Influence of TyG Index on Large Vascular Occlusive Stroke Following Endovascular Treatment

This study aimed to investigate the impact of the triglyceride-glucose index (TyG index) on clinical consequences in individuals with large vascular occlusion (LVO)-induced acute ischemic stroke (AIS) following endovascular treatment (EVT).

We conducted a single-center retrospective cohort study, including AIS with LVO who underwent EVT. Patients were categorized into TyG index groups, calculated as "(fasting triglyceride [mg/dL] × fasting blood glucose [mg/dL]/2)." Clinical outcomes were assessed, including poor outcome (modified Rankin Scale [mRS] > 2 [3-6]) at 90 days, early neurological deterioration (END), symptomatic intracranial hemorrhage (sICH), and 90-day mortality after EVT. Logistic regression and restricted cubic splines (RCS) were used to examine the relationship between the TyG index and clinical outcomes. Receiver operating characteristic (ROC) curve was constructed to evaluate the prognostic capacity of the TyG index.

A total of 424 patients were included. Higher TyG levels were associated with worse functional outcome at 90 days (per unit: p = 0.006), sICH (per unit: p = 0.002, T3 versus T1: p = 0.004), and 90-day mortality (T2 versus T1: p = 0.011, T3 versus T1: p = 0.029) in logistic regression. A RCS model revealed a linear association between the TyG index and poor outcome at 90 days, sICH, and 90-day mortality (p for nonlinearity > 0.05). In ROC curve analysis, the traditional risk factors model (area under the curve [AUC]: 0.824, 95% CI: 0.784-0.859) was outperformed by the conventional risk factors + TyG index model (AUC: 0.845, 95% CI: 0.807-0.878) in predicting poor outcome (p = 0.021).

A higher TyG index is associated with worse clinical outcomes in LVO-induced AIS patients after EVT. Additionally, the TyG index enhances risk prediction of traditional risk factors for poor outcome.