Aims: 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.
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