The Triglyceride-Glucose (TyG) Index as a Significant Predictor of Functional Outcomes in Acute Ischemic Stroke Patients Following Intravenous Thrombolysis: A Systematic Review and Meta-analysis
Objective:
To systematically evaluate the association between pre-treatment Triglyceride-glucose (TyG) index levels and functional outcomes in patients with acute ischemic stroke who have received intravenous thrombolysis therapy.
Background:
The Triglyceride glucose (TyG) index is a novel biomarker of insulin resistance that has been extensively studied in cardiovascular illnesses. However, its value in predicting outcomes after intravenous thrombolysis in patients with acute ischemic stroke is not well documented.
Design/Methods:
We conducted a systematic review and meta-analysis in accordance with the PRISMA guidelines. A comprehensive search of PubMed, Scopus, Embase, and Cochrane Library up to October 2025 was done and studies were identified that assessed the prognostic value of the TyG index in adult stroke patients treated with intravenous thrombolysis therapy. Adjusted odds ratios (ORs) with 95 % confidence intervals (CIs) for poor functional outcome, defined as a modified Rankin Scale (mRS) score > 2 at 3 months, were extracted. Pooled estimates were calculated using a random-effects model.
Results:
Six studies were included (n ≈ 4800) which reported adjusted associations between TyG index and 3-month mRS outcomes. Higher TyG levels were significantly associated with increased odds of poor functional recovery post-thrombolysis (pooled adjusted OR = 1.65, 95 % CI 1.28–2.12; I² = 31 %, τ² = 0.021). No sufficient or comparable data were available to quantitatively synthesize other endpoints such as mortality, early neurological deterioration, or symptomatic intracranial hemorrhage,
Conclusions:
This study establishes that an elevated TyG index is a robust and independent predictor of poor functional outcomes in acute ischemic stroke patients following thrombolysis. As a low cost biomarker calculated from routine laboratory tests, the TyG index represents a practical tool for early risk stratification. Its integration into routine practice could help identify high-risk patients who may benefit from more intensive monitoring and targeted secondary prevention strategies.
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