Familial hypercholesterolaemia (FH) is a frequent genetic disorder that is correlated with increased incidence of cardiovascular events. We investigated clinical and biochemical parameters possibly associated with the results of exercise testing (ET), as an indication of silent myocardial ischemia in asymptomatic patients with heterozygous FH. The study population was consisted of 194 patients with heterozygous FH, who had no medical history of coronary artery disease (CAD) or angina-like symptoms and had agreed to undergo ET. Among all the studied parameters, higher fibrinogen levels, arterial hypertension and family history of CAD were more frequent among patients with heterozygous FH. However, only high fibrinogen levels were significantly and independently associated with a positive result of ET. Thus, in asymptomatic patients with heterozygous FH, fibrinogen levels are an independent predictor of positive ET, while lipids and coronary risk factors profile do not seem to predict exercise-induced myocardial ischemia.