Abstract: Objective：To discuss the analysis on predictive factors of periprocedural myocardial injury (PMI) for type 2 diabetes patients with chronic total occlusion (CTO) from the pespective of clinical data, laboratory examination and imaging characteristics. Methods：Totally 134 cases with type II diabetes combined CTO in Zhongshan hospital of Fudan university heart intervention center database during January 2013 to December 2014 were selected. Results：In 134 cases with type 2 diabetes combined CTO, the average age was (62.12±9.018), in which male accounted for 81.34% (109/134).The incidence of PMI was 14.2% (19/134) . Patients wre divided into PMI group (n=19) and nonPMI group (n=115) according to the occurrence of perioperative myocardial injury. The single factor analysis showed that the significant differences of ostial occlusion ,blunt stump, severe tortuosity, longer CTO length ＞20 mm, retrograde approach, Reverse CART approach, and JCTO score between two groups. The Logistic multiple regression analysis showed that the Reverse CART approach (OR 7.580, P<0.05), occlusion length> 20 mm (OR 3.642, P<0.05) were the independent predictor of PMI in type 2 diabetes patient with CTO. Conclusions：The Reverse CART technology, and occlusion length> 20 mm are the independent predictor of PMI of type 2 diabetes mellitus combined CTO. To predict the special risk for perioperative myocardial injury patients, assessment of adverse cardiac events iscontributing to the choice of treatment strategy.