Objective:

To investigate the association between the triglyceride-glucose (TyG) index and 90-day functional outcome after endovascular therapy in patients with acute ischemic stroke, evaluate the risk assessment performance of the TyG index combined with clinical variables, and assess the effect-modifying role of collateral circulation.

Approach:

Key Findings:

• The TyG index was significantly higher in the poor functional outcome group (mRS > 2).
• Multivariable analysis indicated that the TyG index was independently associated with poor functional outcome (OR = 1.972, p < 0.001).
• Collateral circulation status modified the association between the TyG index and clinical outcomes (p = 0.012).
• The combined risk assessment model showed good discriminative ability for poor functional outcome (AUC = 0.834).

Interpretation:

The TyG index is an independent risk factor for poor 90-day functional outcome after endovascular therapy in patients with acute ischemic stroke, with collateral circulation potentially modifying this association.

Limitations:

• Retrospective design may introduce bias.
• Single-center study limits generalizability.

Conclusion:

The TyG index improves the risk assessment performance of the combined risk model for predicting poor functional outcomes.

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