Abstract P722: Triglyceride-Glucose Index is Associated With Early Neurological Deterioration in Single Subcortical Infarction

Abstract

Introduction: Single subcortical infarction (SSI) has usually favorable prognosis, but early neurological deterioration (END) often occurs in their clinical courses. Fasting glucose and triglyceride are both risk factors for END. Therefore, the triglyceride-glucose (TyG) index that combines them can be a potent predictor of END. Hypothesis: We evaluated the relationship between TyG index and END in patients with SSI. Methods: We included consecutive patients with SSI within 72 hours of symptom onset between 2011 and 2015. END was defined as an increase of ≥ 2 on the total NIHSS score or ≥ 1 on the motor NIHSS score within the first 72 hours of admission. TyG index was calculated according to the following formula: TyG index = Ln [fasting triglyceride (mg/dL) x fasting glucose (mg/dL)/2]. Considering the effect directly on the formula, patients currently taking glucose- or lipid-lowering agents were excluded. Results: A total of 305 patients with SSI were included. In multivariable analysis, TyG index [adjusted odds ratio (aOR) = 2.94, 95% confidence interval (CI): 1.58-5.45] and age (aOR = 1.05, 95% CI: 1.01-1.09) were positively associated with END. In subgroup analysis based on the presence of diabetes, TyG index showed a meaningful association only in patients with diabetes history. In the analysis by type of SSI, TyG index and END were related only in patients with proximal SSI. When examined in accordance with the involved vascular territory, TyG index was associated with END in both the anterior circulation and posterior circulation. When examined in accordance with the involved vascular territory, TyG index was associated with END in both anterior circulation (aOR = 2.66, 95% CI: 1.24-5.68) and posterior circulation (aOR = 3.55, 95% CI: 1.03-12.26), but the posterior circulation had a larger aOR value. Conclusions: TyG index was associated with END in SSI patients. This tendency depends on the presence of diabetes and the location of the SSI lesion.