Triglyceride-Glucose Index and Intravenous Thrombolysis Outcomes for Acute Ischemic Stroke: A Multicenter Prospective–Cohort Study

Lin, Shing‐Jong; Hu, Han‐Hwa; Chao, Hai-Lun; Ho, Bo-Lin; Chen, Chih‐Hung; Chan, Lung; Lin, Hongbo; Sun, Yu; Lin, Yung-Yang; Chen, Po‐Lin; Lin, Shinn-Kuang; Wei, Cheng‐Yu; Lin, Yu-Te; Lee, Jiunn‐Tay; Chao, A-Ching

doi:10.3389/fneur.2022.737441

Cited by 16 publications

(26 citation statements)

References 55 publications

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“…Overall, 34 076 patients with acute IS from eight cohort studies 15 16 17 18 19 20 21 22 were included in the meta-analysis ( Table 1 ). Four prospective cohort studies 16 17 20 22 and four retrospective studies 15 18 19 21 were included, respectively, which were performed in China 15 16 17 19 20 22 , Korea 18 , and Singapore 21 . All the studies included hospitalized patients with acute IS, with mean ages varying from 62 to 72 years.…”

Section: Resultsmentioning

confidence: 99%

“…All the studies included hospitalized patients with acute IS, with mean ages varying from 62 to 72 years. TyG index was measured at admission, and the cutoffs for the analyses of TyG index varied among the included studies, with quartiles [15][16][17]22], tertiles [20], median [19], receiver operating characteristic (ROC) curve analysis derived value [21], and previous study evidenced cut-off for IR [18], respectively. The follow-up durations were within hospitalization for one study [15], three months for three studies [18,20,21], and 12 months for the other four studies [16,17,19,22].…”

Section: Study Characteristicsmentioning

confidence: 99%

“…TyG index was measured at admission, and the cutoffs for the analyses of TyG index varied among the included studies, with quartiles [15][16][17]22], tertiles [20], median [19], receiver operating characteristic (ROC) curve analysis derived value [21], and previous study evidenced cut-off for IR [18], respectively. The follow-up durations were within hospitalization for one study [15], three months for three studies [18,20,21], and 12 months for the other four studies [16,17,19,22]. Possible confounding factors such as age, sex, National Institutes of Health Stroke Scale (NIHSS) at admission, comorbidities, and concomitant medications were adjusted to a varying degree in the included studies when the association between TyG index and the risks of outcomes of interest were presented.…”

Section: Study Characteristicsmentioning

confidence: 99%

“…Six cohort studies [16][17][18][19][20][21] including 31 465 patients with acute IS were included for the meta-analysis of the association between TyG index and the risk of poor functional outcome. A total of 7612 patients had poor functional outcome during follow-up.…”

Section: Association Between Tyg Index and Incidence Of Poor Function...mentioning

confidence: 99%

“…Previous studies showed that a higher TyG index is independently associated with the risk of atherosclerotic CVDs, including stroke [13,14]. However, studies which evaluated the possible predictive role of TyG index for the prognosis of patients with acute IS showed inconsistent findings [15][16][17][18][19][20][21][22]. Some studies suggested that a higher TyG index may predict the mortality risk [15,21,22] or poor functional outcome [17][18][19][20][21] in patients with acute IS, but not all studies [16].…”

Section: Introductionmentioning

confidence: 99%

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Triglyceride-Glucose Index and the Prognosis of Patients with Acute Ischemic Stroke: A Meta-Analysis

Han²,

Jiang³

et al. 2022

Horm Metab Res

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A higher triglyceride-glucose (TyG) index has been related to an increased incidence of stroke in community population. A meta-analysis was performed to evaluate the association between TyG index and prognosis in patients with acute ischemic stroke (IS). Observational studies, which evaluated the influence of TyG index on functional outcome and mortality in patients with acute IS were retrieved by search the PubMed, Embase, Web of Science, Wanfang and China National Knowledge Infrastructure databases from inception to February 20, 2022. Two authors independently collected the data of study characteristics and outcomes. A random-effect model was used to pool the results via incorporating the influence of possible between-study heterogeneity. Eight cohort studies involving 34 076 patients with acute IS contributed to the study. Pooled results showed that a higher TyG index was independently associated with increased risks of all-cause mortality (OR: 1.60, 95% CI: 1.19–2.15, p=0.002; I2=78%) and poor functional outcome (OR: 1.37, 95% CI: 1.11–1.69, p=0.004; I2=71%). Further sensitivity analyses by excluding one cohort study at a time showed consistent results (p all<0.05). Subgroup analyses showed similar results in prospective and retrospective cohort studies, in non-diabetic and diabetic patients, and in studies with follow-up durations within 3 months and of 12 months (p for subgroup analyses all>0.05). In conclusion, higher TyG index is a predictor of all-cause mortality and poor functional outcome in patients with acute IS, and TyG index may be useful for prognostic evaluation in these patients.

