Association of the C-Reactive Protein–Triglyceride–Glucose Index with Stroke–Heart Syndrome and Clinical Prognosis in Patients Undergoing Endovascular Treatment

Background: Stroke–heart syndrome (SHS), particularly acute myocardial injury, is a critical complication following acute ischemic stroke (AIS). The C-reactive protein–triglyceride–glucose index (CTI) integrates inflammatory and metabolic parameters but remains unexplored in the context of post-stroke cardiac complications. This study investigated whether CTI predicts cardiac injury patterns and 90-day clinical outcomes in AIS patients. Methods: A two-center retrospective cohort study was conducted in AIS patients undergoing endovascular treatment (EVT). Cardiac troponin I (cTnI) trajectories were classified into: no injury, non-dynamic elevation, and dynamic elevation. The primary endpoint was poor functional status at 90 days (modified Rankin Scale [mRS] 3–6); the secondary endpoint was 90-day all-cause death. Results: Among 493 individuals (median age 69 years, 42% female), higher baseline CTI was associated with a greater likelihood of dynamic troponin elevation (adjusted odds ratio [aOR] per 1-unit increase = 1.56 (1.26–1.94); p < 0.001). Patients with dynamic elevation had significantly worse outcomes compared to those with no injury. Elevated CTI was an independent predictor of 90-day poor functional outcome (Q4: aOR = 3.04 (1.53–6.05); p < 0.001) and mortality (Q4: aOR = 2.82 (1.33–6.00); p = 0.007). Conclusions: In EVT-treated AIS patients, the CTI is a predictor of SHS and adverse 90-day outcomes. This easily calculable index may help identify individuals at higher risk of cardiac complications after AIS.