Impact of the triglyceride-glucose index on prognosis following endovascular therapy for acute ischemic stroke: effect modification by collateral circulation

 Prognosis DOES NOTHING to get survivors recovered! 
You need EXACT PROTOCOLS for that! When will you provide them?

You described an association but did NOTHING to solve the underlying problem of 100% recovery!  Until we get survivors in charge stroke research will continue to be useless for survivors. 

Impact of the triglyceride-glucose index on prognosis following endovascular therapy for acute ischemic stroke: effect modification by collateral circulation

• 

  Yishu Wang

• Q

  Qinyu Lei

• J

  Jiaqi Wang

• Y

  Yachao Lin

• L

  Liguo Xu *

• Department of Interventional Radiology, The Second Affiliated Hospital of Zhengzhou University, Zhengzhou, China

Abstract

Objective: 

To investigate the association between the triglyceride-glucose (TyG) index and 90-day functional outcome after endovascular therapy in patients with acute ischemic stroke, to evaluate the risk assessment performance of the TyG index combined with clinical variables, and to assess the effect-modifying role of collateral circulation in this association.

Methods: 

A retrospective analysis was conducted in 209 patients with acute ischemic stroke who underwent endovascular therapy at our hospital between October 2022 and December 2025. Multivariable logistic regression was performed to evaluate factors associated with poor functional outcome, defined as a modified Rankin Scale (mRS) score > 2 at 90 days. Interaction and stratified analyses were conducted to assess whether collateral circulation modified the association between the TyG index and clinical outcomes. Receiver operating characteristic (ROC) curves and the corresponding area under the curve (AUC) were used to evaluate the predictive performance of the TyG index combined with clinical variables. Differences in AUCs were compared using DeLong’s test. Calibration was assessed using the Hosmer-Lemeshow test, Brier score, and calibration curve, and internal validation was performed with 1,000 bootstrap resamples.

Results: 

A total of 209 patients were included, with 145 (69.4%) in the good functional outcome group (modified Rankin Scale [mRS] score≤2) and 64 (30.6%) in the poor functional outcome group (mRS > 2). Univariate analysis showed that the TyG index was significantly higher in the poor functional outcome group, and that sex, baseline National Institutes of Health Stroke Scale (NIHSS) score and collateral circulation status also differed significantly between the two groups (all p < 0.05). Multivariable logistic regression analysis showed that the TyG index was independently associated with poor functional outcome at 90 days after endovascular therapy (OR = 1.972, p < 0.001). A significant interaction was observed between the TyG index and collateral circulation (p = 0.012), suggesting a possible effect-modifying role of collateral circulation, and stratified analysis showed that this association appeared to be more pronounced in patients with poor collateral circulation. The combined risk assessment model showed good discriminative ability for poor functional outcome at 90 days (AUC = 0.834, sensitivity = 0.828, specificity = 0.731, DeLong’s test: p < 0.001), and the addition of the TyG index further improved the discriminative ability and assessment performance of the model.

Conclusion: 

The TyG index is an independent risk factor for poor 90-day functional outcome after endovascular therapy in patients with acute ischemic stroke. Collateral circulation may modify this association. The TyG index also improves the risk assessment performance of the combined risk model.

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