CMHC Pulse Blog

With the holiday season approaching and fall in full swing, it’s the perfect time to reaffirm our commitment to delivering excellent care, improving patient outcomes, and making the most of every available resource. What better way to join the fall festivities than by spotlighting key insights in cardiorenal metabolic medicine, primary prevention, and quality of life improvements shared at this year’s biggest U.S. cardiometabolic health CME/CE conference: the 19th Annual CMHC.

Over three days, more than 25 acclaimed experts delivered 22 forward-thinking, clinically relevant educational sessions. The agenda was an unforgettable learning experience for cardiometabolic science and cardiometabolic management enthusiasts. Attendees, including hundreds of health professionals, gained access to the latest knowledge and developments in the field, from exclusive insights from one of the foremost authorities on atherosclerosis, Dr. Peter Libby, to innovations like new therapeutic agents and exciting advancements in renal protection.  

Clinical Pearls and Takeaway Insights From 19th Annual Cardiometabolic Health Congress (CMHC) 

The stakes in cardiometabolic health have never been higher. Cardiovascular disease remains the leading cause of death worldwide, claiming 18 million lives annually. In the U.S., 42% of adults are considered obese, increasing their risk of diabetes, hypertension, and cardiovascular issues. Additionally, 10% of the global population suffers from chronic kidney disease, with diabetes and hypertension as significant risk factors. Disparities in care are also concerning, with diagnosed cardiometabolic diseases varying up to twofold among different racial and ethnic groups. Moreover, cardiovascular disease in women continues to be underrepresented and undertreated. 

Against this backdrop, the 19th Annual CMHC delivered powerful insights to address these critical issues. Here are the five most-cited takeaways from this year’s attendees.  

The 5 Most-Cited Takeaways From 19th Annual Cardiometabolic Health Congress (CMHC)

#1 The Tension in Prevention 

Session: “The Prevention and Treatment of Atherosclerosis” 

Presenter: Peter Libby, MD 

Dr. Peter Libby highlighted the shift from communicable to chronic diseases and the resulting “morbidity extension,” where lifespans outpace healthspan improvements. He emphasized proactive measures like primordial prevention to reduce lifetime cardiovascular risk through early interventions.

Key Takeaways:

1. Primordial Prevention: Early lifestyle changes, like increasing physical activity and reducing sugar intake in schools, are crucial to mitigating future cardiovascular risk.

2. Emerging Risk Factors: Non-traditional factors such as the microbiome, pollution, and somatic mutations are increasingly linked to “SMuRFless” myocardial infarction (MI) cases.

3. Precision Medicine: Dr. Libby stressed personalized treatment approaches, focusing on delivering targeted therapies based on individual genetic and risk profiles.

4. He also highlighted new therapeutic directions targeting inflammation, aiming for LDL levels to be “as low as reasonably achievable.”

#2 Advancements in Cardiovascular Risk Stratification 

Session: “Overview of Cardiac Biomarkers for Cardiovascular Risk Stratification” 

Presenter: Chiadi Ndumele, MD, PhD, FAHA 

Dr. Ndumele provided an in-depth analysis of cardiac biomarkers and their role in cardiovascular risk prediction and heart failure (HF) management at the 19th Annual CMHC. He emphasized the evolving landscape of biomarker utility in enhancing the accuracy of HF prediction and the need for targeted interventions based on these biomarkers. 

Key Takeaways: 

1. Natriuretic Peptides: Useful for diagnosing and monitoring heart failure, particularly HFrEF, but challenging to interpret in patients with obesity due to peptide deficiency. 

2. High Sensitivity Troponin (hs-cTnT): Reflects subclinical myocardial injury and is strongly associated with increased risk of incident HF and mortality, especially in patients with prediabetes and diabetes. 

3. Biomarker-Based HF Prediction: Combined biomarker and imaging assessments provide the highest accuracy in predicting heart failure risk. 

4. Proteomic Approaches: New proteomic analyses offer the potential for more precise HF risk prediction in patients with obesity, improving our understanding of obesity-related cardiovascular risks. 

#3 SGLT2i as Foundational Therapy for Cardio-Kidney Protection 

PME CME Session: “SGLT2i as Foundational Therapy for Cardio-Kidney Protection” 

Presenter: Erin D. Michos, MD, MHS, FAHA, FACC, FASE, FASPC 

Dr. Michos explored the wide-ranging benefits of SGLT2 inhibitors in managing cardio-kidney-metabolic (CKM) conditions, highlighting their role as a cornerstone therapy. The presentation emphasized how these inhibitors can simultaneously provide cardiovascular and kidney protection, addressing interconnected complications like heart failure and chronic kidney disease (CKD). 

