Triglyceride-glucose index with endovascular treatment and outcomes in patients with large ischemic core stroke

This study aims to evaluate the association between the triglyceride-glucose (TyG) index and the prognosis of patients with large ischemic core stroke received or did not receive endovascular treatment (EVT). This subanalysis from a multicenter, prospective registry study focused on patients with large ischemic core stroke. TyG, calculated by ln(triglycerides [mg/dL] × glucose [mg/dL]/2), was evaluated as both a four quartiles variable (⩽8.36 vs 8.36-8.85 vs 8.85-9.40 vs ⩾9.40) and a continuous variable. The primary outcome was the mRS score at 90 days, and the safety outcome was the 90-day mortality. Study registered at Chictr.org.cn (ChiCTR2100051664). Among 588 patients (54.4% men, median age 70 years), a higher continuous TyG index was associated with worse 3-month functional outcomes and increased mortality (adjusted odds ratio, 0.63; 95% confidence interval 0.50-0.78, p < 0.001; adjusted odds ratio, 1.6; 95% confidence interval, 1.31-2.18, p < 0.001). This association remained significant when TyG was treated categorically. A significant interaction between TyG index and treatment modalities was observed (p = 0.02). When the TyG index exceeded 9.18, the risk of death significantly increased in the EVT group. The TyG index more strongly associated with prognosis in EVT patients. Benefit of EVT became nonsignificant when TyG index exceeded 9.18.