Diabetes mellitus is an independent risk factor in the development of coronary artery disease (CAD), myocardial infarction (MI), and cardiac death (CD). The major adverse cardiac events (MACEs) between men and women in diabetic patients stratified by CAD (previous MI and/or coronary revascularization, CR) were analyzed. A cohort of 1327 consecutive diabetic patients (age 66.5 ± 9 years) underwent gated SPECT (single-photon emission computed tomography). During a mean follow-up of 4.7 ± 2.2 years post gated SPECT, MACEs (non-fatal MI, CD, and late CR) were evaluated according to gender stratified by CAD. Among diabetic patients without known CAD (N = 731), men had more MACEs (sHR 1.9;95%CI 1.2-3.2) than women. Among diabetic patients with known CAD (N = 596), there was no difference in MACEs in diabetic men and women (sHR 1.15;95%CI 0.73-1.8). Diabetic women with known CAD (n = 143) were the group with the highest risk (sHR 1.7; = .041) for MACEs (4.5% MACEs/year, [95%CI 3.1%-6.4%]), compared to the remaining diabetic patients (N = 1184) (3% MACEs/year, [95%CI 2.6%-3.5%]). The prognosis of diabetic patients for MACEs is different in men and women stratified by CAD. The worst prognosis for MACEs occurs in women with known CAD.

中文翻译：

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糖尿病患者预后的性别差异

糖尿病是冠状动脉疾病（CAD）、心肌梗死（MI）和心源性死亡（CD）的独立危险因素。分析了按 CAD（既往 MI 和/或冠状动脉血运重建，CR）分层的男性和女性糖尿病患者之间的主要不良心脏事件 (MACE)。1327 名连续糖尿病患者（年龄 66.5 ± 9 岁）组成的队列接受了门控 SPECT（单光子发射计算机断层扫描）。在门控 SPECT 后平均 4.7 ± 2.2 年的随访期间，根据 CAD 性别分层评估 MACE（非致命性 MI、CD 和晚期 CR）。在没有已知 CAD 的糖尿病患者 (N = 731) 中，男性的 MACE (sHR 1.9；95%CI 1.2-3.2) 多于女性。在患有已知 CAD 的糖尿病患者 (N = 596) 中，糖尿病男性和女性的 MACE 没有差异 (sHR 1.15；95%CI 0.73-1.8)。与其余女性相比，患有已知 CAD 的糖尿病女性 (n = 143) 是 MACE 风险最高的群体 (sHR 1.7; = .041)（4.5% MACE/年，[95%CI 3.1%-6.4%]）糖尿病患者 (N = 1184) (3% MACEs/年，[95%CI 2.6%-3.5%])。根据 CAD 分层，男性和女性糖尿病患者的 MACE 预后不同。MACE 的最差预后发生在患有已知 CAD 的女性中。