Background
Methods
Inclusion and exclusion criteria
Data collection
Study outcome
Statistical methods
Results
Baseline information
Total (n = 1281) | TyG# quartile 1 (n = 320) | TyG quartile 2 (n = 320) | TyG quartile 3 (n = 320) | TyG quartile 4 (n = 321) | P* value | P** value | |
---|---|---|---|---|---|---|---|
Age, mean (SD), year | 61.6 (11.6) | 64.6 (11.3) | 62.9 (12.3) | 60.5 (11.4) | 58.6 (10.3) | < 0.001 | < 0.001 |
Male, n (%) | 898 (70.1) | 236 (73.8) | 213 (66.6) | 220 (68.8) | 229 (71.3) | 0.216 | 0.494 |
BMI, mean (SD) | 25.4 (3.6) | 24.1 (3.1) | 25.3 (3.6) | 26.0 (4.0) | 26.1 (3.3) | < 0.001 | < 0.001 |
SBP, mean (SD), mmHg | 156.7 (22.0) | 154.2 (23.6) | 158.3 (20.9) | 155.4 (20.4) | 158.8 (22.6) | 0.018 | 0.011 |
DBP, mean (SD), mmHg | 90.3 (13.8) | 88.8 (14.1) | 90.3 (13.8) | 90.0 (13.8) | 92.0 (13.4) | 0.041 | 0.004 |
NIHSS, median (IQR) | 2.0 (1.0, 3.0) | 2.0 (1.0, 3.0) | 2.0 (1.0, 3.0) | 2.0 (1.0, 3.0) | 2.0 (1.0, 3.0) | 0.575 | 0.632 |
Onset time, mean (SD), hour | 25.7 (19.7) | 25.5 (19.4) | 25.5 (20.0) | 25.5 (19.9) | 26.3 (19.8) | 0.936 | 0.617 |
Prior mRs, n (%) | 0.296 | 0.058 | |||||
0 | 1063 (83.0) | 254 (79.4) | 268 (83.8) | 264 (82.5) | 277 (86.3) | ||
1 | 173 (13.5) | 51 (15.9) | 39 (12.2) | 47 (14.7) | 36 (11.2) | ||
2 | 45 (3.5) | 15 (4.7) | 13 (4.1) | 9 (2.8) | 8 (2.5) | ||
Smoking status, n (%) | 0.634 | 0.37 | |||||
Never | 657 (52.6) | 154 (49.4) | 175 (55.7) | 163 (51.9) | 165 (53.2) | ||
Previous smoker | 70 (5.6) | 20 (6.4) | 19 (6.1) | 18 (5.7) | 13 (4.2) | ||
Current smoker | 523 (41.8) | 138 (44.2) | 120 (38.2) | 133 (42.4) | 132 (42.6) | ||
Drinking, n (%) | 438 (35.0) | 109 (34.7) | 98 (31.1) | 110 (35.4) | 121 (38.7) | 0.265 | 0.513 |
Previous history | |||||||
Diabetes mellitus, n (%) | 387 (30.2) | 31 (9.7) | 65 (20.3) | 103 (32.2) | 188 (58.6) | < 0.001 | < 0.001 |
Lipid disorder, n (%) | 32 (2.5) | 1 (0.3) | 7 (2.2) | 5 (1.6) | 19 (5.9) | < 0.001 | < 0.001 |
Atrial fibrillation, n (%) | 8 (0.6) | 4 (1.2) | 3 (0.9) | 1 (0.3) | 0 (0) | 0.103 | 0.062 |
TIA, n (%) | 24 (1.9) | 9 (2.8) | 3 (0.9) | 6 (1.9) | 6 (1.9) | 0.383 | 0.43 |
Ischemic stroke, n (%) | 339 (26.5) | 109 (34.1) | 79 (24.7) | 88 (27.5) | 63 (19.6) | < 0.001 | < 0.001 |
Carotid stenosis, n (%) | 7 (0.5) | 5 (1.6) | 1 (0.3) | 1 (0.3) | 0 (0) | 0.046 | 0.031 |
In-hospital treatment | |||||||
Antiplatelet therapy, n (%)a | 0.827 | 0.497 | |||||
Single antiplatelet therapy | 493 (38.5) | 130 (40.6) | 122 (38.1) | 119 (37.2) | 122 (38) | ||
Dual antiplatelet therapy | 788 (61.5) | 190 (59.4) | 198 (61.9) | 201 (62.8) | 199 (62) | ||
Statin therapy, n (%)b | 0.749 | 0.326 | |||||
