22 June 2025 : Review article
Linking Triglyceride-Glucose Index to Spontaneous Intracerebral Hemorrhage: Mechanisms and Predictive Insights
Jiahao Wang AEF 1,2, Yanling Zhou AEF 1,2, Yuruo Song EF 1,2, Qi Fang EF 1,2, Juan Xia EF 1,2, Pengxian Tao EF 3,4,5, Haizhong Ma EF 2,3,4, Dongzhi Zhang AEFG 6,2,3,4,7*DOI: 10.12659/MSM.948695
Med Sci Monit 2025; 31:e948695
Introduction
Role of Hypertension in SICH
Impact of Metabolic Abnormalities on SICH
Other Potential Risk Factors
TyG Index and Metabolic Syndrome
Potential Association Between SICH and the TyG Index
Application of the TyG Index in Early Prediction of SICH
Research Limitations and Future Directions
Conclusions
References
Table 1 Four large-scale randomized controlled trials on acute-phase blood pressure management in spontaneous intracerebral hemorrhage.
| Trial name | Principal investigator | Sample size | Study objectives and methodology | Main findings |
|---|---|---|---|---|
| INTERACT1 | Anderson et al []14 | Approximately 400 cases | Comparison of the safety and feasibility of intensive blood pressure lowering (target SBP <140 mmHg) vs standard blood pressure lowering (target SBP <180 mmHg) | Intensive blood pressure lowering within 6 hours after hemorrhage is feasible and may be associated with a trend toward improved outcomes, providing a foundation for large-scale trials such as INTERACT2 |
| INTERACT2 | Anderson et al []15 | Approximately 2,800 cases | Participants were randomly assigned to either the intensive blood pressure lowering group (target SBP <140 mmHg) or the standard blood pressure lowering group (target SBP <180 mmHg), with functional outcomes assessed at 90 days using the modified Rankin score | There was no significant difference in the primary outcome between the two groups. However, the intensive blood pressure lowering group showed a trend toward improved outcomes in the distribution of the modified Rankin scores. Additionally, intensive blood pressure lowering did not increase the incidence of serious adverse events, supporting the feasibility of moderate intensive blood pressure control in the acute phase |
| ATACH1 | Qureshi et al []100 | Pilot study | To investigate the safety and feasibility of intensive blood pressure lowering in intracerebral hemorrhage (ICH) | The results support the safety of intensive blood pressure lowering in acute ICH, providing a foundation for subsequent large-scale trials such as ATACH2 |
| ATACH2 | Qureshi et al []16 | Approximately 1000 cases | Similar to the INTERACT2 trial, this study compares intensive blood pressure lowering (target SBP <140 mmHg) with standard blood pressure lowering (target SBP <180 mmHg), assessing functional outcomes at 90 days and hematoma expansion | There was no significant difference between the two groups in terms of functional outcomes and hematoma expansion rate, raising doubts about the benefits of strictly maintaining SBP below 140 mmHg |