Prevalence of alcohol use disorder and its association with disease severity in symptomatic peripheral arterial disease

Peripheral arterial disease (PAD) is a systemic atherosclerotic condition associated with substantial morbidity and mortality. Although excessive alcohol consumption has been implicated in cardiovascular disease, the prevalence of harmful drinking patterns and their association with PAD severity at clinical presentation remain poorly defined. In this observational cohort study, 103 consecutive patients with symptomatic lower-extremity PAD were enrolled. Alcohol exposure was assessed using the Alcohol Use Disorders Identification Test - Consumption (AUDIT-C) questionnaire and Lifetime Drinking History (LDH); AUD was diagnosed according to Diagnostic and Statistical Manual of Mental Disorders (DSM)-5 criteria. PAD severity was classified by Rutherford categories. Associations between alcohol consumption patterns and PAD severity were evaluated using logistic and ordered logistic regression models. Overall, 24.3% of patients were non-drinkers, 40.8% reported moderate alcohol consumption, 13.5% met criteria for at-risk drinking, and 21.4% were diagnosed with AUD. Patients with AUD were younger, had longer smoking exposure, and higher gamma-glutamyl transferase levels compared with those without AUD. Severe PAD at presentation (Rutherford category 6) was more frequent among patients with AUD than among those without AUD (36.4% vs. 12.3%). In multivariable analyses, AUD remained associated with severe PAD, although with borderline statistical significance. In contrast, at-risk alcohol consumption was not independently associated with PAD severity. Higher daily alcohol intake was associated with increased odds of advanced PAD in univariate analysis. Ordered logistic regression suggested a trend toward a more severe Rutherford category among patients with AUD, although this association did not reach statistical significance. These findings indicate that AUD is common among patients with symptomatic PAD and may be associated with greater disease severity at presentation, supporting the clinical relevance of systematic AUD screening in vascular care settings.