Stable angina
BioMG follows French guidelines. Adapt it to the guidelines and the tests available where you practise.
Initial tests
Fasting laboratory tests
- FBC
- Serum electrolytes
- Serum creatinine with eGFR
- Lipid profile
- Fasting plasma glucose
- TSHif neededClinical suspicion of a thyroid disorder [1,2].
- NT-proBNPif neededSuspected heart failure [1,2]: an NT-proBNP helps confirm or rule out heart failure [3].
- Lipoprotein(a) [Lp(a)], once in a lifetime (not reimbursed in France)if needednon-French guidelineIf never measured: its level is genetically determined and a single measurement is enough in a person suspected of chronic coronary syndrome [3]. See the page “Dyslipidaemia”.
Urine tests
- Urine protein:creatinine ratio (spot sample) (depending on the context)if neededLooking for associated kidney damage: HAS provides for it in the initial tests (urine albumin:creatinine ratio in people with diabetes; urine albumin:creatinine ratio or protein:creatinine ratio otherwise) [4]; ESC 2024 does not list it among the tests [3]. To be requested above all in people with diabetes, or if kidney function is impaired or associated kidney damage is suspected [4].
Also consider
Do not order
- Troponin in primary care: do not measure, either for the diagnosis of chronic coronary syndrome or when destabilisation or acute coronary syndrome is suspected (refer the patient) [2].
- HbA1c to diagnose diabetes: not recommended in France and not reimbursed for this indication [1,8].
- Repeating tests already prescribed by the cardiologist, or the reverse: HAS asks not to duplicate laboratory tests between GP and cardiologist [1,2].
Annual tests
Fasting laboratory tests
- FBC
- Fasting plasma glucose
- Lipid profile
- Serum creatinine with eGFR
Urine tests
- Urine protein:creatinine ratio (spot sample) (depending on the context)if neededYearly search for associated kidney damage, provided by HAS (urine albumin:creatinine ratio in people with diabetes; urine albumin:creatinine ratio or protein:creatinine ratio otherwise) [1,4]; ESC 2024 does not list it among the follow-up tests [3]. To be requested above all in people with diabetes or if kidney function is impaired [1,4].
Also consider
Sources (11)
- GUIDE DU PARCOURS DE SOINS Maladie coronarienne stable
- Haute Autorité de santé. Guide du parcours de soins – Syndrome coronarien chronique. Avril 2021 (mis en ligne le 7 septembre 2021).
- Vrints C, Andreotti F, Koskinas KC, et al. 2024 ESC Guidelines for the management of chronic coronary syndromes. Eur Heart J. 2024;45(36):3415-3537.
- Haute Autorité de santé. Syndrome coronarien chronique. Actes et prestations affections de longue durée (ALD n° 13). Validé par le Collège le 15 avril 2021.
- National Institute for Health and Care Excellence (NICE). Recent-onset chest pain of suspected cardiac origin: assessment and diagnosis. Clinical guideline CG95, publiée le 24 mars 2010, mise à jour le 30 novembre 2016 : recommandations 1.2.5.1 et 1.3.3.7.
- National Institute for Health and Care Excellence (NICE). Cardiovascular disease: risk assessment and reduction, including lipid modification. NICE guideline NG238, publiée le 14 décembre 2023 : recommandations 1.5.5, 1.7.1, 1.11.1, 1.11.2, 1.11.5 et 1.11.9.
- Bundesärztekammer, Kassenärztliche Bundesvereinigung, Arbeitsgemeinschaft der Wissenschaftlichen Medizinischen Fachgesellschaften. Nationale VersorgungsLeitlinie Chronische KHK, version longue, version 7.0, 2024 (AWMF-Register-Nr. nvl-004) : recommandations 3-9, 3-10, 7-12 et 7-13.
- Assurance maladie. Nomenclature des actes de biologie médicale (NABM), version 105 du 2 juin 2026 : actes 1208 (TSH), 1821 (peptides natriurétiques), 1577 (HbA1c).
- Mach F, Baigent C, Catapano AL, et al. 2019 ESC/EAS Guidelines for the management of dyslipidaemias: lipid modification to reduce cardiovascular risk. Eur Heart J. 2020;41(1):111-188.
- Pearson GJ, Thanassoulis G, Anderson TJ, et al. 2021 Canadian Cardiovascular Society Guidelines for the Management of Dyslipidemia for the Prevention of Cardiovascular Disease in Adults. Can J Cardiol. 2021;37(8):1129-1150.
- American Diabetes Association Professional Practice Committee. 10. Cardiovascular Disease and Risk Management: Standards of Care in Diabetes—2026. Diabetes Care. 2026;49(Suppl 1):S216-S245.