Prognostic value of the triglyceride–glucose index in patients with acute ischemic stroke undergoing endovascular treatment

Abstract

Objective

This study aimed to assess the prognostic significance of the triglyceride–glucose index in predicting clinical outcomes in patients with acute ischemic stroke undergoing endovascular thrombectomy.

Methods

This study analyzed 811 patients with anterior circulation large-vessel occlusion who underwent endovascular thrombectomy for acute ischemic stroke. The triglyceride–glucose index was calculated as ln (fasting blood glucose (mg/dL) × fasting triglycerides (mg/dL)/2). A favorable outcome at 90 days was defined as a modified Rankin Scale score of 0–2.

Results

A higher triglyceride–glucose index was significantly associated with an unfavorable prognosis (odds ratio: 1.831, 95% confidence interval: 1.346 to 2.492), demonstrating a linear relationship. Incorporation of the triglyceride–glucose index into baseline models significantly improved risk classification and discrimination, as reflected by net reclassification improvement and integrated discrimination improvement (both p < 0.05). This association remained significant across key subgroups, including older patients (odds ratio: 1.823, 95% confidence interval: 1.320 to 2.519), patients with successful reperfusion (odds ratio: 1.797, 95% confidence interval: 1.351 to 2.392), and those with high Alberta Stroke Program Early CT Score (odds ratio: 1.712, 95% confidence interval: 1.294 to 2.265).

Conclusion

The triglyceride–glucose index is an independent predictor of functional outcome in patients with acute ischemic stroke undergoing endovascular thrombectomy, highlighting its potential for risk stratification.

Keywords

Triglyceride–glucose index endovascular treatment acute ischemic stroke

Introduction

Endovascular thrombectomy (EVT) has become a standard treatment for the early management of acute large-vessel occlusion strokes (LVOSs) and remains effective within 24 h of symptom onset.^1,2 However, the prognosis of EVT remains limited, as approximately 50% of patients who undergo successful recanalization fail to achieve favorable outcomes.³

Previous studies have shown that insulin resistance (IR) can promote atherosclerosis⁴ and induce prothrombotic and proinflammatory states, thereby leading to ischemic stroke.⁵ IR has also been associated with poor outcomes after intravenous thrombolysis (IT).⁶ Cardiovascular research further underscores its role in adverse events. For instance, IR can lead to adverse progression of cardiovascular diseases⁷ and increase susceptibility to major adverse cardiovascular events (MACE) in patients undergoing percutaneous coronary intervention (PCI).⁸ Furthermore, in patients undergoing EVT, IR has been associated with hemorrhagic transformation following the procedure.⁹

IR refers to the reduced sensitivity of target tissues to the action of insulin, which diminishes the biological effects of insulin despite normal levels.¹⁰ IR plays a central role in the pathogenesis of type 2 diabetes and thereby increases the risk of stroke. The homeostasis model assessment of insulin resistance (HOMA-IR), calculated from fasting blood glucose (FBG) and insulin levels, is a widely used indicator of IR. However, its application is limited because of the atypical measurement of serum insulin levels.¹¹ Recently, the triglyceride–glucose (TyG) index has been widely used as a biochemical marker of IR. The TyG index is calculated as ln (fasting triglyceride (mg/dL) × FBG (mg/dL)/2).^12,13 Unlike other IR markers, the TyG index requires only blood glucose and triglyceride levels, making it easily applicable in routine clinical settings and ensuring its widespread utility in research and clinical practice. Previous studies have demonstrated that the TyG index is associated with ischemic stroke recurrence, early neurological deterioration (END), and overall prognosis.^14,15 However, the association between the TyG index and functional outcomes in patients undergoing EVT remains unclear. Therefore, this study aimed to investigate the association between the TyG index and clinical outcomes following EVT.

