Sodium–glucose cotransporter 2 inhibitors at the intersection of cardiovascular, renal and metabolic care: an integrated and multidisciplinary approach to patient-centered care

Verma, Subodh; Klug, Eric; Mareev, V Yu; Kobalava, Zhanna; Connelly, Kim A.; Arıcı, Mustafa; Berwanger, Otávio; Santoso, Anwar; Mehta, Roopa; Meglis, Gus; Kosiborod, Mikhail

doi:10.1097/hco.0000000000000774

Cited by 3 publications

(2 citation statements)

References 52 publications

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“…This model has now been adopted across multiple centres in the United States, as coordinated through the Cardiometabolic Center Alliance, a national not‐for‐profit organization (http://www.cardiometabolicalliance.org). Similar experiences have been reported at HND‐Centrum in Stockholm, Sweden, as well as dedicated interdisciplinary centres in Canada and in a primary care setting in the United Kingdom 111,129–135 …”

Section: Experience From Integrated Interdisciplinary Care Clinicssupporting

confidence: 61%

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Inter‐relationships between cardiovascular, renal and metabolic diseases: Underlying evidence and implications for integrated interdisciplinary care and management

Vora,

Cherney,

Kosiborod

et al. 2024

Diabetes Obesity Metabolism

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Cardiovascular, renal and metabolic (CaReMe) diseases are individually among the leading global causes of death, and each is associated with substantial morbidity and mortality. However, as these conditions commonly coexist in the same patient, the individual risk of mortality and morbidity is further compounded, leading to a considerable healthcare burden. A number of pathophysiological pathways are common to diseases of the CaReMe spectrum, including neurohormonal dysfunction, visceral adiposity and insulin resistance, oxidative stress and systemic inflammation. Because of the shared pathology and common co‐occurrence of the CaReMe diseases, the value of managing these conditions holistically is increasingly being realized. A number of pharmacological and non‐pharmacological approaches have been shown to offer simultaneous metabolic, cardioprotective and renoprotective benefits, leading to improved patient outcomes across the CaReMe spectrum. In addition, increasing value is being placed on interdisciplinary team‐based and coordinated care models built on greater integration between specialties to increase the rate of early diagnosis and adherence to practice guidelines, and improve clinical outcomes. This interdisciplinary approach also facilitates integration between primary and specialty care, improving the patient experience, optimizing resources, and leading to efficiencies and cost savings. As the burden of CaReMe diseases continues to increase, implementation of innovative and integrated care delivery models will be essential to achieve effective and efficient chronic disease management and to ensure that patients benefit from the best care available across all three disciplines.

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Section: Experience From Integrated Interdisciplinary Care Clinicssupporting

confidence: 61%

“…Similar experiences have been reported at HND-Centrum in Stockholm, Sweden, as well as dedicated interdisciplinary centres in Canada and in a primary care setting in the United Kingdom. 111,[129][130][131][132][133][134][135]…”

Section: Clinical Outcomesmentioning

confidence: 99%

Inter‐relationships between cardiovascular, renal and metabolic diseases: Underlying evidence and implications for integrated interdisciplinary care and management

Vora,

Cherney,

Kosiborod

et al. 2024

Diabetes Obesity Metabolism

Self Cite

View full text Add to dashboard Cite

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Cardiorenal effects of SGLT2 inhibitors: who might benefit?

Klug,

Rayner,

Wasserfall

et al. 2023

Journal of Endocrinology, Metabolism and Diabetes of South Afri

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Potential molecular mechanism underlying cardiac fibrosis in diabetes mellitus: a narrative review

et al. 2023

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Background Diabetes mellitus (DM) is among the most common risk factors for cardiovascular disease in the world with prevalence of more than 500 million population in 2021. Cardiac fibrosis with its complex process has been hypothesized as one of the mechanisms explaining development of heart failure in diabetic patients. Recently, the biomolecular mechanism of cardiac fibrosis in the hyperglycemia setting has been focusing around transforming growth factor β-1 (TGFβ-1) as a major factor. However, there is interplay role of several factors including microRNAs (miRNAs) which acts as a potential regulator of cardiac fibrosis connected with TGFβ-1. In this review, we explored interplay role of several factors including microRNAs which acts as a potential regulator of cardiac fibrosis connected with TGFβ-1 in diabetes mellitus. This narrative review included articles from the PubMed and Science Direct databases published in the last 10 years (2012–2022). Main text In diabetic patients, excessive activation of myofibroblasts occurs and triggers pro-collagen to convert into mature collagen to fill the cardiac interstitial space resulting in a pathological process of extracellular matrix remodeling. The balance between matrix metalloproteinase (MMP) and its inhibitor (tissue inhibitor of metalloproteinase, TIMP) is crucial in degradation of the extracellular matrix. Diabetes-related cardiac fibrosis is modulated by increasing level of TGF-β1 mediated by cellular components, including cardiomyocyte and non-cardiomyocyte cells involving fibroblasts, vascular pericytes smooth muscle cells, endothelial cells, mast cells, macrophages, and dendritic cells. Several miRNAs such as miR-21, miR-9, miR-29, miR-30d, miR-144, miR-34a, miR-150, miR-320, and miR-378 are upregulated in diabetic cardiomyopathy. TGF-β1, together with inflammatory cytokines, oxidative stress, combined sma and the mothers against decapentaplegic (smad) protein, mitogen-activated protein kinase (MAPK), and microRNAs, is interconnectedly involved in extracellular matrix production and fibrotic response. In this review, we explored interplay role of several factors including microRNAs which acts as a potential regulator of cardiac fibrosis connected with TGFβ-1 in diabetes mellitus. Conclusions Long-term hyperglycemia activates cardiac fibroblast via complex processes involving TGF-β1, miRNA, inflammatory chemokines, oxidative stress, smad, or MAPK pathways. There is increasing evidence of miRNA’s roles lately in modulating cardiac fibrosis.

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Sodium–glucose cotransporter 2 inhibitors at the intersection of cardiovascular, renal and metabolic care: an integrated and multidisciplinary approach to patient-centered care

Cited by 3 publications

References 52 publications

Inter‐relationships between cardiovascular, renal and metabolic diseases: Underlying evidence and implications for integrated interdisciplinary care and management

Inter‐relationships between cardiovascular, renal and metabolic diseases: Underlying evidence and implications for integrated interdisciplinary care and management

Cardiorenal effects of SGLT2 inhibitors: who might benefit?

Potential molecular mechanism underlying cardiac fibrosis in diabetes mellitus: a narrative review

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