Abstract
BACKGROUND: In-stent restenosis (ISR) remains a significant clinical challenge after percutaneous coronary intervention (PCI). Metabolic syndrome (MetS), characterized by a cluster of metabolic abnormalities, is increasingly recognized as a contributor to cardiovascular disease progression. This study aimed to investigate the association between MetS and the risk of ISR. METHODS: We retrospectively reviewed the clinical and laboratory data of patients who underwent PCI and had follow-up angiography. Patients were categorized into MetS and non-MetS groups. MetS for comparisons of clinical characteristics and metabolic parameters. Cox and logistic regression analysis was used to identify independent risk factors for ISR. The predictive value of the triglyceride-glucose (TyG) index was evaluated using receiver operating characteristic (ROC) curve analysis. RESULTS: A total of 565 patients were included, of whom 99 (17.5%) developed ISR and of whom 146 (25.8%) developed MetS. The prevalence of MetS was significantly higher in the ISR group than in the non-ISR group (46.5% vs. 21.5%). Patients with MetS had significantly higher fasting plasma glucose, triglyceride, TyG index, BMI, and blood pressure, but reduced high-density lipoprotein cholesterol. Multivariable logistic regression revealed MetS (OR = 2.43, 95% CI: 1.43-4.15) and TyG index (OR = 2.65, 95% CI: 1.55-4.52) as independent predictors of ISR. ROC analysis demonstrated that the TyG index had good discriminatory power for ISR (AUC = 0.70). CONCLUSION: Metabolic syndrome is significantly associated with an increased risk of ISR following PCI. The TyG index may serve as a useful marker for predicting ISR in clinical practice.