Leaders of Successful Cardiometabolic Program at University Hospitals Detail Essential Components

Innovations in Cardiovascular Medicine & Surgery | February 2025

Featured in the American Journal of Managed Care (AJMC)

University Hospitals (UH) Harrington Heart & Vascular Institute’s Center for Integrated and Novel Approaches in Vascular-Metabolic Disease (UH CINEMA) is an innovative, patient-centered system of care for managing high-risk patients with type 2 diabetes and pre-diabetes at high risk for cardiovascular-kidney-metabolic (CKM) syndrome and its consequences. Since its inception in 2019, UH CINEMA has resulted in improvements in patient outcomes and use of guideline-directed medical therapy. The largest increases were in use of SGLT2is and GLP-1 RAs, with an approximately three-fold increase from baseline to follow-up. 

Writing recently in the American Journal of Managed Care (AJMC), UH CINEMA Director Ian Neeland, MD, FAHA, FACC, and founder Sanjay Rajagopalan, MD, MBA, Chief of Cardiovascular Medicine and the Herman K. Hellerstein, MD, Professor of Cardiovascular Research at UH Harrington Heart & Vascular Institute, detail the elements that make this cardiometabolic program successful in treating its patients. “At its core, UH CINEMA is a multidisciplinary team of care experts, working together outside of traditional silos,” Dr. Neeland says. “Implementation of a team-based approach is critical to enhancing patient understanding, buy-in, and ultimately, treatment adherence.” For example, patients meet with the entire UH CINEMA team up to four times a year to address all aspects of cardiovascular and type 2 diabetes care. In addition, the UH CINEMA team works with each patient to formulate a personalized, evidence-based approach to improving lifestyle habits, reducing risk of cardiovascular and kidney disease events and increasing access and adherence to guideline-directed pharmacologic therapies. The program also engages community health workers to help patients address social determinants of health.

The UH CINEMA leaders’ AJMC review also addresses the structure, operation and eligibility criteria for admission to the program, provides an overview of how CKM syndrome risks are determined and managed for each patient and discusses how the integrated approach to care is supported by current recommendations from professional societies and results from other coordinated care/multidisciplinary programs.