Angina Pectoris: Test and Diagnosis

Laboratory parameters of the 1st order – obligatory laboratory tests.

Small blood count
Inflammatory parameters – CRP (C-reactive protein).
Fasting glucose (fasting blood glucose) (annual control) [oGTT is more appropriate as a screening parameter – see below. oGTT]
HbA1c [linear association with coronary artery disease (CAD) in nondiabetics; moreover, independent association of HbA1c level with disease severity (1)]
Thyroid parameters – TSH
Atherosclerosis parameters 1st order (annual control):
- Total cholesterol, LDL cholesterol, HDL cholesterol.
- Triglycerides

Laboratory parameters 2nd order – depending on the results of the history, physical examination, etc. – for differential diagnostic clarification.

Oral glucose tetolerence test (oGTT) [120-minute value in the oGTT: ≥ 7.8 mmol/l allows an indication of the risk of cardiovascular events (cardiovascular-related death, nonfatal myocardial infarction (heart attack), apoplexy (stroke), or hospital admission for heart failure/heart failure)]
2nd order atherosclerosis parameters):
- Homocysteine [determination required only once].
- Lipoprotein (a) – lipoprotein electrophoresis, if necessary [in men, a single determination of lipoprotein (a) is sufficient; in women, a determination before and after menopause (menopause) is required]
- Apolipoprotein E – genotype 4 (ApoE4) [determination only required once]
Fasting insulin
Fibrinogen [determination required only once]
High-sensitivity cardiac troponin T (hs-cTnT) or troponin I (hs-cTnI) – in unstable angina pectoris.
D-dimers – acute diagnosis of suspected fresh venous thrombosis (see also under “Venous Thrombosis/Physical Examination” Wells score to determine clinical probability of venous thrombosis, DVT)[positive D-dimers are not specific for thrombosis or pulmonary embolism; however, negative D-dimers rule out thrombosis or pulmonary embolism with greater than 99%. Probability exclude]