Methods

Study participants

We retrospectively enrolled patients who underwent EVT for anterior circulation LVOS at the First Affiliated Hospital of Wannan Medical College between July 2015 and April 2023. This study was approved by the Ethics Committee of Wannan Medical College (Approval Number: 2019-039) and was conducted in accordance with the Declaration of Helsinki of 1975. Due to the retrospective nature of the study, the requirement for written informed consent was waived. The exclusion criteria were as follows: (a) age <18 years; (b) prestroke modified Rankin Scale (mRS) score ≥2; (c) confirmation of anterior cerebral artery occlusion or multivessel occlusion using computed tomography angiography (CTA) or digital subtraction angiography (DSA); (d) technical failure of EVT; (e) unavailable postoperative laboratory measurements for triglyceride and glucose levels; (f) lack of 90-day clinical follow-up data or inpatient records for mRS assessment; and (g) Alberta Stroke Program Early CT (ASPECT) score <3 (Figure 1). The reporting of this study conforms to the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement.¹⁶

Figure 1.

Flowchart of the inclusion of the study population.

For all enrolled patients, we collected demographic information (age and sex), personal medical history (hypertension, atrial fibrillation, and diabetes), smoking and alcohol habits, clinical data (IT, baseline blood pressure, Trial of Org 10172 in Acute Stroke Treatment (TOAST) classification,¹⁷ National Institutes of Health Stroke Scale (NIHSS) score at admission, and ASPECT score), and laboratory data obtained within 24 h (FBG, triglycerides, and other parameters). Surgical patients underwent evaluation and documentation of relevant procedural details, including the time from puncture to reperfusion (PTR), time from symptom onset to reperfusion (OTR), location of vascular occlusion, extent of reperfusion, and collateral status.

Variable definitions

Reperfusion success was defined as achieving a modified Thrombolysis in Cerebral Infarction (mTICI) score of 2b or 3.¹⁸ Prior to reperfusion therapy, collateral circulation was evaluated by retrograde angiography of the occluded vessel using DSA images. Two neuroradiologists, blinded to all clinical and outcome information, graded collateral status on preinterventional DSA images using the contralateral branch scoring system. Collateral circulation was graded according to the American Society of Interventional and Therapeutic Neuroradiology/Society of Interventional Radiology (ASITN/SIR) scale.¹⁹ Functional prognosis was evaluated at 90 days using mRS; scores ranging from 0 to 2 were considered as favorable outcomes and scores ranging from 3 to 6 were considered unfavorable. Follow-up assessments were conducted through telephone interviews or outpatient visits.

TyG index

The TyG index was calculated as ln (fasting triglycerides (mg/dL) × FBG (mg/dL)/2).¹² Following an overnight fast, blood samples were collected in ethylenediaminetetraacetic acid (EDTA) tubes on the morning after reperfusion therapy.

Statistical analysis

Based on the 90-day mRS scores, patients were classified into favorable-prognosis and unfavorable-prognosis groups. Normally distributed continuous variables were summarized as mean ± SD, whereas non-normally distributed continuous variables were reported as median and interquartile range. Categorical variables were presented as counts and percentages. Between-group comparisons were performed using the chi-square test or Fisher’s exact test for categorical variables, the independent-samples t-test for normally distributed continuous variables, and nonparametric tests for non-normally distributed variables. Normality was assessed using the Kolmogorov–Smirnov test.

The association between prognosis and clinical characteristics was evaluated using univariate regression analysis. Variables with a significance level of p <0.05 in the univariate analysis were incorporated into the multivariable regression model. To address the limitations of the dichotomized mRS endpoint, sensitivity analyses were conducted by treating the ordinal mRS score as a continuous variable in univariate and multivariate logistic regression analyses. To assess heterogeneity, subgroups were defined according to age, degree of reperfusion, and ASPECT score. Furthermore, we applied a restricted cubic spline regression model with three knots positioned at the 10th, 50th, and 90th percentiles to investigate the relationship between the TyG index and functional outcomes. The C-statistic, net reclassification improvement (NRI), and integrated discrimination improvement (IDI) were calculated to evaluate risk discrimination and reclassification after incorporating the TyG index into the baseline model containing established risk factors.

