Cardiometabolic Center of Excellence: Analysis of Two-year Outcomes

Background Cardiovascular and kidney complications of T2D are increasing, in part due to suboptimal implementation of guideline-directed therapies. The Saint Luke's Haverty Cardiometabolic Center (CMC) of Excellence implements team-based, patient-centered approach focused on comprehensive risk reduction for patients with T2D and CVD, including use of cardioprotective agents such as GLP-1RA and SGLT-2i. We assessed outcomes during the first two years of CMC. Methods We included consecutive patients with at least two CMC visits January 2019-December 2020. We compared change in outcomes of interest between baseline and last CMC visits. Results Among 382 patients, mean age was 64.8±10.8 years, 62% were men, 81% Caucasian, BMI was 35.8±7.3 kg/m2, 90% had T2D. At baseline, 52(14%) patients were on GLP-1RA [5(1%) on target dose], and 86(23%) on SGLT-2i. After median follow-up of 6.5(3.7-11.4) months, 338(89%) patients were receiving GLP-1RA [249(65%) on target dose], and 240(63%) SGLT-2i, with 222(58%) on both agents. During follow-up, patients experienced significant reductions in body weight (235.2±51.7 to 220.1±50.9 lbs.; p Conclusion CMC approach was associated with greater adoption of guideline-directed therapies and substantial reductions in key CVD risk factors. Treatments were generally well tolerated. Adoption of novel care models such as CMC is important for more effective implementation of guidelines into practice.