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.