Statistical significance was defined as p <0.05 (two-tailed). Statistical analyses were performed using Statistical Package for Social Sciences (SPSS; version 25.0, IBM; Armonk, NY, USA) and R-studio (version 4.2.2, R Foundation for Statistical Computing; Vienna, Austria).

Results

Baseline characteristics

This study enrolled 1018 patients with LVOS who underwent EVT. After applying the exclusion criteria, 207 patients were excluded, leaving 811 eligible patients for analysis. The median age was 71 (59–75) years, and 459 patients (56.6%) were male. Hypertension was documented in 530 patients (65.4%), diabetes mellitus in 128 (15.8%), smoking in 248 (30.6%), and alcohol consumption in 218 (26.9%). At admission, the median NIHSS score was 14 (12–18), and the ASPECT score was 9 (7–10). IT was performed in 105 patients (12.9%). The median systolic and diastolic blood pressures were 151 (137–168) mmHg and 84 (75–93) mmHg, respectively. The median TyG index was 8.49 (8.06–8.90). Overall, 715 patients (88.2%) achieved mTICI 2b/3 reperfusion (Table 1).

Table 1.

Univariate analysis of 90-day functional outcome in patients undergoing mechanical thrombectomy.

Baseline characteristics	All patients	Good outcomes	Poor outcomes	p value
Number of patients, n	811	427	384
Age, median (IQR), years	71 (59, 75)	68 (59, 75)	74 (66, 79)	<0.001
Men, n (%)	459 (56.6)	267 (62.5)	192 (50.0)	<0.001
Hypertension, n (%)	530 (65.4)	263 (61.6)	267 (69.5)	0.018
Diabetes mellitus, n (%)	128 (15.8)	57 (13.3)	71 (18.5)	0.045
Current drinking, n (%)	218 (26.9)	125 (29.3)	93 (24.2)	0.105
Current smoking, n (%)	248 (30.6)	157 (36.8)	91 (23.7)	<0.001
Baseline NIHSS score, median (IQR)	14 (12, 18)	13 (11, 16)	16 (13, 19)	<0.001
Intravenous thrombolysis, n (%)	105 (12.9)	55 (12.9)	50 (13.0)	0.572
Baseline ASPECT, median (IQR)	9 (7, 10)	9 (8, 10)	8 (6, 9)	<0.001
Systolic blood pressure, median (IQR), mmHg	151 (137, 168)	150 (135, 166)	154 (140, 170)	0.001
Diastolic blood pressure, median (IQR), mmHg	84 (75, 93)	84 (74, 92)	84 (76, 93)	0.948
Stroke etiology, n (%)				<0.001
LAA	216 (26.6)	139 (32.6)	77 (20.1)
CE	497 (61.3)	226 (52.9)	271 (70.6)
Other or unknown	98 (12.08)	62 (14.52)	36 (9.38)
Occlusion site, n (%)				<0.001
ICA	328 (40.4)	143 (33.5)	185 (48.2)
MCA M1	405 (49.9)	236 (55.3)	169 (44.0)
MCA M2	78 (9.6)	48 (11.2)	30 (7.8)
Onset to reperfusion^a median (IQR)	350 (283, 450)	348 (275, 445)	355 (291, 468)	0.071
Puncture to reperfusion^b, median (IQR)	60 (40, 80)	50 (37, 74)	60 (43, 90)	<0.001
mTICI, 2 b/3, n (%)	715 (88.2)	400 (93.7)	315 (82.0)	<0.001
Collateral score^c, n (%)				<0.001
ASITN/SIR 0–1	135 (16.7)	26 (6.1)	109 (28.5)
ASITN/SIR 2	229 (28.3)	97 (22.8)	132 (34.5)
ASITN/SIR 3–4	444 (55.0)	302 (71.1)	142 (37.1)
TyG, median (IQR)	8.49 (8.06, 8.90)	8.39 (7.98, 8.82)	8.56 (8.16, 9.00)	<0.001

Twenty-four patients had missing data on OTR.

