Medscape InDiscussion: Cardiorenal Metabolic Syndrome

Join Drs Nihar Desai and Neda Rasouli as they discuss the evolution of obesity treatment over the past two decades, including the latest novel therapies.

Relevant disclosures can be found with the episode show notes on Medscape https://www.medscape.com/viewarticle/999845. The topics and discussions are planned, produced, and reviewed independently of advertisers. This podcast is intended only for US healthcare professionals.

Resources

Cardiovascular-Kidney-Metabolic (CKM) Syndrome: A State-of-the-Art Review https://pubmed.ncbi.nlm.nih.gov/38103820/

Obesity https://emedicine.medscape.com/article/123702-overview

A Synopsis of the Evidence for the Science and Clinical Management of Cardiovascular-Kidney-Metabolic (CKM) Syndrome: A Scientific Statement From the American Heart Association https://pubmed.ncbi.nlm.nih.gov/37807920/

Obesity and Severe Obesity Prevalence in Adults: United States, August 2021–August 2023 https://www.cdc.gov/nchs/products/databriefs/db508.htm

Physiology, Obesity Neurohormonal Appetite and Satiety Control https://www.ncbi.nlm.nih.gov/books/NBK555906/

Melanocortin-4 Receptor Complexity in Energy Homeostasis, Obesity and Drug Development Strategies https://pubmed.ncbi.nlm.nih.gov/34882941/

Bariatric Surgery https://emedicine.medscape.com/article/197081-overview

The Effects of Bariatric Surgery on Cardiovascular Outcomes and Cardiovascular Mortality: A Systematic Review and Meta-Analysis https://pubmed.ncbi.nlm.nih.gov/36909063/

Semaglutide and Cardiovascular Outcomes in Obesity Without Diabetes https://pubmed.ncbi.nlm.nih.gov/37952131/

Comparison of Tirzepatide and Dulaglutide on Major Adverse Cardiovascular Events in Participants With Type 2 Diabetes and Atherosclerotic Cardiovascular Disease: SURPASS-CVOT Design and Baseline Characteristics https://pubmed.ncbi.nlm.nih.gov/37758044/

A Study of Tirzepatide (LY3298176) on the Reduction on Morbidity and Mortality in Adults With Obesity (SURMOUNT-MMO) https://clinicaltrials.gov/study/NCT05556512

Effects of Semaglutide on Chronic Kidney Disease in Patients With Type 2 Diabetes https://pubmed.ncbi.nlm.nih.gov/38785209/

Join Drs Nihar Desai and Seth Martin as they discuss low-density lipoprotein (LDL) cholesterol, dyslipidemia, and lipoprotein(a) for patients with cardiorenal metabolic syndrome.

Relevant disclosures can be found with the episode show notes on Medscape https://www.medscape.com/viewarticle/999844. The topics and discussions are planned, produced, and reviewed independently of advertisers. This podcast is intended only for US healthcare professionals.

Resources

Benefit of Adding Ezetimibe to Statin Therapy on Cardiovascular Outcomes and Safety in Patients With Versus Without Diabetes Mellitus: Results From IMPROVE-IT (Improved Reduction of Outcomes: Vytorin Efficacy International Trial) https://pubmed.ncbi.nlm.nih.gov/29263150/

Evolocumab and Clinical Outcomes in Patients With Cardiovascular Disease https://pubmed.ncbi.nlm.nih.gov/28304224/

Bempedoic Acid and Cardiovascular Outcomes in Statin-Intolerant Patients https://pubmed.ncbi.nlm.nih.gov/36876740/

Two Phase 3 Trials of Inclisiran in Patients With Elevated LDL Cholesterol https://pubmed.ncbi.nlm.nih.gov/32187462/

Study of Heart and Renal Protection (SHARP): Randomized Trial to Assess the Effects of Lowering Low-Density Lipoprotein Cholesterol Among 9438 Patients With Chronic Kidney Disease https://pubmed.ncbi.nlm.nih.gov/21095263/

Cardiovascular Risk Reduction With Icosapent Ethyl for Hypertriglyceridemia https://pubmed.ncbi.nlm.nih.gov/30415628/

Effect of Pelacarsen on Lipoprotein(a) Cholesterol and Corrected Low-Density Lipoprotein Cholesterol https://pubmed.ncbi.nlm.nih.gov/35300814/

