{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,2]],"date-time":"2026-06-02T07:10:49Z","timestamp":1780384249707,"version":"3.54.1"},"reference-count":34,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2026,3,25]],"date-time":"2026-03-25T00:00:00Z","timestamp":1774396800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,3,25]],"date-time":"2026-03-25T00:00:00Z","timestamp":1774396800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100003646","name":"National Health Insurance Service","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100003646","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100003673","name":"Korean Educational Development Institute","doi-asserted-by":"publisher","award":["2023\u2010285"],"award-info":[{"award-number":["2023\u2010285"]}],"id":[{"id":"10.13039\/501100003673","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100014188","name":"Ministry of Science and ICT, South Korea","doi-asserted-by":"publisher","award":["RS\u20102023\u201000262002"],"award-info":[{"award-number":["RS\u20102023\u201000262002"]}],"id":[{"id":"10.13039\/501100014188","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100003569","name":"Ministry of Food and Drug Safety","doi-asserted-by":"publisher","award":["23212MFDS202"],"award-info":[{"award-number":["23212MFDS202"]}],"id":[{"id":"10.13039\/501100003569","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J of Diabetes Invest"],"published-print":{"date-parts":[[2026,6]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>To quantify the risk of cardiovascular disease (CVD) and all\u2010cause mortality associated with diabetic foot ulcer (DFU)\u2010related amputation using a large\u2010scale, nationally representative cohort.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods<\/jats:title>\n                    <jats:p>This longitudinal study included individuals with diabetes who underwent standardized national health checkups between 2009 and 2012, with follow\u2010up data obtained from the Korean National Health Insurance Service claims database. CVD was defined as an incident myocardial infarction or stroke occurring after the index health checkup. Cox proportional hazards models were used to estimate the hazard ratios (HRs) for CVD and mortality in individuals with DFU\u2010related amputation compared with those with diabetes but without amputation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among 1,229,689 individuals with diabetes, 1,486 (0.12%) had a DFU\u2010related amputation at baseline. The median follow\u2010up was 8.2\u2009years in the non\u2010amputation group and 6.7\u2009years in the DFU\u2010related amputation group. People with DFU\u2010related amputation had a significantly higher incidence rate of CVD compared with those without DFU\u2010related amputation (32.6 vs. 11.0 per 1000 person\u2010years) with a HR of 1.9 (95% CI 1.6\u20132.1). The HRs for myocardial infarction and stroke were 2.2 (95% CI 1.9\u20132.6) and 1.6 (95% CI 1.4\u20131.8), respectively. All\u2010cause mortality significantly increased in people with DFU\u2010related amputation compared with those without, with an HR of 2.1 (95% CI 1.9\u20132.3).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In this nationwide population\u2010based cohort, DFU\u2010related amputation was associated with nearly a twofold increased risk of cardiovascular events and mortality. These findings underscore the importance of comprehensive cardiovascular risk assessment and management in patients with diabetic foot complications.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jdi.70268","type":"journal-article","created":{"date-parts":[[2026,3,25]],"date-time":"2026-03-25T15:21:06Z","timestamp":1774452066000},"page":"1024-1033","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Diabetic foot ulcer\u2010related amputation is associated with twofold increased risk of cardiovascular disease: A Korean National Health Information Database Study"],"prefix":"10.1111","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9519-5650","authenticated-orcid":false,"given":"Jinsun","family":"Jang","sequence":"first","affiliation":[{"name":"Department of Internal Medicine Seoul National University College of Medicine and Seoul National University Hospital  Seoul Republic of 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