Lee SW, et al. - In order to assess chronic total occlusion (CTO)-percutaneous coronary intervention (PCI), researchers conducted this open-label, multicenter, randomized, noninferiority trial assigning PCI-eligible patients to either PCI or no PCI for the qualifying de novo CTO lesion with the option for PCI of obstructive non-CTO lesions at the discretion of the operator. Random assignment of 834 patients to the CTO-PCI (n=417) or no CTO-PCI (n=398) strategy was done. In the incidence of a composite of death, myocardial infarction, stroke, or any revascularization, there was no significant difference between the CTO-PCI and the no CTO-PCI strategies over a median follow-up of 4.0 years. Significant improvements were seen with both strategies but without between-group differences in disease-specific health status that was sustained through 36 months. No difference in the incidence of major adverse cardiovascular events was seen between the two groups.