OBJECTIVE Although glucose abnormality status (GAS), prior coronary artery disease (CAD), and other traditional risk factors affect the incidence of subsequent CAD, their impact in the same cohort has been scantly studied. RESEARCH DESIGN AND METHODS We analyzed data from a nationwide claims database in Japan that was accumulated during 2008-2016 involving 138,162 men aged 18-72 years. Participants were classified as having normoglycemia, borderline glycemia, or diabetes mellitus (DM) with prior CAD (CAD+) or without prior CAD (CAD-). Cox regression model identified variables related to the incidence of CAD. RESULTS Among CAD-, management of traditional risks differed from those with and without subsequent CAD events. On the other hand, such differences were weaker in borderline glycemia and DM CAD+, and the influence of traditional risk factors on subsequent CAD was not observed. Cox regression model showed that borderline glycemia and DM confer approximately 1.2- and 2.8-fold excess risks of CAD, respectively, compared with CAD- with normoglycemia. CAD+ confers approximately a 5- to 8-fold increased risk. The impacts of DM and prior CAD additively reached a hazard ratio (HR) of 15.74 (95% confidence interval [CI]: 11.82-21.00). However, the HR in those with borderline glycemia and CAD+ was 7.20 (95% CI: 5.01-10.34), which was not different from those with normoglycemia and CAD+. CONCLUSION Control status of traditional risk factors and impact on subsequent CAD differ among categories of glycemic status with and without prior CAD. Individualizing treatment strategies is needed in consideration of risk factors, such as GAS and CAD+.

中文翻译：

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在日本男性中，根据葡萄糖异常状态和先前的冠状动脉疾病，有发生冠状动脉疾病的风险。

目的尽管葡萄糖异常状态（GAS），先前的冠状动脉疾病（CAD）和其他传统的危险因素会影响随后的CAD发生率，但对它们在同一队列中的影响却很少进行研究。研究设计和方法我们分析了日本全国性索赔数据库的数据，该数据库在2008-2016年期间累积，涉及138,162名18-72岁的男性。参加者被归类为患有高血糖，临界血糖或糖尿病（DM）且有先前的CAD（CAD +）或没有先前的CAD（CAD-）。Cox回归模型确定了与CAD发生率相关的变量。结果在CAD-中，传统风险的管理与有或没有后续CAD事件的管理不同。另一方面，这些差异在临界血糖和DM CAD +方面较弱，没有观察到传统危险因素对随后的CAD的影响。Cox回归模型显示，与具有正常血糖的CAD-相比，临界血糖和DM分别赋予CAD约1.2倍和2.8倍的超额风险。CAD +使风险增加了大约5到8倍。DM和先前的CAD的影响相加达到了15.74的危险比（HR）（95％置信区间[CI]：11.82-21.00）。但是，具有临界血糖和CAD +的患者的HR为7.20（95％CI：5.01-10.34），与具有正常血糖和CAD +的患者的HR没有差异。结论在有和没有事先CAD的血糖状态类别之间，传统危险因素的控制状态及其对后续CAD的影响是不同的。考虑到诸如GAS和CAD +等风险因素，需要个性化的治疗策略。