Background: Diabetes has become an epidemic in developing countries. The incidence of adverse cardiovascular events is high and the control rate is low in Chinese patients with type 2 diabetes mellitus (T2DM), particularly in low-income areas of China. The aim of this study was to identify the risk factors for acute coronary syndrome (ACS) in patients with T2DM in Northwest China.

Methods: A total of 456 patients with T2DM admitted to The First Affiliated Hospital of Xi’an Jiaotong University from January 2018 to January 2019 were included in the study. Among these, 186 individuals newly diagnosed with ACS were categorized as the case group and 270 patients without ACS as the control group. Demographic characteristics and serum biomarkers between the two groups were compared using t-test or Chi-square test. Multivariate logistic regression was used to analyze the risk factors for ACS in T2DM.

Results: The proportion of elderly patients was higher in the case group than in the control group (30.65% vs. 15.56%, p <0.001). Similarly, the case group had a higher proportion of patients with hypertension history (66.67% vs. 34.81%, p <0.001), substandard systolic blood pressure (SBP) (44.09% vs. 21.48%, p <0.001), hyperuricemia (34.41% vs. 11.11%, p <0.001), and higher body mass index (BMI) (26.64 ± 3.96 vs. 24.87 ± 3.53, p <0.001) compared to the control group. The multivariate logistic regression analysis showed that age ≥ 65 years, SBP ≥ 140 mm Hg, overweight or obesity, and hyperuricemia were all risk factors for ACS in T2DM, and their OR (95% CI) were 2.283 (1.371-3.802), 2.067 (1.322-3.233), 2.019 (1.501-2.716), and 3.108 (1.831-5.275), respectively.

Conclusion: Aging, systolic hypertension, obesity and hyperuricemia increase the risk of ACS in T2DM in Northwest China. Thus, weight loss and lowering of SBP and of blood uric acid levels may reduce the risk of ACS in T2DM.


Q. Zhao: None.


Shaanxi Province Science Technology of China (2019KW-079)

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