Twenty-three patients had missing data on PTR.

Three patients had missing data on the collateral score.

ASITN/SIR: American Society of Interventional and Therapeutic Neuroradiology/Society of Interventional Radiology; ASPECT: Alberta Stroke Program Early CT; CE: cardioembolism; ICA: internal carotid artery; LAA: large-artery atherosclerosis; MCA(M1/M2): M1/M2 middle cerebral artery segment; mTICI: modified Thrombolysis in Cerebral Infarction; NIHSS: National Institutes of Health Stroke Scale; TyG: triglyceride–glucose; IQR: interquartile range; OTR: symptom onset to reperfusion; PTR: puncture to reperfusion.

Relationship between the TyG index and outcome

In this study, all patients were categorized into two groups according to their 90-day mRS scores. Overall, 427 patients (52.7%) were classified as having a favorable prognosis, whereas 384 patients (47.3%) were classified as having an unfavorable prognosis.

Compared with the favorable-prognosis group, the unfavorable-prognosis group was older (68 vs. 74 years, p < 0.001), included a lower proportion of males (267 (62.55%) vs. 192 (50.0%), p < 0.001) They more frequently had hypertension (263 (61.6%) vs. 267 (69.5%), p = 0.018) and diabetes (57 (13.3%) vs. 71 (18.5%), p = 0.045), exhibited different distributions of occlusion sites (p < 0.001), had a lower proportion of good collateral circulation (p < 0.001), and achieved a lower rate of successful reperfusion (400 (93.7%) vs. 315 (82.0%), p < 0.001). Additionally, they presented with a higher median NIHSS score at admission (13 vs. 16, p < 0.001), a higher median baseline systolic blood pressure (150 vs. 154 mmHg, p = 0.001), a lower median ASPECT score at admission (9 vs. 8, p < 0.001), and a longer PTR (50 vs. 60 min, p < 0.001). There were no significant differences between the groups in alcohol consumption history, IT, diastolic blood pressure, onset-to-puncture time, or other listed variables (Table 2).

Table 2.

Multivariate analysis of 90-day functional outcome in patients undergoing mechanical thrombectomy.

Baseline characteristics	OR	95% CI	p value
Male	1.226	0.816 to 1.842	0.326
Age	1.038	1.018 to 1.058	<0.001
Hypertension	0.936	0.635 to1.378	0.737
Diabetes mellitus	1.084	0.654 to 1.797	0.755
Current smoking	0.697	0.441 to 1.103	0.123
Baseline NIHSS score	1.093	1.047 to 1.141	<0.001
Baseline ASPECT	0.754	0.678 to 0.837	<0.001
Systolic blood pressure	1.010	1.002 to 1.018	0.012
Stroke etiology		Reference	0.506
CE versus LAA	1.452	0.899 to 2.346	0.127
Other versus LAA	1.176	0.439 to 3.149	0.747
Unknown versus LAA	1.301	0.630 to 2.685	0.476
Occlusion site		Reference	0.008
MCA M1 versus ICA	0.685	0.469 to 0.999	0.049
MCA M2 versus ICA	0.385	0.204 to 0.725	0.003
PTR^a	1.011	1.004 to 1.017	0.001
mTICI, 2b/3	0.468	0.253 to 0.866	0.016
Collateral score^b		Reference	<0.001
ASITN/SIR 2 versus ASITN/SIR 0–1	0.422	0.232 to 0.769	0.005
ASITN/SIR 3–4 versus ASITN/SIR 0–1	0.216	0.120 to 0.387	<0.001
TyG	1.831	1.346 to 2.492	<0.001

Twenty-three patients had missing data on PTR.

Twenty-three patients had missing data on the collateral score.

