Glycemic Control and Diabetes Duration in Relation to Subsequent Myocardial Infarction among Patients with Coronary Heart Disease and Type 2 Diabetes.

Fu Rong LI; Yan DOU; Chun Bao MO; Shuang WANG; Jing ZHENG; Dong Feng GU; Feng Chao LIANG

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Glycemic Control and Diabetes Duration in Relation to Subsequent Myocardial Infarction among Patients with Coronary Heart Disease and Type 2 Diabetes.

Author: Fu Rong LI ¹ ; Yan DOU ² ; Chun Bao MO ¹ ; Shuang WANG ³ ; Jing ZHENG ³ ; Dong Feng GU ⁴ ; Feng Chao LIANG ¹
Author Information

1. School of Public Health and Emergency Management, Southern University of Science and Technology, School of Medicine, Shenzhen 518055, Guangdong, China;Shenzhen Key Laboratory of Cardiovascular Health and Precision Medicine, Southern University of Science and Technology, Shenzhen 518055, Guangdong, China.
2. Department of Epidemiology, National Center for Cardiovascular Diseases, Fuwai Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College/National Center for Cardiovascular Diseases, Beijing 100037, China.
3. Shenzhen Health Development Research and Data Management Center, Shenzhen 518106, Guangdong, China.
4. School of Public Health and Emergency Management, Southern University of Science and Technology, School of Medicine, Shenzhen 518055, Guangdong, China;Shenzhen Key Laboratory of Cardiovascular Health and Precision Medicine, Southern University of Science and Technology, Shenzhen 518055, Guangdong, China;Department of Epidemiology, National Center for Cardiovascular Diseases, Fuwai Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College/National Center for Cardiovascular Diseases, Beijing 100037, China.
Publication Type:Journal Article
Keywords: Coronary heart disease; Diabetes duration; Fasting plasma glucose; Myocardial infarction; Type 2 diabetes
MeSH: Humans; Diabetes Mellitus, Type 2/blood*; Male; Female; Middle Aged; Aged; Coronary Disease/complications*; Myocardial Infarction/etiology*; Retrospective Studies; China/epidemiology*; Glycemic Control; Blood Glucose; Adult; Risk Factors; Time Factors
From: Biomedical and Environmental Sciences 2025;38(1):27-36
CountryChina
Language:English
Abstract: OBJECTIVE:This study aimed to investigate the impact of glycemic control and diabetes duration on subsequent myocardial infarction (MI) in patients with both coronary heart disease (CHD) and type 2 diabetes (T2D).
METHODS:We conducted a retrospective cohort study of 33,238 patients with both CHD and T2D in Shenzhen, China. Patients were categorized into 6 groups based on baseline fasting plasma glucose (FPG) levels and diabetes duration (from the date of diabetes diagnosis to the baseline date) to examine their combined effects on subsequent MI. Cox proportional hazards regression models were used, with further stratification by age, sex, and comorbidities to assess potential interactions.
RESULTS:Over a median follow-up of 2.4 years, 2,110 patients experienced MI. Compared to those with optimal glycemic control (FPG < 6.1 mmol/L) and shorter diabetes duration (< 10 years), the fully-adjusted hazard ratio ( HR) (95% Confidence Interval [95% CI]) for those with a diabetes duration of ≥ 10 years and FPG > 8.0 mmol/L was 1.93 (95% CI: 1.59, 2.36). The combined effects of FPG and diabetes duration on MI were largely similar across different age, sex, and comorbidity groups, although the excess risk of MI associated with long-term diabetes appeared to be more pronounced among those with atrial fibrillation.
CONCLUSION:Our study indicates that glycemic control and diabetes duration significant influence the subsequent occurrence of MI in patients with both CHD and T2D. Tailored management strategies emphasizing strict glycemic control may be particularly beneficial for patients with longer diabetes duration and atrial fibrillation.