Strengths and limitations
ischemia
ISCHEMIA
The main strengths of our study are that it is a randomized controlled trial, involving participants from nine countries, encompassing a wide range of country-income levels and healthcare systems. We used reports generated by a blinded core lab for all analyses. An important limitation of this study is that just over three-fourth of patients in the routine non-culprit PCI arm underwent revascularization. However, this decision was primarily taken by the treating cardiologist based on clinical need, and the ischemia burden remained low at study end. We enrolled a small number of patients, and our study is not powered to detect differences in clinical outcomes. Nevertheless, the sample size was sufficient to demonstrate non-inferiority on the primary outcome with sufficient precision and confidence. Finally, the reduction in cardiac imaging and procedure volumes seen during the Covid-19 pandemic,