A Stable Dilemma

A 54-year-old company director presents to the emergency department with an episode of retrosternal chest pain lasting 15 minutes while playing squash. He went home after the event, but his wife persuaded him to seek medical attention.

He has experienced 2 similar episodes: one 6 months ago when he was walking the dog on a cold morning and another 3 months ago when he experienced a short period of indigestion-type pain while running on the treadmill. The patient stopped smoking 3 years ago and has a history of diabetes controlled on metformin 2000 mg/day.

A review 12 hours after presentation resulted in an electrocardiogram that showed T wave inversion from V4 to V6 and 3-hour high-sensitivity troponin T (TnT) < 3 ng/L.

The patient was diagnosed with stable angina and discharged on guideline-directed medical therapy. He gave consent to participate in a study of follow-up high-sensitivity TnT levels.

Based on the follow-up high-sensitivity TnT level, what is the next step in the management of this patient?

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