C-Reactive Protein–Triglyceride–Glucose Index and 90-Day Outcomes after Endovascular Therapy for Acute Ischemic Stroke

Abstract

Background: The C-reactive protein–triglyceride–glucose index (CTI), a novel composite biomarker that integrates inflammatory activity and insulin resistance (IR), has been proposed as a predictor of stroke. However, its prognostic value in patients undergoing endovascular treatment (EVT) for acute ischemic stroke (AIS) remains uncertain. This study aimed to investigate the association between CTI levels and clinical outcomes among AIS patients receiving EVT. Methods: We retrospectively analyzed AIS patients receiving EVT between January 2016 and March 2025. The primary outcome was poor functional outcome at 90 days (modified Rankin Scale (mRS) 3–6). Secondary outcomes included 90-day mortality, symptomatic intracranial hemorrhage (sICH), and functional outcome. Logistic regression and restricted cubic spline (RCS) analyses were used to assess the associations. Results: A total of 659 patients were included. Logistic regression analysis indicated that higher CTI levels were associated with an increased risk of poor functional outcome and mortality. An RCS model revealed a linear association between CTI and both poor outcome at 90 days and 90-day mortality. Conclusions: Elevated CTI levels were independently associated with poor 90-day functional outcomes and mortality after EVT for AIS. As an integrated marker of insulin resistance and systemic inflammation, CTI may be useful for risk stratification; prospective multicenter validation is warranted.

Keywords: acute ischemic stroke; endovascular therapy; inflammation; insulin resistance; functional outcome