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Section: Resultsmentioning

confidence: 99%

Section: Study Characteristicsmentioning

confidence: 99%

Section: Study Characteristicsmentioning

confidence: 99%

Section: Association Between Tyg Index and Incidence Of Poor Function...mentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Triglyceride-Glucose Index and the Prognosis of Patients with Acute Ischemic Stroke: A Meta-Analysis

Han²,

Jiang³

et al. 2022

Horm Metab Res

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The relationship between temporal muscle thickness and triglyceride glucose index in sarcopenia with mortality and third-month functional outcomes in patients after acute stroke

Tutal Gürsoy,

Görgülü,

Tengirşenk

et al. 2023

Medicine

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Especially in recent years, temporal muscle thickness has been used as an important parameter for sarcopenia in neurological disorders. In addition, triglyceride glucose index was evaluated separately in studies conducted in terms of coronary diseases, diabetes, high blood pressure, body mass index and acute stroke. In this clinical study, unlike the others, both temporal muscle thickness and triglyceride glucose index were evaluated together in acute stroke patients in terms of sarcopenia. We aimed to investigate the relationship between temporal muscle thickness and triglyceride glucose index, which is atherosclerotic index, with mortality and 3rd month functional outcomes in acute stroke patients. In this retrospective study, 147 patients admitted to Ankara City Hospital with the diagnosis of acute ischemic stroke between January 2021 and September 2022 were evaluated. Fasting triglyceride glucose indexes of the patients were calculated. The temporal muscle thickness measurement of the patients was performed by the radiologist using computed tomography images. Those who scored 3 or higher on the modified Rankin Scale (mRS) at the third month were considered to have poor functional outcome. A significant cutoff point was found for estimating mortality for the temporal muscle thickness parameter [area under the curve for a receiver operating characteristic curve (AUC) = 0.636; P = .012]. The cutoff point was obtained as ≤ 5.2. Sensitivity value was 65%, specificity value was 65%, the positive predictive value (PPV) value was 42.62% and the negative predictive value (NPV) value was 82.28%. Similarly, for the triglyceride glucose index parameter, there was a significant cutoff point in estimating mortality (AUC = 0.673; P = .003). The cutoff point was obtained as ≥ 8.23. Sensitivity value was 91.18%, specificity value was 13%, PPV value was 26.96% and NPV value was 81%. Temporal muscle thickness and triglyceride glucose index parameters were found to be statistically important parameters of sarcopenia. It was concluded that the evaluation of these 2 parameters in terms of both mortality and sarcopenia in acute stroke patients is important in the evaluation of neurological and cardiac disorders.

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Thrombolysis exacerbates cerebrovascular injury after ischemic stroke via a VEGF-B dependent effect on adipose lipolysis

Nilsson,

Su,

Fredriksson

et al. 2024

Preprint

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Cerebrovascular injuries leading to edema and hemorrhage after ischemic stroke are common. The mechanisms underlying these events and how they are connected to known risk factors for poor outcome, like obesity and diabetes, is relatively unknown. Herein we demonstrate that increased adipose tissue lipolysis is a dominating risk factor for the development of a compromised cerebrovasculature in ischemic stroke. Reducing adipose lipolysis by VEGF-B antagonism improved vascular integrity by reducing ectopic cerebrovascular lipid deposition. Thrombolytic therapy in ischemic stroke using tissue plasminogen activator (tPA) leads to increased risk of hemorrhagic complications, substantially limiting the use of thrombolytic therapy. We provide evidence that thrombolysis with tPA promotes adipose tissue lipolysis, leading to a rise in plasma fatty acids and lipid accumulation in the ischemic cerebrovasculature after stroke. VEGF-B blockade improved the efficacy and safety of thrombolysis suggesting the potential use of anti-VEGF-B therapy to extend the therapeutic window for stroke management.

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Triglyceride-Glucose Index and Intravenous Thrombolysis Outcomes for Acute Ischemic Stroke: A Multicenter Prospective–Cohort Study

Cited by 16 publications

References 55 publications

Triglyceride-Glucose Index and the Prognosis of Patients with Acute Ischemic Stroke: A Meta-Analysis

Triglyceride-Glucose Index and the Prognosis of Patients with Acute Ischemic Stroke: A Meta-Analysis

The relationship between temporal muscle thickness and triglyceride glucose index in sarcopenia with mortality and third-month functional outcomes in patients after acute stroke

Thrombolysis exacerbates cerebrovascular injury after ischemic stroke via a VEGF-B dependent effect on adipose lipolysis

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