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Objectives To study clinical and coronary angiographic findings in patients with both coronary heart diseases (CHD) and type 2 diabetes mellitus (T2DM). Methods 215 patients with CHD confirmed by coronary angiography were involved in this study. The patients were divided into two groups: 74 CHD patients with T2DM ( mean age 64.7 ±8.2 years, male/female 47/27), and 141 CHD patients without T2DM (mean age 66.2 ± 9.2 years,male/female 100/41 ). The clinical features and the data from selective coronary angiographies were compared between type 2 diabetic and non - diabetic CHD patients. Results Compared to non -diabetic CHD patients, the patients with both CHD and T2DM suffered more from acute myocardial infarction, silent ischemia and severe arrhythmias (P ＜ 0. 01, P ＜ 0. 05 ) ,and had higher serum triglycerides and apo - lipoprotein B, along with increased serum uric acid (P ＜ 0. 01, P ＜0. 05), increased left ventricular end diastolic diameter (P ＜ 0. 01 ), and decreased left ventricular ejection fraction ( P ＜ 0. 001 ). Compared to non - diabetic CHD patients, the patients with both CHD and T2DM suffered more from triple vessel disease ( P ＜ 0. 01 ) ,severe coronary artery stenosis, complete occlusions and diffuse lesions ( P ＜ 0. 001 ). Conclusions Severe clinical manifestation, left ventricular dysfunction,diffuse or complicated lesions of coronary arteries were more common in patients with both CHD and T2DM, it suggests that the type 2 diabetic CHD patients have poor prognosis.