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Endothelial cell hyperproliferation and thrombosis are the primary etiologies, frequently resulting in alterations in intravascular metabolism. However, the metabolic changes related to this process are still undermined.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objective<\/jats:title><jats:p>We tried to characterize the serum metabolome of patients with ISR and those with non\u2010restenosis (NR) using metabolomics and lipidomics, exploring the key metabolic pathways of this pathological phenomenon.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>We observed that the cysteine and methionine pathways, which are associated with cell growth and oxidative homeostasis, showed the greatest increase in the ISR group compared to the NR group. Within this pathway, the levels of N\u2010formyl\u2010l\u2010methionine and L\u2010methionine significantly increased in the ISR group, along with elevated levels of downstream metabolites such as 2\u2010ketobutyric acid, pyruvate, and taurocholate. Additionally, an increase in phosphatidylcholine (PC) and phosphatidylserine (PS), as well as a decrease in triacylglycerol in the ISR group, indicated active lipid metabolism in these patients, which could be a significant factor contributing to the recurrence of blood clots after stent placement. Importantly, phenol sulfate and PS(38:4) were identified as potential biomarkers for distinguishing ISR, with an area under the curve of more than 0.85.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Our study revealed significant metabolic alterations in patients with ISR, particularly in the cysteine and methionine pathways, with phenol sulfate and PS(38:4) showing promise for ISR identification.<\/jats:p><\/jats:sec>","DOI":"10.1111\/cns.14832","type":"journal-article","created":{"date-parts":[[2024,7,16]],"date-time":"2024-07-16T02:34:33Z","timestamp":1721097273000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Alterations in metabolome and lipidome in patients with in\u2010stent restenosis"],"prefix":"10.1111","volume":"30","author":[{"given":"Ziqi","family":"Xu","sequence":"first","affiliation":[{"name":"Department of Neurology, First Affiliated Hospital, School of Medicine 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