Advancing Cardiovascular, Kidney, and Metabolic Medicine: A Narrative Review of Insights and Innovations for the Future.

IF 3.8 3区 医学 Q2 Medicine
Diabetes Therapy Pub Date : 2025-06-01 Epub Date: 2025-04-24 DOI:10.1007/s13300-025-01738-3
Kevin Fernando, Derek Connolly, Eimear Darcy, Marc Evans, William Hinchliffe, Patrick Holmes, W David Strain
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Abstract

Cardiovascular, kidney and metabolic (CKM) conditions are interrelated, significantly contributing to morbidity, mortality and healthcare burden. Despite therapeutic advances, traditional disease-specific approaches often fail to address their complex interplay. Key therapeutic agents-including glucagon-like peptide-1 receptor agonists (GLP-1 RAs), dual GLP-1/glucose-dependent insulinotropic polypeptide RAs, sodium glucose co-transporter inhibitors and the nonsteroidal mineralocorticoid receptor antagonist (MRA) finerenone-offer multi-organ benefits. Emerging therapies, such as triple receptor agonists and second-generation MRAs, target new pathways further expanding treatment options for CKM conditions. A holistic CKM management approach must address and recognise that conditions such as metabolic dysfunction-associated steatotic liver disease, metabolic dysfunction-associated steatohepatitis, obstructive sleep apnoea and obesity are part of the CKM spectrum. Frailty assessment is also important alongside CKM conditions, warranting comprehensive geriatric assessment and deprescribing when appropriate. Multidisciplinary care-including lifestyle interventions, pathway redesign, pharmacological advances and novel technologies-is essential for improving outcomes. As the CKM landscape evolves, future strategies should prioritise early intervention, personalised treatment and addressing unmet needs in high-risk populations. This review advocates for an integrated CKM framework, exploring treatment strategies, emerging therapies and technological innovations. It also examines the role of artificial intelligence and digital health tools in risk stratification, early diagnosis and long-term condition management, alongside ethical and regulatory considerations.

推进心血管、肾脏和代谢医学:对未来的见解和创新的述评。
心血管、肾脏和代谢(CKM)疾病是相互关联的,对发病率、死亡率和医疗负担有重要影响。尽管治疗取得了进步,但传统的针对特定疾病的方法往往无法解决它们复杂的相互作用。关键的治疗药物-包括胰高血糖素样肽-1受体激动剂(GLP-1 RAs),双重GLP-1/葡萄糖依赖的胰岛素性多肽RAs,葡萄糖共转运蛋白钠抑制剂和非甾体矿皮质激素受体拮抗剂(MRA)细烯酮-提供多器官益处。新兴疗法,如三重受体激动剂和第二代MRAs,针对新的途径,进一步扩大了CKM疾病的治疗选择。一个全面的CKM管理方法必须解决并认识到代谢功能障碍相关的脂肪性肝病、代谢功能障碍相关的脂肪性肝炎、阻塞性睡眠呼吸暂停和肥胖等疾病都是CKM谱系的一部分。虚弱评估与CKM条件一起也很重要,需要全面的老年评估和适当的处方。多学科治疗——包括生活方式干预、途径重新设计、药理学进步和新技术——对改善结果至关重要。随着CKM的发展,未来的策略应该优先考虑早期干预、个性化治疗和解决高危人群未满足的需求。本综述倡导综合CKM框架,探索治疗策略、新兴疗法和技术创新。它还研究了人工智能和数字健康工具在风险分层、早期诊断和长期疾病管理方面的作用,以及伦理和监管方面的考虑。
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来源期刊
Diabetes Therapy
Diabetes Therapy Medicine-Endocrinology, Diabetes and Metabolism
CiteScore
6.90
自引率
7.90%
发文量
130
审稿时长
6 weeks
期刊介绍: Diabetes Therapy is an international, peer reviewed, rapid-publication (peer review in 2 weeks, published 3–4 weeks from acceptance) journal dedicated to the publication of high-quality clinical (all phases), observational, real-world, and health outcomes research around the discovery, development, and use of therapeutics and interventions (including devices) across all areas of diabetes. Studies relating to diagnostics and diagnosis, pharmacoeconomics, public health, epidemiology, quality of life, and patient care, management, and education are also encouraged. The journal is of interest to a broad audience of healthcare professionals and publishes original research, reviews, communications and letters. The journal is read by a global audience and receives submissions from all over the world. Diabetes Therapy will consider all scientifically sound research be it positive, confirmatory or negative data. Submissions are welcomed whether they relate to an international and/or a country-specific audience, something that is crucially important when researchers are trying to target more specific patient populations. This inclusive approach allows the journal to assist in the dissemination of all scientifically and ethically sound research.
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