The RCRI scores 1 point each for a history of ischemic heart disease, cerebrovascular disease, heart failure, elevated serum creatinine (> 177 μmol/L), insulin requiring diabetes mellitus and high-risk surgery (thoracic or intra-abdominal), with a higher total score being associated with an increased risk of MACE (Lee et al. 1999). The gene discussed is INS; the disease is diabetes mellitus.