ArticleJournal of diabetes investigation2026
Diabetic foot ulcer-related amputation is associated with twofold increased risk of cardiovascular disease: A Korean National Health Information Database Study.
Article in Journal of diabetes investigation, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
aimsTo quantify the risk of cardiovascular disease (CVD) and all-cause mortality associated with diabetic foot ulcer (DFU)-related amputation using a large-scale, nationally representative cohort. MATERIALS AND
methodsThis longitudinal study included individuals with diabetes who underwent standardized national health checkups between 2009 and 2012, with follow-up data obtained from the Korean National Health Insurance Service claims database. CVD was defined as an incident myocardial infarction or stroke occurring after the index health checkup. Cox proportional hazards models were used to estimate the hazard ratios (HRs) for CVD and mortality in individuals with DFU-related amputation compared with those with diabetes but without amputation.
resultsAmong 1,229,689 individuals with diabetes, 1,486 (0.12%) had a DFU-related amputation at baseline. The median follow-up was 8.2 years in the non-amputation group and 6.7 years in the DFU-related amputation group. People with DFU-related amputation had a significantly higher incidence rate of CVD compared with those without DFU-related amputation (32.6 vs. 11.0 per 1000 person-years) with a HR of 1.9 (95% CI 1.6-2.1). The HRs for myocardial infarction and stroke were 2.2 (95% CI 1.9-2.6) and 1.6 (95% CI 1.4-1.8), respectively. All-cause mortality significantly increased in people with DFU-related amputation compared with those without, with an HR of 2.1 (95% CI 1.9-2.3).
conclusionsIn this nationwide population-based cohort, DFU-related amputation was associated with nearly a twofold increased risk of cardiovascular events and mortality. These findings underscore the importance of comprehensive cardiovascular risk assessment and management in patients with diabetic foot complications.
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