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Time-Cumulative Residual Cardiovascular Risk in Patients with Coronary Heart Disease and Diabetes: A 10-Year

Zeping Li1, Guangling Li1, Yanan Wang1

  • 1Department of Cardiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Jiefang Avenue 1095, Wuhan 430030, China.

Journal of Cardiovascular Development and Disease
|July 27, 2026
PubMed

Insights

Patients with coronary heart disease (CHD) and diabetes mellitus (DM) face a growing cardiovascular risk over time. While initial treatment helps, long-term outcomes show significantly elevated risks, necessitating proactive management strategies.

Area of Science:

  • Cardiology
  • Endocrinology
  • Epidemiology

Background:

  • Patients with coronary heart disease (CHD) and diabetes mellitus (DM) experience substantial residual cardiovascular risk despite current therapies.
  • The long-term progression and temporal pattern of this increased risk are not fully understood.

Purpose of the Study:

  • To investigate the long-term cardiovascular risk trajectory in patients with CHD complicated by DM.
  • To clarify the temporal pattern of excess risk in this patient population.

Main Methods:

  • Retrospective cohort study using UK Biobank and Tongji Hospital data.
  • Follow-up for up to 10 years with major adverse cardiovascular events (MACE) as the primary endpoint.
  • Propensity score matching and multivariable Cox regression were used to analyze risk.

Main Results:

  • Initially, no significant difference in MACE risk was observed between CHD and CHD with DM patients post-matching.
  • A progressive divergence in survival curves occurred over time, with significant risk differences emerging at 10 years.
  • Diabetes was confirmed as an independent risk factor for long-term MACE in both cohorts.

Conclusions:

  • Diabetes significantly elevates long-term residual cardiovascular risk in CHD patients, exhibiting a time-cumulative effect.
  • While early risk may be mitigated by current therapies, long-term adverse events remain high.
  • Intensified, proactive long-term management strategies are crucial for CHD patients with DM.
Abstract

Keywords:
coronary heart diseasediabetes mellituslong-term prognosisresidual risktime-cumulative effect

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