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In the ISCHEMIA trial (NEJM JW Cardiol May 2020 and N Engl J Med 2020; 382:1395), percutaneous coronary intervention (PCI) did not reduce the risk for death or myocardial infarction in patients with stable ischemic heart disease, thus suggesting that PCI was rarely appropriate for patients who were asymptomatic or had nonanginal chest pain and were without left main disease or left ventricular dysfunction. To determine how ISCHEMIA-based criteria would classify the appropriateness of the procedure in real-world patients, investigators applied both current appropriate use criteria and ISCHEMIA-based standards to 352,376 patients with stable ischemic heart disease (mean age, 68; 30% women) from the National Cardiovascular Data Registry CathPC…