The aim of this study is to investigate the correlation between the triglyceride-glucose (TyG) index, a surrogate index of insulin resistance, and the clinical prognosis of patients with acute ischemic stroke (AIS) treated with mechanical thrombectomy (MT).

This retrospective study analyzed clinical data of 284 patients with AIS who underwent MT. Patients were divided into a good prognosis group modified Rankin Scale ([MRS] score ≤2) and a poor prognosis group ([modified Rankin Scale] score >2) based on their outcomes 90 days post-MT. Differences in clinical parameters between groups were evaluated, and multifactorial logistic regression analysis identified risk factors associated with poor prognosis. Receiver operating characteristic (ROC) curve analysis assessed the predictive value of the TyG index and the combined variable (P) for poor prognosis at 90 days post-MT.

The TyG index was identified as an independent risk factor for poor prognosis in patients with AIS undergoing MT. In the total AIS population, the area under the ROC curve for the TyG index and the combined variable (P) predicting poor prognosis were 0.5618 and 0.7870, respectively. In the nondiabetic subgroup, the area under the ROCcurves were 0.5517 and 0.8143, respectively.

The TyG index is a risk factor for poor prognosis in patients with AIS undergoing MT, applicable to both the total population and the nondiabetic subgroup. The combined variable (P), with improved predictive accuracy, can aid clinicians in early prognostic assessments of patients with AIS treated with MT.

Acute stroke

Insulin resistance

Mechanical thrombectomy

Prognosis

TyG index

Alberta Stroke Project

Area under the ROC curve

Mechanical thrombectomy

National Institutes of Health Stroke Scale

Receiver operating characteristic

Transient ischemic attack

Trial of ORG 10172 in acute stroke treatment

© 2025 The Author(s). Published by Elsevier Inc.