Impact of Serum Zinc Level and Oral Zinc Supplementation on Clinical Outcomes in Patients Undergoing Infrainguinal Bypass for Chronic Limb-Threatening Ischemia

Abstract

tality risk after revascularization in patients with CLTI. 5,6 Several guidelines recommend that an interdisciplinary care team, including nutritionists/dietitians, evaluate and provide comprehensive care for patients with CLTI; 1,7 however, the efficacy of nutritional interventions in patients with complicated CLTI is not well understood.Zinc (Zn), one of the essential micronutrients for humans, is involved in numerous biological functions and is considered a multipurpose trace element due to its capacity to bind to more than 300 enzymes and more than 2,000 transcription factors. 8 It has also been reported to play an important role in wound healing. 9 In addition, several reports have recently reinforced the association between Zn deficiency and cardiovascular disease, especially ath-C hronic limb-threatening ischemia (CLTI) is the most severe form of peripheral artery disease (PAD) and is characterized by ischemic resting pain and tissue loss. Revascularization is needed to relieve ischemic pain, heal ischemic wounds, prevent limb loss, and preserve ambulation and quality of life. Although the application of endovascular therapy (EVT) for CLTI has recently increased, surgical bypass using an autogenous vein plays an important role in the treatment of CLTI. 1 Several studies have recommended surgical bypass for appropriately selected patients because of its durable revascularization and superior wound healing rate compared to EVT. [2][3][4] Recently, several studies have reported that preoperative nutritional status is independently associated with the mor-