Puls Cardiac Test


We’ve been working on bringing the PULS test to the UK market for a long time now. This is undoubtedly one of the biggest advancements in cardio-metabolic testing and we’re proud and excited to provide you with it. – Humphrey Bacchus

The PULS (Protein Unstable Lesion Signature) Cardiac Test measures key clinical risk factors, including those commonly measured in the Framingham risk calculator, as well as 9 unique protein biomarkers.

These markers are associated with the biological pathways underlying cardiac lesion formation, progression and rupture.

50% of people who have a heart attack have ‘normal’ cholesterol and many adults are considered at ‘intermediate risk’.

The refined methodology of PULS cardiac risk assessment provides an improved calculation of a patient’s near-term (5 year) risk for a heart attack, and allows for the reclassification of nearly half of those patients considered in the clinical ‘grey zone’.

An Elevated PULS Cardiac Test May Identify:

  • Coronary heart disease development
  • Presence of unstable/vulnerable arterial plaque
  • Increased near-term risk of a heart attack

Atherosclerotic disease progression is characterised by chronic endothelial damage and an accumulation of fatty plaque within the arterial wall. Unstable plaque can rupture and lead to arterial blockage causing a heart attack. The first steps in prevention are the identification of individuals at near-term risk of a heart attack, and allowing for more aggressive therapy to potentially avoid a future event.

Clinical Use:

The PULS Cardiac Test may be performed on individuals at intermediate risk with one or more risk factors for coronary heart disease.

Clinical Significance:

  • Cardiovascular risk prediction models such as the
    Framingham Risk Score calculate risk of a cardiovascular
    event within the next 10 years. When used, these calculations
    rely heavily on established clinical risk factors (1) which may not
    fully estimate the prevalence of cardiovascular disease in the
    general population (2, 3)

  • The PULS Cardiac Test measures clinically significant
    proteins in the blood associated with active unstable lesion
    formation and when combined with established clinical risk
    factors, predicts whether a cardiac lesion could rupture
    within a 5 year period (4).
  • In the Multi-Ethnic Study of Atherosclerosis (MESA), the PULS Cardiac Test outperformed a common risk calculator, yielding a net reclassification index of 42.7% in individuals defined as intermediate risk by the Framingham Risk Score (4). Reclassification of those initially defined as intermediate risk to high risk may result in more appropriate therapeutic intervention.

  • In a large clinical trial, the PULS Cardiac Test identified 61% of
    patients who went on to have a cardiac event who otherwise
    would have been missed using established risk factors alone (5).

Testing Frequency:

The frequency of ordering The PULS Test is determined by an
individual’s medical history, but may be monitored more frequently
in those at moderate to high risk for cardiovascular disease.

Sample Type:

The PULS Cardiac Test should be performed on a serum and EDTA whole blood sample. Patients do not need to fast for the test.


BiomarkersPatient HandoutPractitioner HandoutPULS Sample ReportOrder


1. Wilson PW et al. Prediction of coronary heart disease using risk factor categories. Circulation. 1998; 97: 1837-1847.
2. Greenland P et al. Major risk factors as antecedents of fatal and nonfatal coronary heart disease events. JAMA. 2003; 290: 891-897.
3. Khot UN et al. Prevalence of conventional risk factors in patients with coronary heart disease. JAMA. 2003; 290: 898-904.
4. Cross DS et al. Coronary risk assessment among intermediate risk patients using a clinical and biomarker based algorithm developed and validated in two population cohorts. Curr Med Res
Opin. 2012; 28: 1819-1830.
5. Simonini A and Harrington DS. Early detection of unstable cardiac lesions in asymptomatic individuals at risk of acute coronary syndrome. Cardiology. 2015; 131: 148.


If you have any further questions about the PULS Cardiac Test, please email our technical team: