Effect of glycemic and lipid achievements on clinical outcomes type 2 diabetic, Chinese patients with stable coronary artery disease.
OBJECTIVE
To describe the effect of glycemic and lipid achievements and their joint roles in future major adverse cardiovascular events (MACEs) prediction.


METHODS
One thousand two hundred sixty consecutive, type 2 diabetic patients with stable coronary artery disease (CAD) were identified, they were followed up a median of 24.07months.


RESULTS
At baseline, 85.4% of patients with blood pressure less than 140/90mmHg, while only a minority of patients met guideline-recommended hemoglobin A1C (HbA1C) (44.2%), low-density lipoprotein cholesterol (LDL-C) (24.7%), non high-density lipoprotein cholesterol (NHDL-C) (36.3%), or apolipoprotein B (apoB) levels (38.6%). After follow-up, patients achieving either glycemic or lipid goals experienced a lower rate of future events (HbA1C 35.4%, LDL-C 19.3%, NHDL-C 30.4%, apoB 26.7%). Dual-goal achievements of HbA1C and lipids showed the lowest event risk (adjusted relative risk, RR: HbA1C, 0.92 vs. LDL-C 0.75 vs. dual 0.27; HbA1C, 0.86 vs. NHDL-C 0.59 vs. dual 0.44; HbA1C, 0.74 vs. apoB 0.64 vs. dual 0.55). Patients with suboptimal goals (LDL-C 1.8-2.5mmol/L, NHDL-C 2.5-3.4mmol/L, or apoB 0.8-1.0g/L) were at risk when compared to those with guideline-recommended goals.


CONCLUSIONS
Dual-achievement of glycemic and lipid goals based on a relative well-controlled condition of blood pressure conferred a better prognosis in type 2 diabetic patients with CAD.
Division of Dyslipidemia, State Key Laboratory of Cardiovascular Disease, Fu Wai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Peking Union Medical College, BeiLiShi Road 167, Beijing, 100037, China.
Sha
S
Li
Division of Dyslipidemia, State Key Laboratory of Cardiovascular Disease, Fu Wai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Peking Union Medical College, BeiLiShi Road 167, Beijing, 100037, China.
Yan
Y
Zhang
Division of Dyslipidemia, State Key Laboratory of Cardiovascular Disease, Fu Wai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Peking Union Medical College, BeiLiShi Road 167, Beijing, 100037, China.
Yuan-Lin
YL
Guo
Division of Dyslipidemia, State Key Laboratory of Cardiovascular Disease, Fu Wai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Peking Union Medical College, BeiLiShi Road 167, Beijing, 100037, China.
Cheng-Gang
CG
Zhu
Division of Dyslipidemia, State Key Laboratory of Cardiovascular Disease, Fu Wai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Peking Union Medical College, BeiLiShi Road 167, Beijing, 100037, China.
Na-Qiong
NQ
Wu
Division of Dyslipidemia, State Key Laboratory of Cardiovascular Disease, Fu Wai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Peking Union Medical College, BeiLiShi Road 167, Beijing, 100037, China.
Ping
P
Qing
Division of Dyslipidemia, State Key Laboratory of Cardiovascular Disease, Fu Wai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Peking Union Medical College, BeiLiShi Road 167, Beijing, 100037, China.
Ying
Y
Gao
Division of Dyslipidemia, State Key Laboratory of Cardiovascular Disease, Fu Wai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Peking Union Medical College, BeiLiShi Road 167, Beijing, 100037, China.
Jing
J
Sun
Division of Dyslipidemia, State Key Laboratory of Cardiovascular Disease, Fu Wai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Peking Union Medical College, BeiLiShi Road 167, Beijing, 100037, China.
Geng
G
Liu
Division of Dyslipidemia, State Key Laboratory of Cardiovascular Disease, Fu Wai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Peking Union Medical College, BeiLiShi Road 167, Beijing, 100037, China.
Qian
Q
Dong
Division of Dyslipidemia, State Key Laboratory of Cardiovascular Disease, Fu Wai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Peking Union Medical College, BeiLiShi Road 167, Beijing, 100037, China. Electronic address: lijianjun938@126.com.
Jian-Jun
JJ
Li
D000368:Aged; D053299:Apolipoprotein B-100 / Q000097:blood; D015415:Biomarkers / Q000097:blood; D002681:China / Q000453:epidemiology; D002784:Cholesterol / Q000097:blood; D008078:Cholesterol, LDL / Q000097:blood; D015331:Cohort Studies; D003131:Combined Modality Therapy; D003324:Coronary Artery Disease / Q000150:complications / Q000175:diagnosis / Q000453:epidemiology / Q000517:prevention & control*; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000150:complications / Q000628:therapy*; D003925:Diabetic Angiopathies / Q000150:complications / Q000175:diagnosis / Q000453:epidemiology / Q000517:prevention & control*; D050171:Dyslipidemias / Q000150:complications / Q000517:prevention & control*; D005260:Female; D005500:Follow-Up Studies; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D006943:Hyperglycemia / Q000517:prevention & control*; D006973:Hypertension / Q000150:complications / Q000517:prevention & control*; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance; D011379:Prognosis; D011446:Prospective Studies; D012307:Risk Factors
D053299:Apolipoprotein B-100; D015415:Biomarkers; D002784:Cholesterol; D008078:Cholesterol, LDL; D006442:Glycated Hemoglobin; C569471:APOB protein, human; C517652:hemoglobin A1c protein, human
Coronary artery disease; Diabetes; Glycemic achievement; Lipid achievement; Outcome