (74%), and 11/13 (85%) patients in years of engagement 2, 3, 4, 5, and 6, respectively. The median (interquartile range) number of years reaching the target for sustainers observed was: 2 (2-2); 3 (2-3); 3 (2-3.5); 4 (2-5); 5 (4-6) for patients with 2, 3, 4, 5, or 6 years of engagement at the Center. Conclusions: High sustainability rates for cardiometabolic risk reduction were observed in a multidisciplinary preventive cardiology center based on the CMBCD model with a focus on lifestyle medicine, in patients with and without cardiometabolic presentations.