Larger infarct volume is known to be predictive of poor stroke outcomes. While some studies suggest a correlation between elevated triglycerides and increased stroke risk, others propose a protective role of triglycerides during acute stroke in terms of severity and three months outcomes. However, the effect of fasting triglyceride levels on infarct volume is not well established.

To analyze the association between fasting triglyceride levels and Computed Tomography Perfusion (CTP) infarct volume in acute ischemic stroke (AIS).

We did a retrospective analysis of AIS patients admitted to a tertiary care United States center from 2010 to 2023. Inclusion criteria were AIS patients who within 24 hours of onset (1) underwent CTP and (2) had fasting triglyceride levels measured. Infarct volume was calculated using RAPID software (iSchemaView, Inc.) Statistical analyses were conducted using STATA (Release 16), with T-tests, ANOVA, chi-square tests, and multivariable linear regression applied as appropriate.

We found that hypertriglyceridemia positively correlated with larger infarct volumes, especially in ESUS patients. Our study raises an important question as to whether triglycerides need to be targeted for stroke prevention along with Low Density Lipoproteins (LDL) and glycated hemoglobin (A1C). Future studies are needed to further investigate this potential link.