TNF and Insulin resistance: Study [30] has shownthat insulin resistance and elevated cytokine levels are associated with a higherincidence of ISR after PCI even in patients with normal glucose tolerance.Elevated inflammatory markers (interleukin 6; interleukin 1; tumor necrosis factor alpha; C-reactive protein, etc.)andimpaired endothelial function can be detected in pre-diabetic patients withcoronary heart disease, resulting in abnormally elevated levels of this cytokineafter PCI [31].