Key result
A high triglyceride-glucose index (>9.01) was independently associated with an increased risk of major adverse cardiovascular events compared to a low index (<8.48) after ischemic stroke or TIA (HR 2.01).
Why the study?
Data on the triglyceride-glucose index in stroke were lacking, prompting evaluation of its predictive value for recurrent vascular event risk.
Does a higher Triglyceride-glucose (TyG) index predict recurrent vascular events in patients with recent ischemic stroke or TIA?
Observational (n=866)
No
Does a higher Triglyceride-glucose (TyG) index predict recurrent vascular events in patients with recent ischemic stroke or TIA?
Hazard Ratio: 2.01 (95% CI 1.16–3.47)
Absolute Event Rate: 17.3% vs 8.6%
p-value: p=0.012
A higher Triglyceride-glucose (TyG) index is independently associated with an increased risk of major adverse cardiovascular events at 1 year in patients with recent ischemic stroke or TIA.
TyG index was associated with higher post-stroke MACE risk; supports risk stratification but leaves open whether targeting it improves outcomes.
Background:Triglyceride-glucose (TyG) index has been proposed as a simple and creditable surrogate for insulin resistance and an independent predictor of cardiovascular outcomes. Due to lack of data on TyG index in stroke, we aimed to evaluate the predictive value of the index for recurrent vascular event risk among stroke patients. Methods:This was a prospective observational study, in which 866 patients (mean age, 70.1 years; male, 60.9%) with ischemic stroke (n=781) or transient ischemic attack (n=85) within 1 week of onset were consecutively enrolled and followed up for 1 year. The TyG index was calculated as ln (fasting triglycerides [mg/dL] × fasting glucose [mg/dL]/2). Patients were divided into 3 groups according to the tertile of TyG index levels: tertile 1, <8.48; tertile 2, 8.48–9.01; and tertile 3, >9.01. The primary outcome was a composite of major adverse cardiovascular events (MACE), including nonfatal stroke, nonfatal acute coronary syndrome, and vascular death. Results: The median TyG index was 8.74 (interquartile range, 8.34–9.16). Higher levels of TyG index were significantly associated with increased prevalence of ipsilateral extracranial carotid (P=0.032) and intracranial (P=0.003) atherosclerotic stenosis. There were significant differences in the MACE risk between the three groups (annual rate, 8.6%, 11.6%, and 17.3% in the tertile 1, tertile 2, tertile 3 groups, respectively; log-rank P=0.005). After multivariable adjustments, the TyG index remains to be a significant predictor of MACE, with an adjusted hazard ratio for tertile 3 versus tertile 1 groups (95% confidence interval) of 2.01 (1.16–3.47). Similar results were also found for the risk of recurrent stroke. Conclusions: TyG index is associated with cervicocerebral atherosclerosis and the MACE risk after a stroke, suggesting the potential value of TyG index to optimize the risk stratification of stroke patients. Trial registration:URL: https://upload.umin.ac.jp. Unique identifier: UMIN000031913.
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Hoshino et al. (2022) conducted an observational in Ischemic stroke or transient ischemic attack (n=866). High Triglyceride-glucose (TyG) index (Tertile 3: >9.01) vs. Low TyG index (Tertile 1: <8.48) was evaluated on Composite of major adverse cardiovascular events (MACE), including nonfatal stroke, nonfatal acute coronary syndrome, and vascular death (HR 2.01, 95% CI 1.16-3.47, p=0.012). A high triglyceride-glucose index (>9.01) was independently associated with an increased risk of major adverse cardiovascular events compared to a low index (<8.48) after ischemic stroke or TIA (HR 2.01).
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