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Abstract Details

Triglyceride-glucose Index as a Marker for Insulin Resistance and its Association with CTA Collaterals in Acute Ischemic Stroke: A Retrospective Cohort Study
Cerebrovascular Disease and Interventional Neurology
P10 - Poster Session 10 (11:45 AM-12:45 PM)
Leptomeningeal collateral circulation (LMA) is associated with favorable post-stroke outcomes, yet factors affecting its variation are poorly understood. IR is associated with cardiovascular disease, but its impact on LMA and stroke outcomes is less clear as most evidence comes from cardiology literature. The TyG index, a novel IR biomarker, is more accessible than traditional methods, making it easier to incorporate into clinical practice.  

To evaluate the association between Insulin resistance (IR) and CTA collateral score in acute ischemic stroke (AIS)

In this retrospective single-center study, we reviewed all patients presenting between 2010 and 2022, with either internal carotid artery (ICA) or middle cerebral artery (M1) occlusion, having CTA within 24 hours of symptoms onset, and having fasting triglyceride and glucose levels during that admission. TyG index formula was: ln [triglyceride (mg/dl) × glucose (mg/dl)]/2. Single phase CTA collaterals were classified into symmetrical, malignant, and other as proposed by Regenhardt et al. TyG index scores were stratified into quartiles based on data distribution. Univariable ordinal logistic regression was first used to assess the predictive value of TyG and other demographic variables on CTA collateral score, only significant variables were fitted into the final multivariable ordinal logistic regression model.
Of 266 patients enrolled in our analysis, 54.1% were males, and 45.9% were females, with a mean BMI of 28. 86.5% had MCA involvement, and cardioembolism was the most common etiology (45.9%). 40% received thrombolysis, and 74% underwent EVT. 39.2% and 27.2% of patients had symmetrical and malignant CTA collateral scores, respectively. TyG index was a significant predictor of worse CTA collaterals (β coefficient of 2.2, p < 0.01).
IR, as measured by TyG index is predictive of worse CTA collaterals in AIS. Future studies should focus on multi-regional designs to explore the relationship between stroke and insulin resistance.
Mohammed Qussay Ali Al-Sabbagh, MD (University of Kansas Medical Center)
Dr. Al-Sabbagh has nothing to disclose.
No disclosure on file
Prasanna Venkatesan Eswaradass, MD (University of Kansas Health System) Dr. Eswaradass has nothing to disclose.