A study on factors associated with acute coronary syndrome in patients with severe diabetic foot ulcers

Shi Yun; Shu Chang; Qian Zhifeng; Cui Shaoqi; Yang Enyan; Wang Aiping; Ji Zhaojie; Liang Yong; Wang Hailin

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A study on factors associated with acute coronary syndrome in patients with severe diabetic foot ulcers

更新时间：2026-07-01

- A study on factors associated with acute coronary syndrome in patients with severe diabetic foot ulcers
- Journal of Chongqing Medical University Pages: 1-6(2026)
- 作者机构：
  
  1.东部战区空军医院重症医学科，南京 210002
  2.东部战区空军医院内分泌科，南京 210002
  3.安徽中医药大学药学院，合肥 230012
- 作者简介：
- 基金信息：
- DOI：
  CLC： R587.2;R541.4
- Received：18 January 2026，
  
  Revised：2026-05-17，
  
  Accepted：18 May 2026，
  
  Published：01 July 2026
- 稿件说明：
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Shi Yun,Shu Chang,Qian Zhifeng,et al.A study on factors associated with acute coronary syndrome in patients with severe diabetic foot ulcers[J].Journal of Chongqing Medical University,
DOI：

Shi Yun,Shu Chang,Qian Zhifeng,et al.A study on factors associated with acute coronary syndrome in patients with severe diabetic foot ulcers[J].Journal of Chongqing Medical University, DOI：10.13406/j.cnki.cyxb..

摘要

目的

糖尿病足溃疡（diabetic foot ulcers，DFU）是糖尿病最常见的并发症之一，当DFU患者并发急性冠脉综合征（acute coronary syndrome，ACS）时，患者死亡率显著升高，本研究旨在探究重症DFU患者并发ACS的相关影响因素。

方法

回顾性分析2021年9月至2025年9月东部战区空军医院重症医学科收治的356例重症DFU患者的临床资料，根据患者是否发生ACS分为ACS组和非ACS（non-acute coronary syndrome，NACS）组，比较2组之间一般资料、实验室指标、合并症等，采用多因素logistic回归分析探究影响重症DFU患者并发ACS的独立危险因素，采用受试者工作特征（receiver operating characteristic，ROC）曲线分析这些因素对ACS的预测价值。

结果

ACS组年龄、血乳酸（lactic acid，Lac）、脑钠肽（brain natriuretic peptide，BNP）、血清白蛋白、血钾、合并脑梗死比例、合并冠状动脉粥样硬化性心脏病（coronary atherosclerotic heart disease，CHD）比例以及合并呼吸衰竭（respiratory failure，RF）比例均高于NACS组，而左心室射血分数（left ventricular ejection fraction，LVEF）值低于NACS组，差异均具有统计学意义（

0.05）。多因素logistic回归分析发现，Lac升高、LVEF值下降、合并CHD、合并RF是重症DFU患者并发ACS的独立危险因素（

0.05）。ROC曲线显示，这些因素均可作为重症DFU患者并发ACS的预测因子。

结论

年龄、Lac、BNP、LVEF值、血清白蛋白、血钾、合并脑梗死、合并CHD以及合并RF与重症DFU患者并发ACS密切相关，其中Lac升高、LVEF值下降、合并CHD、合并RF为重症DFU患者并发ACS的独立危险因素，并可作为预测因子。

Abstract

Objective

Diabetic foot ulcers（DFU） represent one of the most common complications of diabetes. When DFU patients develop acute coronary syndrome（ACS），the mortality rate increases significantly. This study aims to investigate the associated factors of ACS in patients with severe DFU.

Methods

A retrospective analysis was conducted on the clinical data of 356 patients with severe DFU admitted to the Department of Intensive Care，Air Force Hospital of Eastern Theater between September 2021 and September 2025. Patients were categorized into an ACS group and a non-ACS group based on the occurrence of ACS. General characteristics，laboratory indicators，and comorbidities were compared between the two groups. Multivariable logistic regression analysis was employed to identify independent risk factors influencing the prognosis of DFU patients. Receiver operating characteristic curve analysis was used to evaluate the predictive value of these factors for ACS.

Results

The ACS group exhibited significantly older age and higher blood lactate level，brain natriuretic peptide level，serum albumin level，serum potassium level，proportion of concomitant cerebral infarction，proportion of concomitant coronary atherosclerotic heart disease（CHD），and proportion of concomitant respiratory failure （RF） compared to the non-ACS group. Conversely，the left ventricular ejection fraction（LVEF） was lower in the ACS group than in the non-ACS group. All differences were statistically significant（

0.05）. Multivariable logistic regression analysis identified elevated blood lactate，decreased LVEF，concomitant CHD，and concomitant RF as independent risk factors for ACS in patients with severe DFU（

0.05）. Receiver operating characteristic curves demonstrated that these factors could serve as predictors of ACS in patients with severe DFU.

Conclusion

Age，blood lactate，brain natriuretic peptide，LVEF，serum albumin，serum potassium，concomitant cerebral infarction，concomitant CHD，and concomitant RF are closely associated with ACS in patients with severe DFU. Among these，elevated blood lactate，decreased LVEF，concomitant CHD，and concomitant RF are independent risk factors for ACS in patients with severe DFU and can serve as predictive factors.

关键词

Keywords

references

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