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Triglyceride glucose index influences platelet reactivity in acute ischemic stroke patients
AIM: Insulin resistance was reported to increase the risk of ischemic stroke, which can be assessed by the triglyceride glucose (TyG) index. However, it remains unclear whether the TyG index influences the platelet reactivity during the treatment of ischemic patients. METHODS: Ischemic stroke patien...
Autores principales: | , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8549262/ https://www.ncbi.nlm.nih.gov/pubmed/34702218 http://dx.doi.org/10.1186/s12883-021-02443-x |
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author | Guo, Yinping Zhao, Jing Zhang, Yi Wu, Lingshan Yu, Zhiyuan He, Dan Huang, Hao Qu, Wensheng Luo, Xiang |
author_facet | Guo, Yinping Zhao, Jing Zhang, Yi Wu, Lingshan Yu, Zhiyuan He, Dan Huang, Hao Qu, Wensheng Luo, Xiang |
author_sort | Guo, Yinping |
collection | PubMed |
description | AIM: Insulin resistance was reported to increase the risk of ischemic stroke, which can be assessed by the triglyceride glucose (TyG) index. However, it remains unclear whether the TyG index influences the platelet reactivity during the treatment of ischemic patients. METHODS: Ischemic stroke patients receiving dual antiplatelet therapy (DAPT) within 48 h onset were consecutively included. The TyG index was calculated as ln (fasting triglyceride [mg/dL] × fasting glucose [mg/dL]/2). The top quartile of TyG index was defined as insulin resistance. The platelet reactivity was assessed by thromboelastography. The platelet inhibition rate induced by arachidonic acid (AA) or adenosine diphosphate (ADP) was used to confirm the high residual on-treatment platelet reactivity (HRPR) to aspirin or clopidogrel, respectively. The association between TyG index and platelet reactivity was assessed by Kruskal–Wallis test. The independent risk factors of HRPR were determined by multivariate logistic regression analysis. RESULTS: A total of 1002 patients were included and divided into 4 groups by quartiles of the TyG index (< 2.02; 2.02–2.27; 2.27–2.52; ≥2.52). The findings demonstrated that the maximum intensity of the clot increased, but the AA-induced platelet inhibition rate decreased, depending on the TyG index quartiles. No significant difference was found in the ADP-induced platelet inhibition rate among groups. The prevalence of aspirin HRPR increased depending on the TyG index quartile. Unlike the non-insulin resistance group, the insulin resistance group was independently associated with aspirin HRPR (OR = 1.689, 95% CI 1.14 to 2.51, P = 0.009). CONCLUSIONS: In acute ischemic stroke patients taking DAPT, the elevation of the TyG index is associated with enhanced platelet reactivity and higher prevalence of aspirin HRPR. Insulin resistance assessed by the TyG index could be an independent risk factor for aspirin HRPR. |
format | Online Article Text |
id | pubmed-8549262 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-85492622021-10-27 Triglyceride glucose index influences platelet reactivity in acute ischemic stroke patients Guo, Yinping Zhao, Jing Zhang, Yi Wu, Lingshan Yu, Zhiyuan He, Dan Huang, Hao Qu, Wensheng Luo, Xiang BMC Neurol Research AIM: Insulin resistance was reported to increase the risk of ischemic stroke, which can be assessed by the triglyceride glucose (TyG) index. However, it remains unclear whether the TyG index influences the platelet reactivity during the treatment of ischemic patients. METHODS: Ischemic stroke patients receiving dual antiplatelet therapy (DAPT) within 48 h onset were consecutively included. The TyG index was calculated as ln (fasting triglyceride [mg/dL] × fasting glucose [mg/dL]/2). The top quartile of TyG index was defined as insulin resistance. The platelet reactivity was assessed by thromboelastography. The platelet inhibition rate induced by arachidonic acid (AA) or adenosine diphosphate (ADP) was used to confirm the high residual on-treatment platelet reactivity (HRPR) to aspirin or clopidogrel, respectively. The association between TyG index and platelet reactivity was assessed by Kruskal–Wallis test. The independent risk factors of HRPR were determined by multivariate logistic regression analysis. RESULTS: A total of 1002 patients were included and divided into 4 groups by quartiles of the TyG index (< 2.02; 2.02–2.27; 2.27–2.52; ≥2.52). The findings demonstrated that the maximum intensity of the clot increased, but the AA-induced platelet inhibition rate decreased, depending on the TyG index quartiles. No significant difference was found in the ADP-induced platelet inhibition rate among groups. The prevalence of aspirin HRPR increased depending on the TyG index quartile. Unlike the non-insulin resistance group, the insulin resistance group was independently associated with aspirin HRPR (OR = 1.689, 95% CI 1.14 to 2.51, P = 0.009). CONCLUSIONS: In acute ischemic stroke patients taking DAPT, the elevation of the TyG index is associated with enhanced platelet reactivity and higher prevalence of aspirin HRPR. Insulin resistance assessed by the TyG index could be an independent risk factor for aspirin HRPR. BioMed Central 2021-10-26 /pmc/articles/PMC8549262/ /pubmed/34702218 http://dx.doi.org/10.1186/s12883-021-02443-x Text en © The Author(s) 2021 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data. |
spellingShingle | Research Guo, Yinping Zhao, Jing Zhang, Yi Wu, Lingshan Yu, Zhiyuan He, Dan Huang, Hao Qu, Wensheng Luo, Xiang Triglyceride glucose index influences platelet reactivity in acute ischemic stroke patients |
title | Triglyceride glucose index influences platelet reactivity in acute ischemic stroke patients |
title_full | Triglyceride glucose index influences platelet reactivity in acute ischemic stroke patients |
title_fullStr | Triglyceride glucose index influences platelet reactivity in acute ischemic stroke patients |
title_full_unstemmed | Triglyceride glucose index influences platelet reactivity in acute ischemic stroke patients |
title_short | Triglyceride glucose index influences platelet reactivity in acute ischemic stroke patients |
title_sort | triglyceride glucose index influences platelet reactivity in acute ischemic stroke patients |
topic | Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8549262/ https://www.ncbi.nlm.nih.gov/pubmed/34702218 http://dx.doi.org/10.1186/s12883-021-02443-x |
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