The C‐Reactive Protein–Triglyceride–Glucose Index and Functional Outcomes in Acute Ischemic Stroke Patients Following Endovascular Thrombectomy

BACKGROUND AND PURPOSE: The C-reactive protein-triglyceride-glucose index (CTI), capturing insulin resistance (IR) and systemic inflammation, is related to stroke prognosis in general, but has not yet been studied with respect to functional outcomes after endovascular thrombectomy (EVT). METHODS: A retrospective analysis was carried out on individuals with acute ischemic stroke (AIS) experiencing EVT (September 2018-December 2024). CTI is measured as: 0.412 × Ln (C-reactive protein) (mg/L) + Ln [fasting triglyceride (mg/dL) × fasting glucose (mg/dL)]/2. The endpoint was unfavorable functional outcomes, characterized by a modified Rankin Scale (mRS) score of 3-6 at 90-day follow-up. Restricted cubic splines (RCS) and logistic regression (LR) analysis were utilized to estimate the link between the CTI and clinical outcomes. RESULTS: Among 813 patients, a high CTI level was significantly correlated with unfavorable functional outcome (p < 0.05). Compared with patients in the lowest quartile (Q1) of CTI, those in the highest CTI quartile (Q4) demonstrated an increased likelihood of unfavorable outcome (adjusted odds ratio [aOR] of 2.04, 95% confidence interval (95% CI) of 1.17-3.54). RCS modeling, after adjustment for significant variables identified in the univariate analysis, confirmed that there was no nonlinear connection between CTI levels and the probability of unfavorable functional recovery. Stratified analysis indicated that these associations were more significant among elderly and non-smoking patients. CONCLUSION: The CTI is an independent indicator of functional outcomes in individuals with AIS undergoing EVT, underlining its potential clinical value as a readily accessible marker for risk stratification and individualized prognostic assessment.