Association of the Triglyceride-Glucose (TyG) Index and TyG-BMI With 1-Year Outcomes Following Endovascular Treatment in Acute Basilar Artery Occlusion.

BACKGROUND

Long-term outcomes after endovascular treatment (EVT) in acute basilar artery occlusion (BAO) vary substantially, yet metabolic correlates remain incompletely characterized. This study evaluated whether the triglyceride-glucose (TyG) index and TyG-body mass index (TyG-BMI) are associated with 1-year functional status and mortality after EVT.

METHODS

A single-center registry with prospective data collection was retrospectively analyzed. Consecutive acute BAO patients undergoing EVT within 24 h (December 2012-September 2024) were included. Unfavorable functional outcome at 1 year was defined as modified Rankin Scale (mRS) 4-6; 1-year all-cause mortality was also assessed. Multivariable logistic regression was applied, with receiver operating characteristic analyses and prespecified subgroup analyses.

RESULTS

The final cohort comprised 298 patients (median age 62 years; 78.5% male), among whom 165 (55.4%) had an unfavorable 1-year outcome and 109 (36.6%) died. After adjustment, each 1-SD increase in TyG and TyG-BMI corresponded to higher odds of unfavorable outcome (TyG OR 1.69, 95% CI 1.25-2.30; TyG-BMI OR 1.46, 95% CI 1.10-1.96) as well as mortality (TyG OR 1.44, 95% CI 1.09-1.90; TyG-BMI OR 1.61, 95% CI 1.23-2.12). Discrimination was modest and similar between indices. A significant sex interaction was observed for TyG-BMI and mortality (p for interaction = 0.03), with an association in men only.

CONCLUSIONS

In EVT-treated acute BAO, TyG and TyG-BMI may help identify EVT-treated acute BAO patients at higher risk of poor 1-year outcome and death. The mortality risk associated with TyG-BMI was modified by sex, with an effect confined to men.