Among patients with diabetic foot ulcers, PAD was associated with a higher prevalence of CAD; however, this association was not independent after adjustment for major comorbidities, suggesting that PAD indicates a higher cardiovascular risk rather than serving as a predictive marker for CAD.
The majority of patients with diabetic foot ulcers in this cohort had peripheral arterial disease.
The incidence of CAD was significantly higher in DFU patients with PAD compared to those without PAD.
After multivariable adjustment, PAD was not independently associated with CAD in patients with diabetic foot ulcers.
Male sex was a significant independent predictor of CAD in patients with diabetic foot ulcers after multivariable adjustment.
The level of PAD involvement (above-ankle versus below-ankle) was not significantly associated with differences in CAD incidence.
This research examined whether blocked leg arteries (peripheral arterial disease, or PAD) could serve as a warning sign for heart artery disease (coronary artery disease, or CAD) in people with diabetic foot ulcers. The study looked at records from 190 patients treated at a wound care clinic in Ankara, Turkey between 2018 and 2022. Researchers found that more than half of the diabetic foot ulcer patients had PAD, and those with PAD were more likely to also have CAD (53% vs. 35%) compared to those without PAD. However, when the researchers accounted for other health factors — such as age, sex, high blood pressure, and kidney disease — the link between PAD and CAD was no longer statistically significant. This means that PAD itself may not be a direct cause or independent predictor of CAD; instead, both conditions likely share common underlying risk factors. Notably, being male was the only factor that remained a strong independent predictor of CAD after all adjustments were made. The researchers also found that it did not matter whether the arterial blockages were located above or below the ankle — both groups had similar rates of CAD. This research suggests that patients with diabetic foot ulcers and PAD carry a higher overall cardiovascular risk, but PAD alone should not be used as a standalone marker to predict CAD. The findings highlight the importance of comprehensive heart health screening for all patients with diabetic foot ulcers and PAD, as many of these individuals may have undetected heart disease that could affect their treatment and outcomes.
Sunter K, Ozgu K, Kama C, Uncu H. (2026). Can obstructive peripheral arterial disease be a marker for coronary artery disease in patients with diabetic foot ulcers?. Journal of wound care. https://doi.org/10.12968/jowc.2025.0042