Abstract
ObjectiveThis 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.MethodsThis 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.ResultsA 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).ConclusionThe 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.