Excess risk of cardiovascular disease and mortality after amputation in type 2 diabetes: a nationwide population study from the Swedish National Diabetes Register
Authors' conclusion
Lower-extremity amputation in individuals with type 2 diabetes is associated with a substantially increased risk of cardiovascular disease and mortality, independent of pre-existing cardiovascular disease and established risk factors.
Study context
- Population
- Individuals with T2D, Swedish National Diabetes Register linked to the National Patient Register and Cause of Death Register, 2006–2019matched cohort
- Participants
- 3,485 vs 13,940
- Exposure
- T2D with lower-extremity amputation vs matched T2D controls without amputation
- Amputationn = 3,485
- Matched controlsn = 13,940reference
- Outcome
- Cardiovascular events and mortality
Methodological detailsobservational, population-based, nationwide, matched on age, sex, and calendar time, cause-specific Cox proportional hazards regression
- Observational
- Population-based
- Nationwide
- Matched on age, sex, and calendar time
- Cause-specific Cox proportional hazards regression
Main finding
As reported in the abstract
Each group vs matched controlsEstimate (95% CI)
Amputation
aHR, all-cause mortality 2.46(2.31–2.61)
Amputation
aHR, cardiovascular mortality 2.43(2.18–2.71)
Amputation
aHR, HF 2.13(1.92–2.36)
Amputation
aHR, MI 1.79(1.55–2.08)
Amputation
aHR, stroke 1.52(1.31–1.76)
Observational data: associations, not effects.
Further findings
All-cause mortality by time since amputation · first year; after five years
- Hazard of all-cause mortality more than threefold higher in the first year after amputation vs matched controls
- Hazard of all-cause mortality about 50% higher after five years
Original publication
Excess risk of cardiovascular disease and mortality after amputation in type 2 diabetes: a nationwide population study from the Swedish National Diabetes Register. Cardiovasc Diabetol. Published 24 August 2026. doi:10.
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