Key Points
• Source: BMC Neurology
• Conclusion/Relevance: “In acute ischemic stroke patients taking dual antiplatelet therapy [DAPT], the elevation of the triglyceride glucose [TyG] index is associated with enhanced platelet reactivity and higher prevalence of aspirin HRPR [high residual on-treatment platelet reactivity]. Insulin resistance assessed by the TyG index could be an independent risk factor for aspirin HRPR.”
• In the current study, researchers included 1002 patients and divided them into 4 groups by quartiles of the TyG index (<  ; –2.27; 2.27–2.52; ≥2.52).
• The researchers found that the prevalence of diabetes, blood lipids, and glucose levels significantly increased as the TyG index heightened. The TyG index was related to the increased platelet reactivity and decreased response to aspirin in acute ischemic stroke patients administered DAPT. Insulin resistance was an independent risk factor with regard to aspirin HRPR. Consequently, insulin resistance may increase the progression and recurrence of ischemic stroke by lowering the platelet reactivity to aspirin in those receiving DAPT.
• “In the present study, it was demonstrated that a higher TyG index is related to diabetes mellitus, triglycerides, total cholesterol, and LDL-C, which suggests that the TyG index is a reliable alternative index for evaluating the insulin resistance,” wrote the authors.
• Limitations of the current study include its retrospective design, with confounding variables affecting platelet reactivity, including proton pump inhibitors, statins, or heterogeneity of metabolic genes. Measurement error could have also been in issue, with only one fasting test of triglyceride and glucose done. Third, the cohort was Chinese, which could inhibit the exorability of results to other patient populations.