Not used | 43 (3.4) | 7 (2.2) | 13 (4.1) | 10 (3.1) | 13 (4) | ||
Normal dose | 521 (40.7) | 139 (43.4) | 124 (38.8) | 129 (40.3) | 129 (40.2) | ||
Intensive dose | 717 (56.0) | 174 (54.4) | 183 (57.2) | 181 (56.6) | 179 (55.8) | ||
Antihypertensive treatment | 833 (67.6) | 211 (67.6) | 207 (68.1) | 218 (70.3) | 197 (64.4) | 0.469 | 0.394 |
Hypoglycemic treatment | 291 (22.8) | 21 (6.6) | 50 (15.6) | 79 (24.8) | 141 (44.2) | < 0.001 | < 0.001 |
Laboratory findings | |||||||
TG, mean (SD), mg/dL | 159.1 (111.5) | 80.3 (19.0) | 114.5 (22.6) | 164.1 (42.7) | 277.2 (157.4) | < 0.001 | < 0.001 |
FBG, mean (SD), mg/dL | 121.9 (51.8) | 89.4 (15.5) | 102.2 (19.3) | 119.2 (34.5) | 176.6 (67.0) | < 0.001 | < 0.001 |
LDL-C, mean (SD), mg/dL | 102.0 (32.8) | 89.8 (27.9) | 99.9 (28.9) | 105.0 (31.0) | 113.2 (38.0) | < 0.001 | < 0.001 |
HDL-C, mean (SD), mg/dL | 39.9 (12.3) | 43.2 (10.6) | 40.4 (10.0) | 38.1 (10.2) | 37.9 (16.4) | < 0.001 | < 0.001 |
TC, mean (SD), mg/dL | 164.9 (43.6) | 147.0 (36.3) | 158.6 (35.9) | 169.0 (41.7) | 184.6 (50.1) | < 0.001 | < 0.001 |
HCY, mean (SD), mg/dL | 3.3 (3.2) | 3.8 (4.1) | 3.3 (2.7) | 3.5 (3.5) | 2.7 (2.2) | < 0.001 | < 0.001 |
PLT, mean (SD), 103/µL | 220.2 (66.7) | 208.8 (65.4) | 223.7 (67.8) | 223.9 (66.0) | 224.4 (66.5) | 0.008 | 0.004 |
WBC, mean (SD),/µL | 7183.8 (2083.5) | 6758.9 (2177.6) | 7088.5 (1893.5) | 7364.5 (2109.0) | 7512.5 (2075.8) | < 0.001 | < 0.001 |
Uric acid, mean (SD), mg/dL | 5.5 (1.6) | 5.1 (1.4) | 5.5 (1.6) | 5.8 (1.7) | 5.6 (1.7) | < 0.001 | 0.175 |
Imaging features | |||||||
Multiple infarctions, n (%)c | 447 (34.9) | 111 (34.7) | 113 (35.3) | 103 (32.2) | 120 (37.4) | 0.585 | 0.477 |
ICASB, median (IQR)d | 1.0 (0.0, 4.0) | 0.0 (0.0, 3.0) | 2.0 (0.0, 4.0) | 1.0 (0.0, 4.0) | 2.0 (0.0, 5.0) | 0.014 | < 0.001 |
sICAS, n (%)e | 338 (26.4) | 76 (23.8) | 85 (26.6) | 77 (24.1) | 100 (31.2) | 0.122 | 0.036 |
Regression analysis of TyG with sICAS and ICASB
TyG quantiles* | OR/β (95% CI) (TyG as quantiles) | P value | OR/β (95% CI) (TyG as continuous) | P value | |
---|---|---|---|---|---|
sICASa | |||||
Unadjusted OR (95%CI) | Q1 (< 8.4) | 1 (Ref.) | 1.19 (1–1.41) | 0.048 | |
Q2 (8.4–8.9) | 1.16 (0.81–1.66) | 0.412 | |||
Q3 (8.9–9.4) | 1.02 (0.71–1.46) | 0.926 | |||
Q4 (≥ 9.4) | 1.45 (1.02–2.06) | 0.036 | |||
P for trend | 0.074 | ||||
Adjusted model I OR (95%CI) | Q1 (< 8.4) | 1 (Ref.) | 1.23 (1.03–1.46) | 0.022 | |
Q2 (8.4–8.9) | 1.16 (0.81–1.67) | 0.411 | |||
Q3 (8.9–9.4) | 1.05 (0.73–1.52) | 0.799 | |||
Q4 (≥ 9.4) | 1.54 (1.08–2.2) | 0.018 | |||
P for trend | 0.036 | ||||
Adjusted model II OR (95%CI) | Q1 (< 8.4) | 1 (Ref.) | 1.25 (1.01–1.55) | 0.037 | |