Key Takeaways: 

1. Cardio-Renal Protection: SGLT2 inhibitors offer comprehensive protection, reducing cardiovascular events, slowing CKD progression, and decreasing mortality. 

2. Meta-Analysis Evidence: A meta-analysis of five heart failure (HF) trials demonstrated significant reductions in cardiovascular deaths and first heart failure hospitalizations. 

3. CKD Outcomes: SGLT2 inhibitors reduce kidney disease progression by 38% in dedicated trials, benefiting a wide range of CKD patients. 

4. Safety Profile: Although there is a slight increase in genital infections, the overall safety profile remains favorable, with a reduced risk of serious hyperkalemia in CKD and heart failure patients. 

#4 Advances in Obesity Pharmacotherapy 

Session: “Advances in Obesity Pharmacotherapy” 

Presenter: Louis J. Aronne, MD, FACP, FTOS, DABOM 

Dr. Aronne presented a comprehensive overview of current and emerging pharmacotherapies for obesity, highlighting significant progress in treatments and their implications for cardiometabolic health. The session focused on the evolution of obesity management and the pivotal role of new therapeutic agents in addressing a wide range of health complications. 

Key Takeaways: 

1. Greater Weight Loss, Greater Benefit: Achieving 2-5% weight loss yields metabolic improvements, while over 15% weight loss significantly reduces obesity-related complications like hypertension, NAFLD, and heart failure with preserved ejection fraction (HFpEF). 

2. New and Pipeline Therapies: Innovations such as retatrutide and cagrilinitide show up to 30% weight loss, surpassing current therapies like semaglutide and tirzepatide. 

3. SELECT Trial Results: Semaglutide 2.4 mg reduced major adverse cardiovascular events (MACE) by 20% in overweight patients and reduced diabetes risk and blood pressure, making it a landmark in obesity treatment. 

4. Obesity as a Disease: The introduction of highly effective, hormone-based therapies marks a pivotal shift in viewing obesity as a disease with complex pathophysiology akin to the evolution of hypertension treatment decades ago. 

#5 Understanding Lipoprotein(a): Implications for Cardiovascular Risk and Management 

Session: “Understanding Lipoprotein(a): Implications for Cardiovascular Risk and Management” 

Presenter: Christie M. Ballantyne, MD 

Dr. Ballantyne discussed the significant impact of lipoprotein(a) [Lp(a)] on cardiovascular risk, emphasizing its role as a genetically determined, independent driver of cardiovascular disease (CVD). The presentation highlighted recent findings on the atherogenic properties of Lp(a) and the emerging therapeutic approaches targeting it. 

Key Takeaways: 

1. Genetic Influence: Lp(a) levels are over 90% genetically determined and can vary 1,000-fold within populations. High Lp(a) is a causal risk factor for atherosclerotic cardiovascular disease (ASCVD), aortic stenosis, and all-cause mortality. 

2. Atherogenicity of Lp(a): Despite its lower abundance than LDL, Lp(a) is approximately six times more atherogenic per particle. Elevated Lp(a) is associated with complex, difficult-to-treat atherosclerotic lesions and fast-progressing plaques. 

3. Emerging Therapies: Novel targeted therapies, such as antisense oligonucleotides (ASO) and small interfering RNA (siRNA) treatments like pelacarsen and olpasiran, show promise in significantly lowering Lp(a) levels and improving cardiovascular outcomes. 

4. Clinical Guidance: It is recommended to measure Lp(a) at least once in all adults, consider intensive management for those with high levels, and cascade screening for family members at risk. 

19th Annual Cardiometabolic Health Congress CMHC On Demand – Pre-order for December 2024 Now!  

Did you miss the live event or want to catch up on sessions you couldn’t attend? 19th Annual CMHC On Demand is launching next month, giving you the opportunity to:  

1. Earn additional CME/CE credit hours at your convenience  

2. Access sessions you might have missed at the live event  

3. Learn anytime, anywhere, from any device  

Access available through December 2025 allows you to engage with the latest cardiorenal metabolic research and clinical training on your schedule. Click here to start: Join the Cardiometabolic Health Congress in Boston in 2024.