Small Interfering RNA to Reduce Lipoprotein(a) in Cardiovascular Disease https://pubmed.ncbi.nlm.nih.gov/36342163/

Lipoprotein(a) in Atherosclerotic Cardiovascular Disease and Aortic Stenosis: A European Atherosclerosis Society Consensus Statement https://pubmed.ncbi.nlm.nih.gov/36036785/

A Focused Update to the 2019 NLA Scientific Statement on Use of Lipoprotein(a) in Clinical Practice https://pubmed.ncbi.nlm.nih.gov/38565461/

Drs Nihar Desai, Andrew J. Sauer, and Matthew A. Sparks discuss novel therapies in cardiorenal metabolic syndrome, focusing in on the MRAs and potassium binders.

Relevant disclosures can be found with the episode show notes on Medscape https://www.medscape.com/viewarticle/999843. The topics and discussions are planned, produced, and reviewed independently of advertisers. This podcast is intended only for US healthcare professionals.

Resources

The Kidney Failure Risk Equation: Evaluation of Novel Input Variables Including eGFR Estimated Using the CKD-EPI 2021 Equation in 59 Cohorts https://pubmed.ncbi.nlm.nih.gov/36857500/

Cardiovascular-Kidney-Metabolic Health: A Presidential Advisory From the American Heart Association https://pubmed.ncbi.nlm.nih.gov/37807924/

KDIGO 2024 Clinical Practice Guideline for the Evaluation and Management of Chronic Kidney Disease https://pubmed.ncbi.nlm.nih.gov/38490803/

Heart Failure in Patients With Chronic Kidney Disease https://pubmed.ncbi.nlm.nih.gov/37763045/

Lokelma Prescribing Information https://den8dhaj6zs0e.cloudfront.net/50fd68b9-106b-4550-b5d0-12b045f8b184/6de8f71b-d3af-4f76-9600-907c98616be6/6de8f71b-d3af-4f76-9600-907c98616be6_viewable_rendition__v.pdf

Sodium Zirconium Cyclosilicate in Hyperkalemia https://pubmed.ncbi.nlm.nih.gov/25415807/

Veltassa Prescribing Information https://veltassa.com/pi

Patiromer for the Management of Hyperkalemia in Heart Failure With Reduced Ejection Fraction: The DIAMOND Trial https://pubmed.ncbi.nlm.nih.gov/35900838/

Sodium Zirconium Cyclosilicate in HFrEF and Hyperkalemia: REALIZE-K Design and Baseline Characteristics https://pubmed.ncbi.nlm.nih.gov/38878009/

Effect of Finerenone on Chronic Kidney Disease Outcomes in Type 2 Diabetes https://pubmed.ncbi.nlm.nih.gov/33264825/

Finerenone Reduces Risk of Incident Heart Failure in Patients With Chronic Kidney Disease and Type 2 Diabetes: Analyses From the FIGARO-DKD Trial https://pubmed.ncbi.nlm.nih.gov/34775784/

Press Release: First Patient Enrolled in CARE-HK in HF to Evaluate Role of Veltassa® (Patiromer) in Enabling RAASi Treatment https://newsroom.csl.com/2021-04-28-First-patient-enrolled-in-CARE-HK-in-HF-to-evaluate-role-of-Veltassa-R-patiromer-in-enabling-RAASi-treatment

Medical Therapy for Heart Failure With Reduced Ejection Fraction: The CHAMP-HF Registry https://pubmed.ncbi.nlm.nih.gov/30025570/

Finerenone in Patients With Heart Failure With Mildly Reduced or Preserved Ejection Fraction: Rationale and Design of the FINEARTS-HF Trial https://pubmed.ncbi.nlm.nih.gov/38742248/

Additional Studies With Finerenone Across a Wide Range of Heart Failure Patients Initiated https://www.bayer.com/media/en-us/additional-studies-with-finerenone-across-a-wide-range-of-heart-failure-patients-initiated/

Treatment Effects of Empagliflozin in Hospitalized Heart Failure Patients Across the Range of Left Ventricular Ejection Fraction — Results From the EMPULSE Trial https://pubmed.ncbi.nlm.nih.gov/38572654/

Safety, Tolerability and Efficacy of Up-Titration of Guideline-Directed Medical Therapies for Acute Heart Failure (STRONG-HF): A Multinational, Open-Label, Randomised, Trial https://pubmed.ncbi.nlm.nih.gov/36356631/

Steroidal MRA Across the Spectrum of Renal Function: A Pooled Analysis of RCTs https://pubmed.ncbi.nlm.nih.gov/36328653/

Join Drs Nihar Desai and Matthew Cavender as they discuss the history, studies, and implementation of GLP-1 receptor agonists for people with cardiorenal metabolic syndrome.

