Abstract Details

Title The Impact of Insulin Resistance on Clinical Outcomes After Acute Ischemic Stroke Endovascular Treatment

Topic Cerebrovascular Disease and Interventional Neurology

Presentation(s) P7 - Poster Session 7 (5:00 PM-6:00 PM)

Poster/Presentation
Number 14-010

Objective To assess the relationship between Insulin Resistance (IR) and clinical outcomes after acute ischemic stroke (AIS) in patients with large vessel occlusion (LVO)

Background

IR adversely impacts atherosclerotic vascular diseases. This notion is mainly driven from cardiac literature. Due to the lack of convenient IR biomarker in acute setting, its impact on clinical outcomes of AIS has been difficult to investigate. The Triglyceride glucose (TyG) index is a novel biomarker useful to measure IR conveniently in the acute setting.

Design/Methods In this single-center retrospective cohort study, we reviewed all patients presenting between 2010 and 2022, with either internal carotid artery (ICA) or middle cerebral artery (M1) occlusion, undergoing endovascular treatment (EVT), having a pre-event modified Rankin Scale (mRS) score of ≤2, and having fasting triglyceride and glucose levels. TyG index formula was: ln [triglyceride (mg/dl) × glucose (mg/dl)]/2. 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 90-day mRS, only significant variables were fitted into the final multivariable ordinal logistic regression model.

Results Of 155 patients enrolled in our analysis 53.1% were males, and 46.9% were females. 79% had a history of hypertension, while 30% had a history of coronary artery disease CAD. The TyG index was a significant predictor of 90-day mRS (β coefficient of 2.04, p < 0.01). Other significant predictors included age (β coefficient of 1.05, p < 0.01), and smoking status with lower odds for former smokers (β coefficient of 0.44, p = 0.03).

Conclusions Lower TyG index values, a surrogate marker for IR, was associated with better post-EVT outcomes in patients with AIS. Future studies should focus on determining the optimal TyG index cut-off points to optimize management of vascular risk factors, and improve stroke outcomes.

Authors/Disclosures
Tuqa Asedi, MD PRESENTER	Dr. Asedi has nothing to disclose.
Sai Kumar Reddy Pasya, MD, MBBS	Dr. Pasya has nothing to disclose.
Maryam Q. Al sabbagh	Dr. Al sabbagh has nothing to disclose.
Hussein Alsadi (University of Kansas Medical Center)	Hussein Alsadi has nothing to disclose.
Mohammed Qussay Ali Al-Sabbagh, MD (University of Kansas Medical Center)	Dr. Al-Sabbagh has nothing to disclose.
Prasanna Venkatesan Eswaradass, MD (University of Kansas Health System)	Dr. Eswaradass has nothing to disclose.

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