Introduction
Stroke is a leading cause of disability and death worldwide.
Atherosclerotic narrowing of the extracranial carotid arteries is
responsible for approximately one-fifth of all strokes (1). There are
two main interventional treatment methods in symptomatic or asymptomatic
high-grade carotid artery stenosis: carotid artery stenting (CAS) and
carotid endarterectomy (2,3). Although there is sufficient evidence on
the long-term outcomes of patients after CAS, potential risk factors
affecting the long-term course of the disease have not yet been studied
sufficiently (4,5).
Comorbid diseases accompanying severe CAS affect the long-term outcomes
of the disease. Although risk factors showing long-term consequences
such as diffuse proliferative hyperplasia after CAS, low high-density
lipoprotein cholesterol level, diabetes mellitus, low body mass index
(BMI), and contralateral carotid artery occlusion have so far been
identified, a detailed risk assessment has not yet been performed
(6-10).
Malnutrition is associated with adverse outcomes in many diseases
(11-12). The Controlling Nutritional Status (CONUT) score is an
objective index widely used for evaluating nutritional status of
individuals. The CONUT score is calculated based on serum albumin level,
total cholesterol level, and total lymphocyte count and it can assess
protein reserves, calorie deficit, and immune response (13). Clinical
significance of malnutrition as assessed by the CONUT score has been
demonstrated in patients with hypertension, acute coronary syndrome
(ACS), and heart failure (14-16).
Although the CONUT score is a practical, applicable, scoring system with
a prognostic value, its clinical significance has not yet been
elucidated in CAS patients. The aim of this study was to investigate the
relationship between malnutrition assessed by CONUT score and prognosis
in patients undergoing CAS.