Relevant disclosures can be found with the episode show notes on Medscape https://www.medscape.com/viewarticle/999842. The topics and discussions are planned, produced, and reviewed independently of advertisers. This podcast is intended only for US healthcare professionals.

Resources

Glucagon-Like Peptide-1 Receptor Agonists https://www.ncbi.nlm.nih.gov/books/NBK551568/#:~:text=Glucagon%2Dlike%20peptide%2D1%20(,options%20for%20these%20endocrine%20diseases.

Effect of Rosiglitazone on the Risk of Myocardial Infarction and Death From Cardiovascular Causes https://pubmed.ncbi.nlm.nih.gov/17517853/

Guidance for Industry on Diabetes Mellitus-Evaluating Cardiovascular Risk in New Antidiabetic Therapies to Treat Type 2 Diabetes; Availability https://www.federalregister.gov/documents/2008/12/19/E8-30086/guidance-for-industry-on-diabetes-mellitus-evaluating-cardiovascular-risk-in-new-antidiabetic

Liraglutide and Cardiovascular Outcomes in Type 2 Diabetes https://pubmed.ncbi.nlm.nih.gov/27295427/

Effects of Oral Semaglutide on Cardiovascular Outcomes in Individuals With Type 2 Diabetes and Established Atherosclerotic Cardiovascular Disease and/or Chronic Kidney Disease: Design and Baseline Characteristics of SOUL, a Randomized Trial https://pubmed.ncbi.nlm.nih.gov/36945734/

Semaglutide and Cardiovascular Outcomes in Obesity Without Diabetes https://pubmed.ncbi.nlm.nih.gov/37952131/

Heart Failure With Preserved Ejection Fraction (HFpEF) https://www.ncbi.nlm.nih.gov/books/NBK599960/

Effects of Liraglutide on Clinical Stability Among Patients With Advanced Heart Failure and Reduced Ejection Fraction: A Randomized Clinical Trial https://pubmed.ncbi.nlm.nih.gov/27483064/

Semaglutide Versus Placebo in People With Obesity-Related Heart Failure With Preserved Ejection Fraction: A Pooled Analysis of the STEP-HFpEF and STEP-HFpEF DM Randomised Trials https://pubmed.ncbi.nlm.nih.gov/38599221/

Interpreting the Kansas City Cardiomyopathy Questionnaire in Clinical Trials and Clinical Care: JACC State-of-the-Art Review https://pubmed.ncbi.nlm.nih.gov/33183512/

Comparison of Tirzepatide and Dulaglutide on Major Adverse Cardiovascular Events in Participants With Type 2 Diabetes and Atherosclerotic Cardiovascular Disease: SURPASS-CVOT Design and Baseline Characteristics https://pubmed.ncbi.nlm.nih.gov/37758044/

Coordinated Care to Optimize Cardiovascular Preventive Therapies in Type 2 Diabetes: A Randomized Clinical Trial https://pubmed.ncbi.nlm.nih.gov/36877177/

Join Drs Nihar Desai and Jay Udell as they discuss the role of SGLT2 inhibitors in the treatment of cardiorenal metabolic syndrome.

Relevant disclosures can be found with the episode show notes on Medscape https://www.medscape.com/viewarticle/999841. The topics and discussions are planned, produced, and reviewed independently of advertisers. This podcast is intended only for US healthcare professionals.

Resources

Effects of SGLT2 Inhibitors on Kidney and Cardiovascular Function https://pubmed.ncbi.nlm.nih.gov/33197224/

Study to Evaluate the Effect of Empagliflozin on Hospitalization for Heart Failure and Mortality in Patients With Acute Myocardial Infarction - EMPACT-MI https://www.acc.org/Latest-in-Cardiology/Clinical-Trials/2024/04/05/03/00/empact-mi

The Bark Giving Diabetes Therapy Some Bite: The SGLT Inhibitors https://pubmed.ncbi.nlm.nih.gov/30132029/

Effects of Dapagliflozin on Development and Progression of Kidney Disease in Patients With Type 2 Diabetes: An Analysis From the DECLARE-TIMI 58 Randomized Trial https://pubmed.ncbi.nlm.nih.gov/31196815/

