Abstract 235: A Joint Cardiometabolic Program: An Innovative Approach to Providing Care for High-Risk Patients With Cardiovascular Disease

Abstract

Introduction: There are over 400 million adults with diabetes mellitus (DM) worldwide. Diabetes is associated with multiple vascular complications; atherosclerotic cardiovascular disease (ASCVD) and coronary heart disease (CHD) are major mediators of morbidity and mortality in diabetic patients. In fact, the association between these disease states is so strong that DM is considered a CHD equivalent. New consensus guidelines in both the cardiology and endocrinology literature now support the use of DM medications that enhance cardiovascular health and significantly reduce major adverse cardiovascular events (MACE). Hypothesis: Collaboration among disciplines, particularly endocrinology, cardiology, social work, diabetes education and pharmacy will improve care of patients with co-morbid diabetes and cardiovascular disease. This will be demonstrated by improved adherence to guideline recommended risk modifying treatments. Methods & Conclusions: A collaborative cardiometabolic clinic has been established at a large tertiary care center. The focus of this venture is on the optimization of guideline directed medical therapies through joint office visits with both cardiology and endocrinology. Patients admitted with Type II DM, MI (STEMI or NSTEMI), or CHD requiring CABG, are identified by inpatient providers and referred to our clinic. Prior to the appointment, the patient’s insurance formulary is screened, so that appropriate medications are prescribed at the time of the visit. Patients are then returned to their primary outpatient providers with recommendations for long term management. Observational data from this clinic will be compared to retrospective outcomes analysis of a similar demographic of patients prior to the establishment of this collaborative clinic. As our therapeutic landscape broadens comprehensive cardiometabolic care will continue to be of paramount importance for patients with co-morbid cardiovascular disease and diabetes.