Call to action: identifying an underlying bleeding disorder in adolescents with heavy menstrual bleeding.

We evaluated whether hypertriglyceridemia predicts outcome in acute ischemic stroke patients treated with mechanical thrombectomy at the Comprehensive Stroke Centre. Among patients with large-vessel disease, elevated triglyceride levels were found to be an independent predictor of good outcome within 90 days. Importantly, triglycerides’ protective mechanism operated independently of infection prevention, despite lower antibiotic use in patients with elevated triglycerides, with mediation analysis showing that this pathway explained only a minority of the protective effect. Our study revealed a context-dependent effect, i.e. while triglycerides protected patients without infections, they became ineffective in those with severe infections. This indicates the dominance of systemic inflammation over metabolic reserves. Moreover, the protective effect of triglycerides was masked by the combined TyG index, which clarifies the inconsistencies observed in the research. This study’s strengths include: (1) a homogeneous population of AIS patients treated with mechanical thrombectomy; (2) rigorous statistical methodology with penalized likelihood regression to address small-sample issues; comprehensive mechanistic analyses, including formal mediation testing and interaction analysis; multivariable predictive models; and (3) a novel observation of how a combined lipid index masks individual protective effects. Future studies should focus on potential mechanisms of TG’s protective effect, including nutritional status, collateral circulation and ischemic preconditioning.