The triglyceride-glucose (TyG) index has demonstrated a significant association with stroke outcomes. However, its prognostic value in acute ischemic strok

Background Collateral status provides compensatory flow to ischemic regions in acute large vessel occlusion (LVO) patients and is closely linked to clinical outcomes after endovascular therapy (EVT). This study aimed to evaluate the association between the triglyceride-glucose (TyG) index and collateral status in ischemic stroke patients undergoing EVT, focusing on sex-based differences. Methods A total of 789 patients undergoing EVT between September 2018 and January 2024 were retrospectively included in this study. Collateral status was assessed using the ASITN/SIR grading system based on digital subtraction angiography (DSA), classifying patients into poor (grades 0–1) and good (grades 2–4) collateral groups. The association between the TyG index and collateral status was evaluated using multivariable logistic regression analysis, and restricted cubic spline modeling. Results Among EVT patients (median age 69 years, 55.8% male), 256 were included in poor collateral group. The TyG index was significantly elevated in patients with poor collaterals compared to those with good collaterals (8.86 [8.43, 9.54] vs. 8.74 [8.35, 9.30], P = 0.021). Logistic regression analysis revealed that an elevated TyG index was independently associated with the risk of poor collateral status (OR = 1.30, 95% CI: 1.05–1.62, P = 0.017), with the association being significant in males (OR = 1.50, 95% CI: 1.08–2.08, P = 0.016) but not in females (OR = 1.21, 95% CI: 0.90–1.64, P = 0.205). In addition, restricted cubic spline modeling showed a positive linear association between the TyG index and poor collateral status in the total patients and males. Conclusion In this study, we found that the TyG index was significantly associated with poor collateral status in patients undergoing EVT, particularly in males.

Background The triglyceride-glucose (TyG) index, a simple and reliable surrogate marker of insulin resistance, has been shown to correlate with adverse stroke outcomes. This study aims to evaluate the association between TyG index and outcomes in patients undergoing endovascular treatment (EVT) for large vessel occlusion (LVO) due to different etiologies. Methods A total of 702 patients with acute anterior-circulation LVO due to large artery atherosclerosis (LAA) and cardioembolism (CE), who underwent EVT, were retrospectively included in this study between September 2018 and January 2024. The TyG index was categorized into tertiles: T1 (TyG ≤ 6.92), T2 (6.92 < TyG ≤ 7.60), and T3 (TyG > 7.60). The primary outcome was a shift toward worse outcome on the modified Rankin Scale (mRS). Secondary outcomes included 3-month poor outcome (mRS ≥ 3), successful recanalization, symptomatic intracranial hemorrhage (sICH), and 3-month mortality. Results Among EVT patients (median age 69 years, 55.1% male), the median TyG index was 7.43 (6.93-8.00) for LAA and 7.05 (6.65–7.71) for CE ( p < 0.001). In LAA patients, an elevated TyG index was associated with mRS shift (adjusted odds ratio [OR] = 1.79; 95% CI = 1.34–2.41; p < 0.001), 3-month poor outcome ( OR = 1.61; 95% CI = 1.13–2.34; p = 0.009), and mortality (OR = 1.77; 95% CI = 1.12–2.82; p = 0.015), but not with successful recanalization or sICH. Similar association was also oberved in CE or all patients. However, there was no significant CE/LAA and TyG index interaction on any outcome. Conclusion This study found that while the TyG index differed between LAA and CE patients with LVO undergoing EVT, elevated TyG index was associated with worse clinical outcomes in both groups.

This study aims to evaluate the association between the triglyceride-glucose (TyG) index and outcomes in large vessel occlusion (LVO) patients undergoing e