Thiazolidinediones and Heart Failure: A Teleo-Analysis https://pubmed.ncbi.nlm.nih.gov/17536074/

Empagliflozin, Cardiovascular Outcomes, and Mortality in Type 2 Diabetes https://pubmed.ncbi.nlm.nih.gov/26378978/

Sotagliflozin in Patients With Diabetes and Recent Worsening Heart Failure https://pubmed.ncbi.nlm.nih.gov/33200892/

Effect of Empagliflozin on Heart Failure Outcomes After Acute Myocardial Infarction: Insights From the EMPACT-MI Trial https://pubmed.ncbi.nlm.nih.gov/38581389/

Effects of an Angiotensin-Converting-Enzyme Inhibitor, Ramipril, on Cardiovascular Events in High-Risk Patients https://pubmed.ncbi.nlm.nih.gov/10639539/

Join Drs Nihar Desai and Erica Spatz as they discuss the critical importance of social determinants of health in preventing and managing cardiorenal conditions.

Relevant disclosures can be found with the episode show notes on Medscape https://www.medscape.com/viewarticle/999840. The topics and discussions are planned, produced, and reviewed independently of advertisers. This podcast is intended only for US healthcare professionals.

Resources

Cardiovascular-Kidney-Metabolic (CKM) Syndrome: A State-of-the-Art Review https://pubmed.ncbi.nlm.nih.gov/38103820/

What Is a Social Determinant of Health? Back to Basics https://pubmed.ncbi.nlm.nih.gov/34162174/

Multi-Ethnic Study of Atherosclerosis (MESA): JACC Focus Seminar 5/8 https://pubmed.ncbi.nlm.nih.gov/34167645/

What to Know About PREVENT, the AHA's New Cardiovascular Disease Risk Calculator https://pubmed.ncbi.nlm.nih.gov/38150239/

Accountable Health Communities Model https://www.cms.gov/priorities/innovation/innovation-models/ahcm

Racial and Ethnic Approaches to Community Health (REACH) https://www.cdc.gov/reach/php/about/index.html

Join Drs Nihar Desai and Chiadi Ndumele as they define and discuss cardiorenal metabolic syndrome, a chronic health condition with the potential to impact up to 90% of the US population.

Relevant disclosures can be found with the episode show notes on Medscape https://www.medscape.com/viewarticle/999839. The topics and discussions are planned, produced, and reviewed independently of advertisers. This podcast is intended only for US healthcare professionals.

Resources

Cardiovascular-Kidney-Metabolic Health: A Presidential Advisory From the American Heart Association https://pubmed.ncbi.nlm.nih.gov/37807924/

American Heart Association PREVENTTM Online Calculator https://professional.heart.org/en/guidelines-and-statements/prevent-calculator

Prevalence of Cardiovascular-Kidney-Metabolic Syndrome Stages in US Adults, 2011-2020 https://pubmed.ncbi.nlm.nih.gov/38717747/

2013 ACC/AHA Guideline on the Assessment of Cardiovascular Risk: A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines https://pubmed.ncbi.nlm.nih.gov/24222018/

Renoprotection With SGLT2 Inhibitors in Type 2 Diabetes Over a Spectrum of Cardiovascular and Renal Risk https://pubmed.ncbi.nlm.nih.gov/33222693/

Cardiovascular and Kidney Outcomes With Finerenone in Patients With Type 2 Diabetes and Chronic Kidney Disease: The FIDELITY Pooled Analysis https://pubmed.ncbi.nlm.nih.gov/35023547/

Study to Evaluate the Efficacy (Effect on Disease) and Safety of Finerenone on Morbidity (Events Indicating Disease Worsening) & Mortality (Death Rate) in Participants With Heart Failure and Left Ventricular Ejection Fraction (Proportion of Blood Expelled Per Heart Stroke) Greater or Equal to 40% (FINEARTS-HF) https://classic.clinicaltrials.gov/ct2/show/NCT04435626

Novo Nordisk Will Stop the Once-Weekly Injectable Semaglutide Kidney Outcomes Trial, FLOW, Based on Interim Analysis https://www.novonordisk.com/news-and-media/news-and-ir-materials/news-details.html?id=166327

Long-Term Kidney Outcomes of Semaglutide in Obesity and Cardiovascular Disease in the SELECT Trial https://pubmed.ncbi.nlm.nih.gov/38796653/