Principal Findings:

5% of the TMR patients and 10% of the medical therapy patients died during the study. Unstable angina requiring hospitalization occurred in 37 patients of the TMR group vs 69 patients in the medical therapy group. Heart failure or left ventricular dysfunction occurred in 25 patients of the TMR group vs 10 patients in the medical therapy group, and myocardial infarction was noted in 14 and 8 patients of the TMR and medical therapy group, respectively. Exercise duration increased in the TMR group at all time points, with median improvement of >60 seconds. Over 50% of the medical therapy group had a decrease in their exercise time. At 12 months, total exercise time increased by a median of 65 seconds in the TMR group and decreased by 46 seconds in the medical therapy group (p<0.0001). Only 26% of the TMR patients had angina during the final exercise test, compared with 58% of the medical therapy group. After 12 months, CCSA score had decreased by greater than or equal to 2 scores in 61% of the TMR group vs only 11% in the medical therapy group. Patients with more severe angina at baseline were more likely to have greater improvement with TMR. At 12 months 48% of the TMR group vs only 14% of the medical therapy group were in CCSA Class less than or equal to 2 (p<0.001). The quality of life index score increased significantly more in the TMR group than in the medical treatment group. However, the change in the percentage of myocardium with fixed and reversible perfusion defects at 3, 6 and 12 months was comparable between the TMR and medical therapy group. LVEF did not change in the medical therapy group from baseline to 3 months, whereas it decreased by 3% in the TMR group (p<0.0001).