Evaluation of Triglyceride to HDL-C Ratio in Patients with Acute Ischemic Stroke in a Tertiary Care Hospital

Introduction: The triglyceride to high-density lipoprotein cholesterol (TG/HDL-C) ratio is a composite lipid marker associated with cardiovascular risk and insulin resistance. Its prognostic value in acute ischemic stroke (AIS), particularly in South-Asian populations, remains unclear. The current study aimed to evaluate the association between TG/HDL-C ratio and short-term functional outcomes in patients with AIS. Methods & Materials: This prospective observational study enrolled 96 AIS patients at a tertiary care hospital in Bangladesh. Fasting lipid profiles were obtained within 24 hours of admission. Stroke severity was assessed using the NIH Stroke Scale (NIHSS), and 30-day functional outcome was measured using the modified Rankin Scale (mRS). Statistical analyses included t-tests, Pearson correlation, logistic regression, and ROC curve analysis. Results: A total of 96 patients with acute ischemic stroke were enrolled. The mean TG/HDL-C ratio was 3.96 ± 2.01. There was no statistically significant difference in TG/HDL-C ratio between patients with good outcomes and those with poor outcomes (4.25 ± 2.44 vs. 3.83 ± 1.79; p = 0.346). ROC analysis showed poor discriminatory ability of the TG/HDL-C ratio for predicting poor outcome (AUC = 0.470). In multivariable logistic regression, the TG/HDL-C ratio was not an independent predictor of poor 30-day functional outcome (p = 0.660). Additionally, no significant correlation was observed between TG/HDL-C ratio and stroke severity as measured by NIHSS (r = 0.033, p= 0.746). Conclusion: TG/HDL-C ratio was not associated with short-term outcome or stroke severity in AIS patients. Its use as a prognostic marker in this context remains limited.