The predictive value of TyG index in patients with vertebrobasilar system thrombectomy

The triglyceride-glucose (TyG) index, a robust surrogate marker of metabolic dysregulation reflecting both insulin resistance and lipid-glucose homeostasis, has emerged as a significant predictor of cerebrovascular outcomes. Given the critical role of metabolic-nutritional status in post-stroke recovery, we supposed that the TyG index may predict the prognosis of ischemic stroke patients who underwent thrombectomy in the posterior circulation.

We studied 60 patients with cerebral infarction who underwent emergency posterior circulation interventional thrombectomy at a comprehensive stroke center from January 2018 to July 2024. The TyG index was used as the cut-off value of 8.53, and the formula was calculated as TyG index = ln [fasting glucose(mg/dL) × fasting triglycerides(mg/dL) /2]. Univariate analysis and multivariate logistic regression were used to adjust for age, the National Institutes of Health Stroke Scale (NIHSS) score at onset, APOA-1, and diabetes. A modified Rankin scale score of 0-2 at 90 days defined a good functional outcome, and the incidence of death within 90 days was investigated.

The number of patients with good functional outcome in the high TyG index group was significantly less than that in the low TyG index group (adjusted OR 6.85, 95%CI 1.83, 32.13, p = 0.008). TyG index was significantly associated with 90-day mortality (adjusted OR: 5.113, 95%CI 1.274 to 20.519, p = 0.021).

This study found that TyG index was linearly correlated with the 90-day neurological recovery in patients with acute posterior circulation cerebral infarction after interventional thrombectomy. The higher the TyG index, the worse the neurological recovery and the higher the risk of death.