{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T20:14:49Z","timestamp":1790280889687,"version":"4.1.0"},"reference-count":27,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"7","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circ: Population Health and Outcomes"],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:sec>\n                    <jats:title>BACKGROUND:<\/jats:title>\n                    <jats:p>Cardiovascular diseases (CVD) are leading causes of morbidity and mortality among patients with cardiovascular-kidney-metabolic syndrome. Adoption of guideline-directed medical therapy remains suboptimal. Our objective was to evaluate the impact of a team-based multisite care model on improving quality and reducing disparities in patients with cardiovascular-kidney-metabolic syndrome.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS:<\/jats:title>\n                    <jats:p>We conducted a prospective clinical cohort study across 9 US sites of the Cardiometabolic Center Alliance, a network of health care organizations with a standardized approach to address CVD risk, between May 2020 and August 2024. Consecutive patients with type 2 diabetes\/prediabetes and CVD and chronic kidney disease were enrolled in a clinical program with team care, structured visits, and standardized assessments. Cardiometabolic risk factor levels and proportion of adherence to guideline-directed medical therapy were assessed using longitudinal mixed-effects models accounting for clustering by site.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS:<\/jats:title>\n                    <jats:p>\n                      Two thousand two hundred twenty-three individuals were enrolled with a mean (SD) age of 63.9 (11.2) years, 44.2% female, 84.0% White, and 62.5% noncommercially insured; 58.5% had atherosclerotic CVD, 32.6% heart failure, and 29.5% chronic kidney disease. Median follow-up was 6.8 (4.0\u20139.4) months. Participants had reductions in weight (mean [95% CI], \u221216.7 [\u221217.9 to \u221215.6] lbs), body mass index (\u22122.6 [\u22122.8 to \u22122.4] kg\/m\n                      <jats:sup>2<\/jats:sup>\n                      ), systolic (\u22125.8 [\u22127.0 to \u22124.6] mm\u2009Hg) and diastolic (\u22121.7 [\u22122.4 to\u22120.9] mm\u2009Hg) blood pressure, total cholesterol (\u221226.4 [\u221229.5 to \u221223.2] mg\/dL), low-density lipoprotein cholesterol (\u221218.8 [\u221221.4 to \u221216.2] mg\/dL), triglycerides (\u221245.1 [\u221254.0 to \u221236.3] mg\/dL), fasting glucose (\u221230.9 [\u221235.4 to \u221226.4] mg\/dL), HbA1c (\u22121.2 [\u22121.3% to \u22121.0%]), and insulin dose (\u221230.4 [\u221236.1 to \u221224.8] units\/d),\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt;0.001 for all. Guideline-directed medical therapy increased from 31.0% to 59.6% for atherosclerotic CVD type 2 diabetes and from 33.3% to 63.8% for chronic kidney disease type 2 diabetes,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt;0.001.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS:<\/jats:title>\n                    <jats:p>The Cardiometabolic Center Alliance model is feasible and effective, leading to significant improvement in CVD risk factors and increased utilization of GDMT. Implementation and dissemination of this paradigm remains a priority to close gaps in cardiometabolic care.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/circoutcomes.125.012828","type":"journal-article","created":{"date-parts":[[2026,6,22]],"date-time":"2026-06-22T09:00:25Z","timestamp":1782118825000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["Optimizing Care in Cardiovascular-Kidney-Metabolic Syndrome: Registry Data From the Cardiometabolic Center Alliance"],"prefix":"10.1161","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2831-3618","authenticated-orcid":true,"given":"Ian J.","family":"Neeland","sequence":"first","affiliation":[{"name":"Department of Medicine, Case Western Reserve University School of Medicine, Cleveland, OH (I.J.N., S.R.)."},{"name":"Division of Cardiovascular Medicine, University Hospitals Harrington Heart and Vascular Institute, University Hospitals Cleveland Medical Center, OH (I.J.N., A.K., S.R.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Melissa L.","family":"Magwire","sequence":"additional","affiliation":[{"name":"Saint Luke\u2019s Michael &amp; Marlys Haverty Cardiometabolic Center of Excellence, Kansas City, MO (M.L.M., A.J.S., M.N.K.)."},{"name":"Cardiometabolic Center Alliance, American Heart Association, Dallas, TX (M.L.M., D.S.A., A.S., A.J.S.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-6535-5379","authenticated-orcid":true,"given":"Audrey","family":"Kwun","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Medicine, University Hospitals Harrington Heart and Vascular Institute, University Hospitals Cleveland Medical Center, OH (I.J.N., A.K., S.R.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8560-3702","authenticated-orcid":true,"given":"Daniel S.","family":"Aistrope","sequence":"additional","affiliation":[{"name":"Cardiometabolic Center Alliance, American Heart Association, Dallas, TX (M.L.M., D.S.A., A.S., A.J.S.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emily Ann Kapunan","family":"Andaya","sequence":"additional","affiliation":[{"name":"Major Health Partners, Shelbyville, IN (E.A.K.A., A.B., L.H.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anthony","family":"Bashall","sequence":"additional","affiliation":[{"name":"Major Health Partners, Shelbyville, IN (E.A.K.A., A.B., L.H.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8992-6197","authenticated-orcid":true,"given":"Catherine P.","family":"Benziger","sequence":"additional","affiliation":[{"name":"Heart and Vascular Center, Essentia Health, Duluth, MN (C.P.B.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9539-8805","authenticated-orcid":true,"given":"Natalia","family":"De Albuquerque Rocha","sequence":"additional","affiliation":[{"name":"Southern Medical Group, Tallahassee, FL (N.D.A.R.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7683-4720","authenticated-orcid":true,"given":"Javed","family":"Butler","sequence":"additional","affiliation":[{"name":"University of Mississippi Medical Center, Jackson (J.B.)."},{"name":"Baylor Scott and White Healthcare, Dallas, TX (J.B.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lisa","family":"Davis","sequence":"additional","affiliation":[{"name":"Baptist Health South Florida, Miami, FL (L.D., A.I.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dawn","family":"Denicola","sequence":"additional","affiliation":[{"name":"Louisiana Cardiology Associates, Baton 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