1077-P: A Multicenter Initiative to Improve Care in Cardiometabolic Disease—Initial Report From Cardiometabolic Center Alliance (CMCA)
Authors: KOSIBOROD MIKHAIL N. , MAGWIRE MELISSA L. , AISTROPE DANIEL S. , ANDAYA EMILY , BUTLER JAVED , CUMMINGS KATIE , DAVIS LISA , ECKEL ROBERT H. , FIALKOW JONATHAN A. , FRYOUX ELIZABETH , HARNESS LACY , HEATH REBECCA , MILLER KEITH A. , NEELAND IAN , PATEL SHACHI , PLUTZKY JORGE , SAALFELD ROSALIE K. , STAFOS ANDREA , RAJAGOPALAN SANJAY 
Published: June 2023

Background: Despite high risk, minority of individuals with Type 2 diabetes (T2D) and cardiovascular or chronic kidney disease (CVD/CKD) receives optimal guideline directed medical therapy (GDMT). Professional societies advocate for collaborative, team-based models to improve care in this group but successful multicenter implementation efforts are lacking.
Methods: CMCA is a non for profit organization that seeks to transform care and outcomes in individuals with cardiometabolic disease. CMCA assists members in implementing team-based, coordinated care models (Cardiometabolic Centers) and GDMT driven pathways. Quality of care and outcomes are monitored via multicenter registry. Since launch in 2020, 14 US organizations joined CMCA. This initial report includes sites with data reported for ≥30 participants (each with ≥ 2 visits).
Results: In total 606 individuals with T2D and CVD/CKD from 6 sites were evaluated (age 64 years, 44% women, 78% white, median follow up 6 months). After initiation of care at CMCA sites, large improvements in GDMT and reductions in weight, HbA1c, blood pressure, total/LDL cholesterol, triglycerides, and insulin requirements were observed (Figure panels 1 and 2; p&lt; 0.001 for all).
Conclusion: CMCA directed implementation of coordinated team-based care produced rapid and large improvements in GDMT and quality of care across multiple sites.

Disclosure
M.N.Kosiborod: Consultant; Alnylam Pharmaceuticals, Inc., Amgen Inc., Applied Therapeutics Inc., AstraZeneca, Bayer Inc., Boehringer Ingelheim Inc., Cytokinetics Inc., Dexcom, Inc., Eli Lilly and Company, ESPERION Therapeutics, Inc., Janssen Pharmaceuticals, Inc., Lexicon Pharmaceuticals, Inc., Merck & Co., Inc., Novo Nordisk, Pharmacosmos A/S, Pfizer Inc., Sanofi, Vifor Pharma Management Ltd., Youngene Therapeutics, Other Relationship; AstraZeneca, Research Support; AstraZeneca, Boehringer Ingelheim Inc. E.Fryoux: None. L.Harness: None. R.Heath: None. K.A.Miller: None. I.Neeland: Consultant; Nestlé Health Science, Speaker's Bureau; Boehringer Ingelheim and Eli Lilly Alliance, Bayer Inc. S.Patel: None. J.Plutzky: Advisory Panel; ESPERION Therapeutics, Inc., Consultant; Amgen Inc., Merck & Co., Inc., Novo Nordisk, Research Support; Boehringer Ingelheim Inc. R.K.Saalfeld: None. A.Stafos: None. S.Rajagopalan: Advisory Panel; Novartis, Novo Nordisk, Speaker's Bureau; Novo Nordisk. M.L.Magwire: Consultant; AstraZeneca, Novo Nordisk. D.S.Aistrope: None. E.Andaya: None. J.Butler: Consultant; Abbott,, Amgen, Applied Therapeutics, Array, Astra Zeneca, Bayer,, Boehringer Ingelheim, Bristol Myers Squibb, CVRx, G3 Pharma,, Impulse Dynamics, Innolife, Janssen, LivaNova, Luitpold, Medtronic, Merck, Novartis, NovoNordisk, Relypsa, Roche, Sequana Medical, Vifor, Speaker's Bureau; Novartis, Boehringer Ingelheim-Lilly, Astra Zeneca, Janssen. K.Cummings: None. L.Davis: Speaker's Bureau; Amgen Inc. R.H.Eckel: Advisory Panel; Amarin Corporation, 89bio, Inc., Novo Nordisk, Weight Watchers International, Board Member; Lexicon Pharmaceuticals, Inc., Consultant; Amgen Inc., Better Therapeutics, Inc, The Healthy Aging Company, Other Relationship; Arrowhead Pharmaceuticals, Inc. J.A.Fialkow: Speaker's Bureau; Amgen Inc., ESPERION Therapeutics, Inc., Amarin Corporation.

Funding
AstraZeneca; Boehringer Ingelheim; Novo Nordisk, Amgen Inc.; Eli Lilly and Company; Novartis