Figure. Participant Flow From Enrollment to Randomization.

Those who were excluded after consent and enrollment are indicated in the right side box. An enrolled participant may have more than 1 reason for being excluded before randomization and therefore may be counted in more than 1 screen failure category (n = 594). Coronary computed tomography angiography (CCTA) was not required in all participants, eg, those with estimated glomerular filtration rate of less than 60 mL/min/1.73 m² or catheterization or CCTA within the prior year. To maximize information about baseline coronary anatomy, we subsequently collected available CCTA images that were performed less than 1 year prior to enrollment for CCTA core laboratory review (n = 148). No obstructive disease was defined as no epicardial coronary artery stenosis at least 50% on study CCTA for participants who were enrolled after stress imaging or no stenosis at least 70% in specified segments for participants who were enrolled after exercise tolerance test.⁴ Unprotected left main disease was defined as at least 50% stenosis on study CCTA. Incidental findings were defined as incidental findings on study CCTA of sufficient clinical importance that site investigators did not find randomization appropriate.