Objective To explore the characteristics of traditional Chinese medicine（TCM） syndromes in real-world patients with type 2 diabetes mellitus and stable angina pectoris（T2 DM-SAP） as well as the relationship between TCM syndromes and the occurrence of major adverse cardiovascular and cerebrovascular events（MACCE）. Methods The clinical data of 965 patients with T2 DM-SAP were retrospectively analyzed; the TCM syndrome types

syndrome elements

tongue and pulse manifestations were assessed; and the syndrome distribution in different disease courses and ages was analyzed. Logistic regression analysis was used to analyze the correlation between TCM syndromes and MACCE. Results There were 19 TCM syndromes in 965 T2 DM-SAP patients

and the top three frequent syndromes were qi deficiency and blood stasis（n=229）

qi and yin deficiency with blood stasis（n=194）

and binding of phlegm and blood stasis（n=119）. Eight shared disease location-related syndrome elements were remained

of which heart vessels（n=485）

heart（n=211） and spleen（n=178） were in majority. There are 13 disease nature-related syndrome elements

mainly including blood stasis（n=649）

qi deficiency（n=448） and phlegm turbid（n=299）. The tongue body was often dusky（n=598） and red（n=519）

and the tongue coating was white（n=496） and greasy（n=412）; the pulse was often wiry（n=425）

thready（n=354）

and deep（n=294）. Although there were differences between the patients with varied disease courses in the TCM syndrome distribution

the main symptoms of all disease courses were qi deficiency and blood stasis（24.2%

214/885）. Regarding the TCM syndrome distributions in different ages

the group of patients aged >60 to 74 years accounted for the highest proportion（46.1%

239/965）. There were 389 cases of MACCE. Logistic regression analysis showed that transient ischemic attack and re-admission due to angina pectoris were positively correlated to internal accumulation of damp-heat and blood stasis obstructing collaterals（OR=5.39

P=0.04）; re-admission due to myocardial infarction

coronary revascularization

and recurrence of stroke were positively correlated to age（OR=1.56

P=0.04）

wind-phlegm obstructing collaterals（OR=2.07

P=0.02）

and ascendant hyperactivity of liver yang（OR=5.07

P=0.02）; all-cause mortality was positively correlated to age（OR=1.09

P<0.01）

heart and kidney yang deficiency（OR=8.71

P=0.03）

deficiency of both yin and yang（OR=38.81

P<0.01）. Conclusion Qi deficiency and blood stasis as well as deficiency of both qi and yin with blood stasis are the main syndromes of T2 DM-SAP

and blood stasis is the major disease nature-related syndrome element. Internal accumulation of damp-heat with blood stasis obstructing the collaterals

wind phlegm obstructing the collaterals

ascendant hyperactivity of liver yang

heart and kidney yang deficiency

and deficiency of both yin and yang may be the high risk factors of occurrence of MACCE.