Carotid PWV and TyG index may help discriminate LAA from SVO in acute ischemic stroke

A retrospective cohort study analyzed 298 consecutive acute ischemic stroke patients (179 with small-vessel occlusion, 119 with large-artery atherosclerosis) from a single center between September 2021 and November 2023. The study examined whether combining carotid pulse wave velocity (PWV) with triglyceride-glucose (TyG) index could improve early in-hospital discrimination between LAA and SVO etiologies.

Patients with LAA showed significantly higher median carotid PWV (17.72 m/s) compared to those with SVO (15.02 m/s), with p < 0.001. The researchers developed a predictive model integrating PWV, TyG index, and clinical indicators to aid discrimination. The study did not report specific effect sizes, TyG index values, or model performance metrics.

Safety and tolerability data were not reported. The primary limitation is the single-center retrospective design, which limits generalizability and introduces potential selection bias. The study authors note this approach may be clinically relevant when advanced imaging is unavailable or delayed, but emphasize this represents association rather than causation.

This observational evidence suggests PWV and TyG index may help differentiate stroke mechanisms, but requires prospective validation. Clinicians should interpret these findings cautiously given the study design limitations and lack of external validation.