Aims:
We aimed to evaluate cardiovascular outcomes and mortality between patients with diabetic foot disease (DFD) and non-diabetic individuals with myocardial infarction (MI).
Methods:
In a nationwide cohort in South Korea, patients with DFD (n=43,288), and non-diabetic individuals with MI (n=26,873) between 2012 and 2015 were followed until 2021. The primary outcome was a composite of non-fatal MI, non-fatal ischemic stroke (IS), and cardiovascular death. Cox proportional hazard models were used.
Results:
Over a median follow-up of 7.0 years, the primary outcome event rate was 31.5 and 18.1 per 1000 person-years in the DFD and MI groups, respectively (adjusted hazard ratio [HR], 1.60; 95% confidence interval [CI], 1.53–1.66). The risk of non-fatal MI (adjusted HR, 0.94; 95% CI, 0.85–1.04) was comparable between the groups, but the DFD group had significantly higher risks of non-fatal IS (adjusted HR, 2.38; 95% CI, 2.24–2.53) and cardiovascular death (adjusted HR, 1.33; 95% CI, 1.26–1.41). They also exhibited increased risks of heart failure hospitalization (adjusted HR, 1.35; 95% CI, 1.31–1.40) and all-cause death (adjusted HR, 2.09; 95% CI, 2.02–2.15).
Conclusion:
Patients with DFD have a significantly higher risk of major cardiovascular events and mortality than non-diabetic patients with MI.