Prognostic Significance of Metabolic Score for Insulin Resistance and Subclinical Myocardial Injury for Cardiovascular Mortality in the General Population

Background/Objectives: The Metabolic Score for Insulin Resistance (METS-IR), a non-insulin-based index of insulin resistance (IR), and subclinical myocardial injury (SCMI), identified by electrocardiogram (ECG), are each associated with cardiovascular disease (CVD). However, their joint impact on mortality remains unclear. We examined the association of METS-IR with SCMI and evaluated the individual and combined associations of SCMI and IR with cardiovascular mortality. Methods: We analyzed adults without baseline CVD from the Third National Health and Nutrition Examination Survey. METS-IR was calculated from fasting glucose, triglycerides, high-density lipoprotein cholesterol, and body mass index and categorized as low (