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†These authors contributed equally.
Background: Rotational atherectomy (RA) is the major tool used to treat
severely calcified lesions in patients with coronary artery disease (CAD). The
relationship between coronary microvascular dysfunction and RA remains unknown.
Therefore, we attempted to explore the predictive implications of the coronary
angiography-derived index of microcirculatory resistance (angio-IMR) in CAD
patients undergoing RA. Methods: This retrospective study included 118
patients with severe coronary calcification who underwent a successful RA from
January 2018 to June 2021. The angio-IMR was calculated based on computed flow
and pressure dynamic principles to assess coronary microcirculatory function.
Follow-up was performed on all patients for major adverse cardiovascular events
(MACEs), including all-cause death, non-fatal myocardial infarction, target
vessel revascularization (TVR), and stroke. Results: The mean angio-IMR
for all patients was 25.58