Sheng Z, Zhou P, Liu C, et al. - Given the close link between diabetes mellitus (DM) or pre-diabetes status and characteristics of vulnerable coronary lesions in patients with stable coronary heart disease or acute coronary syndrome, researchers examined patients with acute myocardial infarction (AMI) to fully determine the link between duration of diabetes and the morphologies and characteristics of vulnerable plaques. This study included 279 patients who presented with AMI and received preintervention optical coherence tomography imaging of culprit lesions. Two subgroups of patients with DM were defined: a Short-DM group and a Long-DM group with DM duration of < 10 years and of ≥ 10 years, respectively. The Long-DM group vs the Non- or Short-DM groups exhibited significantly higher glycated hemoglobin A1c (HbA1c) levels. The Long-DM group displayed the highest prevalence of lipid-rich plaques, thin-cap fibroatheroma, and plaque ruptures of culprit lesions. In patients with DM and AMI, culprit-plaque features were influenced by increased duration of DM together with higher HbA1c levels. These results might account for the higher risks of cardiac mortality in DM patients with long disease duration.