Aim The aim of the current study is to evaluate the association between below-the-ankle (BTA) arterial disease and coronary artery disease (CAD) in patients with diabetic foot ulcers (DFUs). Methods The study group was composed of patients with an active neuro-ischaemic DFUs managed in a tertiary care diabetic foot clinic. All patients received a pre-set limb salvage protocol including lower limb revascularization. By a retrospective analysis of individual angiograms, patients were divided in two groups: below-the-ankle (BTA) and above-the-ankle (ATA) arterial disease groups. The rate of CAD at baseline assessment and the new events of acute myocardial ischaemia (AMI) during 1-year of follow-up were evaluated and compared between the two groups. Results Two hundreds seventy-two (272) patients were included, 120 (44.1%) showed BTA arterial disease while 152 (55.9%) ATA arterial disease. The mean age was 68.9 +/- 9.6 years, 198 (72.8%) were male, 246 (90.4%) had type 2 diabetes, the mean diabetes duration was 20.7 +/- 11.6 years, the mean HbA1c was 7.8 +/- 4.2% (62 +/- 22 mmmol/mol). The whole population reported CAD in 172 cases (63.4%), and the rate in the BTA group was significantly higher than in ATA group, respectively, 90 (75.4%) vs 82 (54.1%), p < 0.0001. During the follow-up, BTA group had 5% of new cases of AMI in comparison to 1.3% in ATA group (p < 0.001). At the multivariate analysis BTA resulted an independent marker of CAD [OR 1.9 CI 9 5% (1.3-4.5) p = 0.0001]. Conclusion The current study shows a significant association between BTA arterial disease and CAD. A close cardiovascular screen should be required in patients with DFUs.

Meloni, M., Bellia, A., Giurato, L., Lauro, D., Uccioli, L. (2022). Below-the-ankle arterial disease: a new marker of coronary artery disease in patients with diabetes and foot ulcers. ACTA DIABETOLOGICA, 59(10), 1331-1338 [10.1007/s00592-022-01932-w].

Below-the-ankle arterial disease: a new marker of coronary artery disease in patients with diabetes and foot ulcers

Meloni, Marco;Bellia, Alfonso;Giurato, Laura;Lauro, Davide;Uccioli, Luigi
2022-10-01

Abstract

Aim The aim of the current study is to evaluate the association between below-the-ankle (BTA) arterial disease and coronary artery disease (CAD) in patients with diabetic foot ulcers (DFUs). Methods The study group was composed of patients with an active neuro-ischaemic DFUs managed in a tertiary care diabetic foot clinic. All patients received a pre-set limb salvage protocol including lower limb revascularization. By a retrospective analysis of individual angiograms, patients were divided in two groups: below-the-ankle (BTA) and above-the-ankle (ATA) arterial disease groups. The rate of CAD at baseline assessment and the new events of acute myocardial ischaemia (AMI) during 1-year of follow-up were evaluated and compared between the two groups. Results Two hundreds seventy-two (272) patients were included, 120 (44.1%) showed BTA arterial disease while 152 (55.9%) ATA arterial disease. The mean age was 68.9 +/- 9.6 years, 198 (72.8%) were male, 246 (90.4%) had type 2 diabetes, the mean diabetes duration was 20.7 +/- 11.6 years, the mean HbA1c was 7.8 +/- 4.2% (62 +/- 22 mmmol/mol). The whole population reported CAD in 172 cases (63.4%), and the rate in the BTA group was significantly higher than in ATA group, respectively, 90 (75.4%) vs 82 (54.1%), p < 0.0001. During the follow-up, BTA group had 5% of new cases of AMI in comparison to 1.3% in ATA group (p < 0.001). At the multivariate analysis BTA resulted an independent marker of CAD [OR 1.9 CI 9 5% (1.3-4.5) p = 0.0001]. Conclusion The current study shows a significant association between BTA arterial disease and CAD. A close cardiovascular screen should be required in patients with DFUs.
Pubblicato
Rilevanza internazionale
Articolo
Esperti anonimi
Settore MED/13
English
Con Impact Factor ISI
Below-the-ankle arterial disease
Coronary artery disease
Diabetes
Diabetic foot ulcers
Peripheral arterial disease
Coronary Artery Disease
Diabetes Mellitus, Type 2
Diabetic Foot
Foot Ulcer
Meloni, M., Bellia, A., Giurato, L., Lauro, D., Uccioli, L. (2022). Below-the-ankle arterial disease: a new marker of coronary artery disease in patients with diabetes and foot ulcers. ACTA DIABETOLOGICA, 59(10), 1331-1338 [10.1007/s00592-022-01932-w].
Meloni, M; Bellia, A; Giurato, L; Lauro, D; Uccioli, L
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/2108/309219
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