Department of Cardiology, Tokyo Women's Medical University, Tokyo 162-8666, Japan.
Nutrients. 2019 Jul 29;11(8):1745. doi: 10.3390/nu11081745.
Peripheral artery disease (PAD) occurs at an advanced stage of atherosclerosis and its comorbidities are associated with poor prognoses. Malnutrition is related to the severity of atherosclerosis in patients with cardiovascular disease and it predicts mortality. The Controlling Nutritional Status (CONUT) score is calculated from serum albumin concentration, peripheral lymphocyte count and total cholesterol concentration, and it robustly represents the nutritional status of hospitalized patients. This study aimed to determine the prognostic value of the CONUT score in patients with peripheral artery disease (PAD) who were undergoing endovascular therapy (EVT).
This study included 628 PAD patients who underwent EVT between 2013 and 2017 and were assigned to low (CONUT score 0: = 81), mild (CONUT score 1-2: = 250), moderate (CONUT score 3-4: = 169), and high (CONUT score ≥ 5: = 128) risk groups. The study's primary endpoint was any death. Patients in the groups with higher CONUT scores were more likely to have chronic kidney disease ( < 0.001), impaired left ventricular ejection fractions ( < 0.001), and critical limb ischemia ( < 0.001) on admission. During follow-up, 95 patients (15%) died. Kaplan-Meier analyses revealed that the patients with higher CONUT scores had lower survival rates ( < 0.001; log-rank trend test). Multivariate Cox regression analyses showed that following adjustments for the confounding factors, a higher CONUT score was significantly associated with any death (hazard ratio, 1.15; 95% confidence interval, 1.03-1.30).
The simple index CONUT score at the time of EVT may predict long-term mortality in PAD patients.
外周动脉疾病（PAD）发生于动脉粥样硬化的晚期，其合并症与不良预后相关。营养不良与心血管疾病患者的动脉粥样硬化严重程度相关，并且可以预测死亡率。CONUT 评分是根据血清白蛋白浓度、外周血淋巴细胞计数和总胆固醇浓度计算得出的，它能够准确地反映住院患者的营养状况。本研究旨在确定 CONUT 评分在外周动脉疾病（PAD）患者行血管腔内治疗（EVT）后的预后价值。
本研究纳入了 628 例于 2013 年至 2017 年期间行 EVT 的 PAD 患者，并将其分为低危（CONUT 评分 0：n = 81）、低中危（CONUT 评分 1-2：n = 250）、中高危（CONUT 评分 3-4：n = 169）和高危（CONUT 评分≥5：n = 128）组。本研究的主要终点为任何死亡。CONUT 评分较高的患者更有可能患有慢性肾脏病（<0.001）、左心室射血分数受损（<0.001）和严重肢体缺血（<0.001）。随访期间，95 例（15%）患者死亡。Kaplan-Meier 分析显示，CONUT 评分较高的患者生存率较低（<0.001；log-rank 趋势检验）。多因素 Cox 回归分析显示，在校正混杂因素后，较高的 CONUT 评分与任何死亡显著相关（危险比，1.15；95%置信区间，1.03-1.30）。
EVT 时的简单指标 CONUT 评分可能预测 PAD 患者的长期死亡率。
