This analysis included participants enrolled in the ISCHEMIA trial. Those without a coronary CT angiogram (CCTA) were excluded. We excluded participants with prior coronary artery bypass grafting (CABG) or prior percutaneous coronary intervention (PCI), because they had obstructive coronary artery disease (CAD) at one time. We compared participants with no obstructive CAD, defined as all stenoses on CCTA <50%, who were excluded from randomization in the trial, to randomized trial participants with at least one stenosis of ≥50% on CCTA, termed obstructive CAD. The final cohort for analysis consisted only of participants with moderate or severe ischemia as determined by core laboratories.