Abstract 12895: Classification of Patients According to the Cardiometabolic-Based Chronic Disease Model in a Preventive Cardiology Center

Abstract

Introduction: Cardiovascular disease results from complex interactions between metabolic drivers. The purpose of the novel cardiometabolic-based chronic disease model is to expose opportunities for early and sustainable prevention. Hypothesis: The cardiometabolic-based chronic disease (CMBCD) model allows allocation of patients with stage 1 (“risk”), stage 2 (“predisease”), stage 3 (“disease”), and stage 4 (“complications”) of each of the four metabolic drivers - adiposity, dysglycemia, dyslipidemia, and hypertension. Methods: Patients with a visit at the Center for Cardiovascular Health at Mount Sinai Heart, a multidisciplinary preventive cardiology center, were classified according to the CMBCD model relative to baseline characteristics. The context of this classification is the determination, based on statistical and mechanistic corroboration, of a dominant driver to be used to subsequently determine response and sustainability rates. Results: The most frequent dominant driver was adiposity-based chronic disease, in 642 (76.9%) patients, followed by dysglycemia-based chronic disease, in 104 (12.5%), hypertension-based chronic disease in 76 (7.5%), and lipid-based chronic disease in 13 (1.3%). A very large proportion of patients with adiposity-, dysglycemia-, and hypertension-based chronic disease (49%, 57%, and 25%, respectively) present with “complications” of “predisease” and “disease”. Conclusions: Abnormal adiposity and dysglycemia have proximal roles in the pathogenesis of cardiovascular disease in the cardiometabolic-based chronic disease model. This presents a window of opportunity for early lifestyle prevention strategies.