Key result
Elevated METS-IR linked to ~42% higher risk of severe in-stent restenosis per SD.
Why the study?
The study evaluated the clinical forecasting potential of the Metabolic Score for Insulin Resistance (METS-IR) as a predictor for in-stent restenosis in patients undergoing PCI.
Does an elevated Metabolic Score for Insulin Resistance (METS-IR) predict the occurrence of in-stent restenosis in patients presenting with recurrent chest pain after PCI?
Cohort (n=818)
No
Does an elevated Metabolic Score for Insulin Resistance (METS-IR) predict the occurrence of in-stent restenosis in patients presenting with recurrent chest pain after PCI?
Odds Ratio: 1.42 (95% CI 1.18–1.71)
p-value: p=<0.001
Elevated METS-IR serves as a practical, independent predictor for risk stratification of in-stent restenosis following coronary stent implantation, showing particularly pronounced predictive value for severe restenosis (>70%).
METS-IR may support risk stratification for severe in-stent restenosis post-PCI; leaves open whether it guides interventions in prospective studies.
OBJECTIVE: The aim of this study was to evaluate the clinical forecasting potential of the Metabolic Score for Insulin Resistance (METS-IR) as a reliable predictor for in-stent restenosis (ISR) among patients receiving percutaneous coronary intervention (PCI). METHODS: A total of 818 patients undergoing repeat coronary angiography for recurrent chest pain after percutaneous coronary intervention from 2022 to 2025 were retrospectively collected. Clinical, blood and angiography-related data were analyzed. The predictive efficacy of METS-IR was assessed through both univariate and multivariate logistic regression analyses, along with receiver operating characteristic curves, for the evaluation of ISR (defined as 50% luminal narrowing) and severe ISR (defined as 70% luminal narrowing). RESULTS: < 0.05). ROC analysis identified an optimal METS-IR cutoff of 42.27 for ISR >50% and ISR >70% (sensitivity 50%, specificity 63%). Furthermore, incorporating the tertiles of METS-IR into the fully adjusted model significantly enhanced the ability to discriminate ISR. CONCLUSION: Our findings established that elevated METS-IR levels were strongly correlated with an increased risk of in-stent restenosis, with a markedly pronounced impact on severe ISR (>70%). METS-IR can serve as a straightforward and practical predictor for risk stratification after coronary stent implantation.
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Tang et al. (2026) conducted a cohort in Recurrent chest pain after percutaneous coronary intervention (PCI) (n=818). Elevated Metabolic Score for Insulin Resistance (METS-IR) vs. Lower METS-IR levels was evaluated on Severe in-stent restenosis (>70% luminal narrowing) per standard deviation increase in METS-IR (OR 1.42, 95% CI 1.18-1.71, p=<0.001). Elevated METS-IR was independently associated with an increased risk of severe (>70%) in-stent restenosis, with an adjusted OR of 1.42 per standard deviation increase.
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