Increased risk of major adverse cardiovascular events in patients with deep and infected diabetes-related foot ulcers
Authors' conclusion
Deep and/or infected DFUs are associated with increased cardiovascular risk compared with DFUs that are not deep or infected. These findings provide a potential mechanistic explanation that requires investigation.
Study context
- Population
- Patients attending a multidisciplinary DFU service
- Participants
- 513 patients
- Exposure
- DFU categories by depth and infection
- D-/I-n = 241reference
- D-/I+n = 110
- D+/I-n = 35
- D+/I+n = 127
- Outcome
- MACE or all-cause mortality; MACE (hospitalisation for MI, stroke or TIA, or HF)
- Follow-up
- Median 381 days (IQR 220-551)
Methodological detailsprospectively collected data, multidisciplinary DFU service, Survival analyses: logrank test and multivariate Cox regression
- Prospectively collected data
- Multidisciplinary DFU service
- Survival analyses: logrank test and multivariate Cox regression
Main finding
As reported in the abstract
MACE or all-cause mortality
P < 0.001
- Overall major adverse cardiovascular events (MACE) or all-cause mortality
- 75 patients (14.6%)
Observational data: associations, not effects.
Further findings
| Outcome | P value |
|---|---|
| MACE alone · median follow-up 404 days (IQR 228-576)Across the four groups | P = 0.017 |
- MACE alone — Overall MACE alone
- 46 patients (9.0%)
- MACE alone: D-/I- 5.0%
- MACE alone: D-/I+ 10.9%
- MACE alone: D+/I- 5.7%
- MACE alone: D+/I+ 15.7%
Infection vs no infection
- MACE or all-cause mortality higher with infection (21.5% vs 8.7%; p<0.001)
- MACE alone higher with infection (13.5% vs 5.1%; p=0.003)
Original publication
Increased risk of major adverse cardiovascular events in patients with deep and infected diabetes-related foot ulcers. Diabetologia. Published 7 November 2024. doi:10.
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