{
  "abstract": "Introduction Diabetes mellitus (DM) remains a prevalent condition worldwide and a significant risk factor for atherosclerotic cardiovascular disease. Recent evidence suggest the use of glucose lowering therapies with cardiovascular benefit in optimising the cardiometabolic profile of patients with type 2 diabetes mellitus. However, uptake remains low, particularly in patients presenting with acute coronary syndrome (ACS). This study was carried out to assess the impact of a novel cardiodiabetes service for the management of patients with diabetes mellitus presenting with acute coronary syndromes.Purpose To assess the impact of a dedicated cardiodiabetic service on (i) screening and monitoring of patients for DM via a valid glycated haemoglobin (HbA1c) (ii) early optimisation of glucose lowering therapies with proven cardiovascular benefit and (iii) impact on reno-cardiovascular outcomes including all cause death and hospitalisations.Methods A retrospective, observational, registry based analysis was performed among patients presenting with ACS and DM to a regional heart centre, before and after the implementation of a cardiodiabetes service. Intergroup comparison was made for the proportion of patients having a valid HbA1c during admission, initiation of guideline recommended glucose lowering therapies and outcome events analysis using Chi-square test, Poisson regression and Wald test with survival analysis performed using Kaplan-Meier method.Results At median follow up of 29.7 months, a valid HbA1c measurement at baseline was lower in the pre-intervention compared to the post-intervention group (556/711 [78.2%] vs 302/362 [83.4%], p=0.043) while more patients in the post-intervention group were prescribed sodium glucose co-transporter inhibitors (297/362 [82.0%] vs 359/711 [50.5%]. All-cause mortality (5.2 vs 12.3 [events/100-patient-years], relative ratio [RR] 0.42, 95% confidence interval [CI] 0.28–0.61, and p<0.001), first events of acute kidney injury (AKI) (10.0 vs 13.0, RR 0.77, CI 0.57–1.03, p=0.090), all events of AKI (16.6 vs 22.1, RR 0.75, CI 0.60–0.94, p=0.015) and all-cause events requiring urgent hospitalisation (47.1 vs 64.0 events per 100 patient-years, RR 0.74, CI 0.64–0.84, p<0.001) were significantly lower in the post-intervention group.Abstract 2-044 Figure 1Prescription of SGLT2is among eligible patients with T2DM and ACS on a yearly: cardiodiabetic programme established in 2021. Note: cardiodiabetic clinic started in summer 2021 and active in-reach service commenced in autumn 2022Abstract 2-044 Figure 2Kaplan-Meier graphs of first events of all cause death (A), acute kidney injury (B), hospitalisation for heart failure (C), myocardial infarction (D), hospitalisation for unstable angina (E) and stroke/transient ischaemic attack (TIA) (F)Conclusion The introduction of a joint-speciality cardiodiabetes service suggested improved care and survival of patients with reduction in reno-cardiovascular events in patients with DM when presenting with ACS.",
  "authors": [
    {
      "affiliations": [
        "Cardiorenal Group, Diabetes, Metabolism, and Inflammation, Joseph Bank Laboratories, University of Lincoln, Lincoln",
        "Lincoln Heart Centre, United Lincolnshire Hospitals, Lincoln"
      ],
      "name": "MU Shah"
    },
    {
      "affiliations": [
        "Lincoln Heart Centre, United Lincolnshire Hospitals, Lincoln"
      ],
      "name": "A Roebuck"
    },
    {
      "affiliations": [
        "Department of Diabetes and Endocrinology, United Lincolnshire Hospitals, Lincoln"
      ],
      "name": "B Srinivasan"
    },
    {
      "affiliations": [
        "Cardiorenal Group, Diabetes, Metabolism, and Inflammation, Joseph Bank Laboratories, University of Lincoln, Lincoln"
      ],
      "name": "JK Ward"
    },
    {
      "affiliations": [
        "Cardiorenal Group, Diabetes, Metabolism, and Inflammation, Joseph Bank Laboratories, University of Lincoln, Lincoln"
      ],
      "name": "PE Squires"
    },
    {
      "affiliations": [
        "Lincoln Institute for Rural and Coastal Health, University of Lincoln, Lincoln"
      ],
      "name": "M Inghels"
    },
    {
      "affiliations": [
        "Cardiorenal Group, Diabetes, Metabolism, and Inflammation, Joseph Bank Laboratories, University of Lincoln, Lincoln"
      ],
      "name": "CE Hills"
    },
    {
      "affiliations": [
        "Cardiorenal Group, Diabetes, Metabolism, and Inflammation, Joseph Bank Laboratories, University of Lincoln, Lincoln",
        "Lincoln Heart Centre, United Lincolnshire Hospitals, Lincoln"
      ],
      "name": "K Lee"
    }
  ],
  "title": "2-044 Reducing reno-cardiovascular risk and mortality though a specialised multi-disciplinary cardiodiabetic service approach for early optimisation of care among patients with diabetes mellitus and acute coronary syndrome",
  "uid": "3a473ef1-c81d-5be0-aba5-95d45407edfe"
}