ASITN/SIR: American Society of Interventional and Therapeutic Neuroradiology/Society of Interventional Radiology; ASPECT: Alberta Stroke Program Early CT; CE: cardioembolism; CI: confidence interval; ICA: internal carotid artery; LAA: large-artery atherosclerosis; MCA(M1/M2): M1/M2 middle cerebral artery segment; mTICI: modified Thrombolysis in Cerebral Infarction; NIHSS: National Institutes of Health Stroke Scale; OR: odds ratio; PTR: puncture to reperfusion time; TyG: triglyceride–glucose.

In the multivariate analysis, the TyG index was significantly associated with 3-month functional outcome (odds ratio (OR): 1.831, 95% confidence interval (CI): 1.346 to 2.492, p < 0.001). The multivariable-adjusted spline regression model demonstrated a significant linear relationship between the TyG index and functional outcome after EVT (p < 0.001), with no evidence of nonlinearity (p = 0.745) (Figure 2).

Figure 2.

Association between the TyG index and outcome with the RCS function. The model included 3 knots located at the 10th, 50th, and 90th percentiles. The y-axis represents the OR to present outcome for any value of TyG compared to individuals with a reference value (50th percentile) of TyG. The logistic regression was adjusted for occlusion site, baseline SBP, NIHSS, age, ASPECT score, mTICI, collateral, and PTR. ASPECT: Alberta Stroke Program Early CT; mTICI: modified Thrombolysis in Cerebral Infarction; NIHSS: National Institutes of Health Stroke Scale; OR: odds ratio; PTR: puncture to reperfusion; SBP: systolic blood pressure; TyG: triglyceride–glucose; RCS: restricted cubic spline.

Sensitivity analysis

Using mRS as a continuous variable, we first performed univariate linear regression. Variables with p <0.05 were entered into the final multivariable model. Age was positively associated with mRS (β = 0.03, 95% CI: 0.02 to 0.05, p < 0.001), as were the NIHSS score (β = 0.08, 95% CI: 0.06 to 0.11, p < 0.001) and the TyG index (β = 0.45, 95% CI: 0.25 to 0.65, p < 0.001). In contrast, the ASPECT score (β = −0.24, 95% CI: −0.31 to −0.17, p < 0.001) was inversely associated with outcome (Table S1).

Subgroup analyses

Subgroup analyses were performed for age, reperfusion status, and admission ASPECT score, which yielded consistent results. No significant interactions were observed between changes in the TyG index and the stratified variables (all interactions, p > 0.05). However, a significant positive correlation of the TyG index was still evident in older patients (OR: 1.823, 95% CI: 1.320 to 2.519, p < 0.001), in patients with successful reperfusion (OR: 1.797, 95% CI: 1.351 to 2.392, p < 0.001), and in patients with high ASPECT score (OR: 1.712, 95% CI: 1.294 to 2.265, p < 0.001) (Figure 3).

Figure 3.

Subgroup analyses of the association between the TyG index and 90-day functional outcome in patients undergoing endovascular treatment. TyG: triglyceride–glucose.

Incremental predictive value of changes in the TyG index

We further assessed the predictive ability of the TyG index for functional outcomes after EVT beyond established risk factors. The base model included age, NIHSS score at admission, ASPECT score at admission, systolic blood pressure, occlusion location, PTR, mTICI, and collateral circulation. Incorporating the TyG index into the base model resulted in no significant change in the C-statistics (p = 0.112). However, incorporating the TyG index to the base model significantly improved risk classification, as evidenced by an NRI of 0.220 (95% CI: 0.081 to 0.358, p = 0.002) and an IDI of 0.016 (95% CI: 0.062 to 0.0247, p = 0.001; Table 3). The NRI used in our analysis was a continuous metric, as opposed to a categorical one.

Table 3.

Performance of models with the TyG index to predict 90-day functional outcome in patients undergoing mechanical thrombectomy.

Models	C-statisticsEstimate (95% CI), % p value	NRI (continuous)Estimate (95% CI), % p value	IDIEstimate (95% CI), % p value
Basic model	0.815（0.785 to 0.845）	Reference	Reference
Basic model + TyG index	0.823（0.794 to 0.852)	0.220 (0.081 to 0.358) 0.002	0.016 (0.0062 to 0.0247) 0.001

The basic model included occlusion site, baseline SBP, NIHSS, age, ASPECT score, mTICI, collateral, and PTR.

