Abstract
BACKGROUND: Malnutrition has been associated with poor prognosis in patients with lower extremity arterial disease (LEAD). Malnutrition can influence adverse bleeding events in patients with coronary artery disease. However, the association between bleeding events and malnutrition in patients with LEAD remains unclear. Therefore, this study evaluated the association between nutritional screening with controlled nutritional status (CONUT) score and bleeding events in patients with LEAD. METHODS AND RESULTS: This single-center retrospective observational study included 297 patients with LEAD who underwent endovascular therapy between January 2016 and December 2021. The high CONUT group was compared with the low CONUT group. The primary outcome was freedom from bleeding events, which was defined as Bleeding Academic Research Consortium type 3 or type 5. The high CONUT group had significantly higher cumulative bleeding events than the low CONUT group (log-rank P value <0.0001). Univariate analysis revealed that patients with a high CONUT score (hazard ratio [HR] 4.48; 95% confidence Interval [CI] 1.92-10.4; P=0.0005), chronic limb-threatening ischemia (HR 5.30; 95% CI 2.07-13.5; P=0.0005), non-ambulatory (HR 3.12; 95% CI 1.11-8.77; P= 0.03), and chronic kidney disease on hemodialysis (HR 4.01; 95% CI 1.72-9.33; P=0.001) had significantly more bleeding events than those with low CONUT scores. CONCLUSIONS: A high CONUT score at admission is closely associated with bleeding events in patients with LEAD.