Q2 (8.4–8.9) | 1.16 (0.79–1.71) | 0.445 | |||
Q3 (8.9–9.4) | 1.02 (0.68–1.53) | 0.917 | |||
Q4 (≥ 9.4) | 1.59 (1.04–2.43) | 0.033 | |||
P for trend | 0.074 | ||||
ICASBb | |||||
Unadjusted β (95%CI) | Q1 (< 8.4) | 0 (Ref.) | 0.29 (0.03, 0.55) | 0.03 | |
Q2 (8.4–8.9) | 0.63 (0.1, 1.16) | 0.02 | |||
Q3 (8.9–9.4) | 0.52 (− 0.01, 1.05) | 0.055 | |||
Q4 (≥ 9.4) | 0.81 (0.27, 1.34) | 0.003 | |||
P for trend | 0.007 | ||||
Adjusted model I β (95%CI) | Q1 (< 8.4) | 0 (Ref.) | 0.46 (0.2–0.72) | 0.001 | |
Q2 (8.4–8.9) | 0.72 (0.2–1.25) | 0.007 | |||
Q3 (8.9–9.4) | 0.76 (0.23–1.28) | 0.005 | |||
Q4 (≥ 9.4) | 1.15 (0.62–1.68) | < 0.001 | |||
P for trend | < 0.001 | ||||
Adjusted model II β (95%CI) | Q1 (< 8.4) | 0 (Ref.) | 0.43 (0.13–0.74) | 0.006 | |
Q2 (8.4–8.9) | 0.74 (0.19–1.28) | 0.008 | |||
Q3 (8.9–9.4) | 0.63 (0.07–1.19) | 0.028 | |||
Q4 (≥ 9.4) | 1.08 (0.47–1.69) | 0.001 | |||
P for trend | 0.002 |
Effect of TyG, sICAS, and ICASB on stroke recurrence
Variable | No. total | No. event (%) | Unadjusted HR (95% CI) | P value | Model I HR (95% CI) | P value | Model II HR (95% CI) | P value | Model III HR (95% CI) | P value |
---|---|---|---|---|---|---|---|---|---|---|
TyG (continuous) | 1281 | 117 (9.1) | 1.15 (0.9–1.47) | 0.254 | 1.12 (0.86–1.46) | 0.388 | 1.04 (0.78–1.38) | 0.812 | 1.13 (0.85–1.49) | 0.403 |
TyG (categories) | ||||||||||
TyG quartile 1 | 320 | 19 (5.9) | 1 (Ref.) | 1 (Ref.) | 1 (Ref.) | 1 (Ref.) | ||||
TyG quartile 2 | 320 | 32 (10) | 1.73 (0.98–3.05) | 0.059 | 1.85 (1.02–3.36) | 0.043 | 1.82 (0.97–3.41) | 0.061 | 1.72 (0.91–3.26) | 0.065 |
TyG quartile 3 | 320 | 32 (10) | 1.72 (0.98–3.04) | 0.061 | 1.85 (1.01–3.38) | 0.046 | 1.88 (1.01–3.53) | 0.048 | 1.96 (1.05–3.66) | 0.043 0.010 |
TyG quartile 4 | 321 | 34 (10.6) | 1.84 (1.05–3.23) | 0.033 | 1.9 (1.04–3.48) | 0.038 | 1.91 (1.12–3.15) | 0.027 | 2.02 (1.07–3.84) | 0.025 |
ICASB (continuous) | 1281 | 117 (9.1) | 1.07 (1.03–1.12) | 0.001 | 1.08 (1.04–1.13) | < 0.001 | 1.08 (1.03–1.13) | 0.003 | 1.08 (1.03–1.13) | 0.002 |
ICASB (categories) | ||||||||||
ICASB < 4 | 922 | 70 (7.6) | 1 (Ref.) | 1 (Ref) | 1 (Ref.) | 1 (Ref.) | ||||
ICASB 4–5 | 137 | 17 (12.4) | 1.67 (0.98–2.84) | 0.058 | 1.84 (1.07–3.14) | 0.026 | 1.57 (0.88–2.79) | 0.125 | 1.73 (1–2.99) | 0.05 |
ICASB > 5 | 222 | 30 (13.5) | 1.8 (1.18–2.76) | 0.007 | 1.86 (1.18–2.92) | 0.007 | 1.82 (1.14–2.92) | 0.012 | 1.76 (1.1–2.81) | 0.018 |
sICAS | ||||||||||
Without sICAS | 943 | 70 (7.4) | 1 (Ref.) | 1 (Ref.) | 1 (Ref.) | 1 (Ref.) | ||||
With sICAS | 338 | 47 (13.9) | 1.89 (1.31–2.74) | 0.001 | 1.94 (1.32–2.84) | 0.001 | 1.73 (1.16–2.59) | 0.007 | 1.65 (1.1–2.46) | 0.014 |