Deans' stroke musings: The predictive value of triglyceride-glucose index on early neurological functional improvement in non-diabetic patients with acute ischemic stroke undergoing intravenous thrombolysis

Changing stroke rehab and research worldwide now.Time is Brain! trillions and trillions of neurons that DIE each day because there are NO effective hyperacute therapies besides tPA(only 12% effective). I have 523 posts on hyperacute therapy, enough for researchers to spend decades proving them out. These are my personal ideas and blog on stroke rehabilitation and stroke research. Do not attempt any of these without checking with your medical provider. Unless you join me in agitating, when you need these therapies they won't be there.

What this blog is for:

My blog is not to help survivors recover, it is to have the 10 million yearly stroke survivors light fires underneath their doctors, stroke hospitals and stroke researchers to get stroke solved. 100% recovery. The stroke medical world is completely failing at that goal, they don't even have it as a goal. Shortly after getting out of the hospital and getting NO information on the process or protocols of stroke rehabilitation and recovery I started searching on the internet and found that no other survivor received useful information. This is an attempt to cover all stroke rehabilitation information that should be readily available to survivors so they can talk with informed knowledge to their medical staff. It lays out what needs to be done to get stroke survivors closer to 100% recovery. It's quite disgusting that this information is not available from every stroke association and doctors group.

Monday, September 29, 2025

The predictive value of triglyceride-glucose index on early neurological functional improvement in non-diabetic patients with acute ischemic stroke undergoing intravenous thrombolysis

Are you that blitheringly stupid? Survivors don't want predictions; they want EXACT RECOVERY PROTOCOLS! Right now, stroke rehab is a complete failure; 10% full recovery! Why aren't you solving that problem? Predictions are fucking lazy crapola; YOU'RE FIRED!

The predictive value of triglyceride-glucose index on early neurological functional improvement in non-diabetic patients with acute ischemic stroke undergoing intravenous thrombolysis

Furong Li¹

Xiaowen Sui²

Xin Pan²

Jun Li¹

Yan Gao¹

Dandan Shi¹

Hongling Zhao¹^*

Dong Chen³^*

¹Stroke Center, Central Hospital of Dalian University of Technology (Dalian Municipal Central Hospital), Dalian, China
²Neurology Department, Central Hospital of Dalian University of Technology (Dalian Municipal Central Hospital), Dalian, China
³Neurosurgery Department, Central Hospital of Dalian University of Technology (Dalian Municipal Central Hospital), Dalian, China

Objective: To explore the predictive role of the triglyceride-glucose index (TyG index) on the early neurological improvement in non-diabetic patients with acute ischemic stroke (AIS) undergoing alteplase intravenous thrombolysis (IV-rtPA).

Methods: This study included 490 AIS patients without diabetes, whose time from onset to hospital time ≤3 h undergoing IV-rtPA in the Stroke Center of our hospital from September 2023 to September 2024 through the Stroke Emergency Map Management Platform in Dalian City. According to the National Institutes of Health Stroke Scale (NIHSS) score at 24 h after IVT, the patients were divided into early neurological improvement (ENI) group (n = 332) and non-ENI group (n = 158). General information, risk factors, experimental data and the location of cerebral infarction were collected. Intergroup analyses were conducted using univariate or multivariate logistic regression.

Results: (1) In the ENI group, blood glucose (FBG), triglycerides (TG), TyG index, and baseline NIHSS score were significantly lower than those in the non-ENI group (p < 0.05). (2) Binary logistic regression analysis indicated that a TyG index ≤7.15 and a low baseline NIHSS score could predict early neurological improvement undergoing intravenous thrombolysis (IVT) in AIS patients. The area under the curve (AUC) values for the TyG index, baseline NIHSS score, and the combined variable (Y) in predicting ENI were 0.640, 0.641, and 0.721, respectively, with the combined variable (Y) exhibiting the highest AUC value.

Conclusion: The TyG index, baseline NIHSS score, and the combined variable (Y) are predictors of early neurological improvement, with the combined variable (Y) exhibiting a higher predictive efficiency.

1 Introduction

Currently, intravenous thrombolysis remains the primary treatment option for acute ischemic stroke (AIS) within the therapeutic time window (1), yet some patients still experience a poor long-term prognosis. It is therefore crucial to investigate the risk factors and measurable biomarkers that influence the early neurological outcomes of AIS patients post-intravenous thrombolysis.

Insulin resistance (IR), recognized as the primary pathophysiological mediator of metabolic syndrome, is deemed a significant contributor to the onset and progression of atherosclerosis and cardiovascular and cerebrovascular diseases (2). Research (3) has indicated that elevated IR levels are linked to adverse neurological outcomes in patients with AIS. Analysis of data from 273,368 cases in the UK Biobank has revealed that the triglyceride-glucose index (TyG index) surpasses individual blood glucose and triglyceride levels in forecasting stroke incidence, suggesting that the TyG index is an effective biomarker for IR in predicting stroke outcomes and a novel surrogate marker for IR (4). Recent studies have proposed that the TyG index is correlated with atherosclerosis (5, 6), serves as an independent predictor of cardiovascular events, and is associated with poor prognoses in patients with cardiovascular diseases (7, 8). Nevertheless, there is a relative scarcity of studies examining the correlation between the TyG index and the prognosis of AIS patients. This study aims to investigate the predictive value of the TyG index for the early neurological function of non-diabetic AIS patients undergoing alteplase intravenous thrombolysis (IV-rtPA), thereby aiding clinicians in rapidly assessing the prognosis of AIS patients post-intravenous thrombolysis with alteplase and in creating personalized treatment strategies.