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Evaluation and Management

Testing modalities include noninvasive and invasive procedures.

Noninvasive Testing

Biochemical Tests

In patients with stable IHD, including those with chronic angina, metabolic abnormalities that are risk factors for the development of CAD are frequently detected. These abnormalities include hypercholesterolemia and other dyslipidemias (see  Chap. 47), carbohydrate intolerance, and insulin resistance. Moreover, chronic kidney disease is strongly associated with the risk of atherosclerotic vascular disease (see  Chap. 93).[12] All patients with established or suspected CAD warrant biochemical evaluation of total cholesterol, low-density lipoprotein (LDL) cholesterol, high-density lipoprotein (HDL) cholesterol, triglyceride, serum creatinine (estimated glomerular filtration), and fasting blood glucose levels.

Other biochemical markers have also been shown to be associated with higher risk of future cardiovascular events (see  Chap. 44). Measurement of lipoprotein(a) and …