ASPECT: Alberta Stroke Program Early CT; CI: confidence interval; IDI: integrated discrimination improvement; mTICI: modified Thrombolysis in Cerebral Infarction; NIHSS: National Institutes of Health Stroke Scale; NRI: net reclassification index; PTR: puncture to reperfusion time; SBP: systolic blood pressure; TyG: triglyceride–glucose.

Discussion

Our study demonstrated a positive correlation between the TyG index and adverse post-EVT functional outcomes. The results remained consistent even after adjusting for potential confounders. Similar findings were observed among subgroups of older patients, those with successful postprocedural recanalization, and those with higher ASPECT scores. Our findings suggests that the TyG index may have significant implications for post-EVT functional outcomes.

Recent studies have provided evidence supporting the value of the TyG index in ischemic stroke. A community-based cohort study revealed that, during an 11-year follow-up period, an elevated TyG index independently predicted ischemic stroke in the general population, irrespective of sampling time.²⁰ Huo et al.²¹ demonstrated that the TyG index is a valuable tool for identifying individuals at high risk of stroke. Furthermore, a recent single-center retrospective study focusing on patients treated with EVT showed that a lower TyG index was significantly associated with better functional outcomes at 90 days.²² Another retrospective study also identified that the TyG index may be an independent predictor of functional outcome after EVT.²³ Our study further demonstrated that the TyG index is a significant factor associated with adverse post-EVT functional outcomes. Moreover, a linear correlation between the TyG index and post-EVT functional outcome was observed using a multivariable-adjusted spline regression model. The subgroup analyses were consistent with these findings.

We designated age, reperfusion status, and ASPECT score as subgroups because these factors represent core dimensions of stroke pathophysiology and key modifiers of functional recovery after EVT.^24–26 However, no significant association between the TyG index and prognosis was observed in patients aged <65 years, in the post-nonreperfusion group, or in the large-core infarction group. These divergent findings likely reflect the varying dominance of competing pathophysiological processes in different clinical contexts, within which the mechanisms linking IR to outcomes may operate with differing potency. Several interlinked pathways may explain the detrimental role of a higher TyG index. First, IR promotes endothelial dysfunction, a prothrombotic state, and accelerates atherosclerosis, all of which may adversely affect clot composition, stability, and response to thrombectomy.^27–29 Second, IR is associated with impaired cerebral hemodynamic reserve and poorer collateral circulation, potentially due to reduced angiogenesis and vascular remodeling. This mechanism can explain the stronger predictive value of the TyG index in older patients and those with higher ASPECT scores, in whom collateral flow is a critical determinant of tissue fate.^30–32 Conversely, in large-core infarctions or failed reperfusion, the overwhelming impact of severe initial ischemic injury and subsequent inflammation may eclipse the more subtle contributions of metabolic dysfunction. Finally, IR may increase the risk of symptomatic intracranial hemorrhage after EVT, further compromising recovery.⁹ Therefore, the TyG index may serve as a composite marker of these deleterious pathways, with its prognostic weight modulated by overall stroke severity and reperfusion status.

To enhance the accuracy of risk assessment, statisticians have proposed the use of NRI and IDI to measure the incremental value of introducing a new risk marker alongside established factors.³³ In our study, reclassification of prognosis risk based on the TyG index led to significant improvements in category-less NRI and IDI scores. The results of the classification analysis indicate the utility of the TyG index in identifying individuals at high risk of ischemic stroke. By integrating the TyG index into clinical practice, healthcare providers may improve their ability to predict post-EVT functional outcomes, thereby facilitating informed treatment and prevention strategies. In summary, our findings highlight the value of the TyG index in refining risk stratification for post-EVT functional outcomes in the general population.

