Silent and Sinister: High Prevalence of Silent, Severe Coronary Ischemia in Patients with Diabetic Foot Ulcers
Summary: A recent study published in *Journal of Vascular Surgery* (Monahan et al., 2025) found that a large portion of patients with diabetic foot ulcers (DFUs), even without prior known coronary artery disease or symptoms, have **silent but severe coronary ischemia** detectable on advanced imaging. This suggests underrecognized cardiovascular risk in the DFU population and possible need to integrate cardiac screening into comprehensive care.
Key Highlights:
- Among selected DFU patients who underwent coronary CT angiography (cCTA), more than half showed functional evidence of severe coronary disease via CT-derived fractional flow reserve (FFRct ≤ 0.75).
- Some patients required coronary intervention following catheterization despite no history of cardiac disease or symptoms.
- Suggests that DFU should be treated not only as a local wound issue but as a marker of systemic vascular disease.
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Keywords:
diabetic foot ulcer,
coronary ischemia,
silent ischemia,
CT-angiography,
Monahan et al.,
vascular risk