The findings of this study suggest that the TyG index holds potential as a supplementary risk stratification tool. Its calculation is straightforward and based on routinely available laboratory parameters. Future prospective studies are warranted to validate its incremental value in predicting post-EVT functional outcomes. If validated, monitoring the TyG index could help identify a subgroup of patients at higher risk for poor recovery who may benefit from closer surveillance and tailored management strategies aimed at mitigating metabolic risk factors, in conjunction with established clinical and imaging prognostic indicators.

Although our study yielded significant findings, several limitations should be acknowledged. First, our study may be limited by the narrow population selection, as it was a retrospective analysis conducted at a single center. To enhance the validity of our findings, future prospective multicenter studies are needed. Second, our study did not directly compare the TyG index with the gold standard measure of IR, which limits a direct interpretation of the relationship between IR and prognosis. Third, the TyG index may be influenced by various factors, including recent use of antidiabetic or lipid-lowering medications, stress, and other confounders that were not adequately controlled for in our study. Consequently, caution should be exercised when interpreting the results. Fourth, the results are specific to the Chinese population and may not be generalizable to other ethnic groups. Fifth, the TyG index was measured after reperfusion and may therefore have been influenced by acute physiological stress, inflammation, and periprocedural medications, such as antiplatelet and anticoagulant therapy administered during EVT. Moreover, we were unable to account for the use of antidiabetic or lipid-lowering medications, which are known to influence the TyG index and stroke outcomes. An additional limitation is the potential selection bias resulting from our predefined enrollment criteria, which restricts the applicability of our findings to a broader spectrum of patients with acute ischemic stroke (AIS) eligible for EVT. Finally, data on HOMA-IR and related measures of insulin sensitivity were not available in our dataset, precluding further correlational analyses. Although the TyG index serves as a convenient surrogate marker of IR, it was measured during the acute phase of stroke and therefore likely reflects acute fluctuations in IR rather than serving as a stable biomarker of chronic IR.

Conclusions

Our study demonstrates that a higher TyG index at admission is associated with unfavorable functional outcomes in patients with anterior circulation AIS undergoing EVT. A positive correlation was also observed across the subgroups. These findings highlight the potential of the TyG index as a biomarker for risk stratification in patients treated with EVT and may contribute to more accurate prognostic evaluation.

Supplemental Material

sj-pdf-1-imr-10.1177_03000605261426206 - Supplemental material for Prognostic value of the triglyceride–glucose index in patients with acute ischemic stroke undergoing endovascular treatment

Supplemental material, sj-pdf-1-imr-10.1177_03000605261426206 for Prognostic value of the triglyceride–glucose index in patients with acute ischemic stroke undergoing endovascular treatment by Ke Yang, Qiwu Xu, Xiangxiang Peng, Xiangjun Xu, Yapeng Guo and Junfeng Xu in Journal of International Medical Research

Footnotes

Acknowledgments

None.

Authors’ contributions

JFX and KY conceived the study. All authors conducted data acquisition. YPG and QWX analyzed the data. QWX, KY, and XXP drafted and revised the manuscript. Neither this manuscript nor any similar one by the authors has been published or is being considered for publication elsewhere.

Consent for publication

Informed consent was not sought for the present study because this study is a retrospective research.

Data availability

On reasonable request, the corresponding author will allow access to the raw data of all patients who participated in this investigation.

Declaration of conflicting interests

The authors declare that they have no competing interests.

Ethics approval and consent to participate

This study was conducted in accordance with the Declaration of Helsinki and local regulations. The study was approved by the Ethics Committee of Yijishan Hospital of Wannan Medical College (No. 2019-039). Due to the retrospective nature of the study, the requirement for informed consent was waived, and the committee granted an exemption for formal ethical approval.

Funding

This work was supported by the Scientific Research Project of Anhui Provincial Health Commission (AHWJ2024Ab0199), the Wuhu City Science and Technology Project (2023jc28), and the Key Research Project of Wannan Medical College (WK2023ZZD21).

Supplemental material

Supplemental material for this article is available online.

ORCID iD

Junfeng Xu

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