The PULS (Protein Unstable Lesion Signature) Cardiac Test measures key clinical risK factors including age, sex, diabetic status, and family history if heart attack as well as distinct protein biomakers.

These markers are the body’s immune response associated with the biological pathways underlying cardiac lesion formation, progression and rupture. This refined methodology of cardiac risk assessment provides an improved calculation of a patient’s near-term (5 year) risk for a heart attack.

Atherosclerotic disease progression is characterized by chronic endothelial damage leading to the formation and progression of unstable cardiac lesions. Unstable cardiac lesions can rupture and lead to arterial blockage causing a heart attack.

The first step in prevention is the identification of individuals at near-term risk of a heart attack, allowing for more aggressive therapy ton potentially avoid a future event.



The PULS Cardiac Test is optimized for patients 40 years or older who have had no previous history of a Heart Attack (myocardial infarction). The clinical situation and medical necessity can dictate use in younger patients.



The frequency of testing is determined by an individual’s medical history, but may be monitored more frequently if an individual’s risk is Borderline or Elevated.



The PULS Cardiac Test should be performed on a serum and EDTA plasma sample. Patients do not need to fast for the test. Follow collection instruction below:



PULS Cardiac Test result provide a personalized 5-year Cardiac Profile score that conforms to ACC/AHA Guidelines for Normal, Borderline, or Elevated Risk:

Normal (<3.5%): These patients are in the desired range. Reviewing good nutrition and exercise habits and identifying any areas of concern like heart age, rising BMI or family history will dictate if additional recommendations are encouraged.

Borderline (3.5-7.49%): Patients in the intermediate range are generally early in disease progression. Frequently, simply lifestyle modifications such as a healthy diet, physical activity, smoking cessation, and stress management can bring these individuals back into the normal range.

Elevated (>7.5%): These patients have an elevated risk of ACS and should be treated as such using the ACC/AHA guidelines. Further evaluation is recommended to better define the clinical picture and treatment plan. If the patient is not currently under the care of a cardiologist, referral to a cardiologist should be considered.

Case studies have shown that some patients with high-risk result who have not acted on the information have experienced heart attacks within weeks or months of the test.



These treatment considerations are for educational purposes only. Specific treatment plans should be provided and reviewed by the treating practitioner.

  • LDL- C Levels: If elevated, consider LDL-lowering therapies.
  • Lifestyle Habits: Consider diet, exercise, and weight reduction efforts if appropriate.
  • Blood Pressure: If not at goal, consider initiating or titrating anti-hypertensive therapy.
  • Smoking Habits: Smoking cessation is essential as individuals who smoke are at increased risk of heart disease and blood clots.
  • Risk for Pre-Diabetes/Diabetes: If abnormal glucose. HbA1c, or insulin levels, consider insulin sensitizing therapy.
  • Additional Work-Up: Assessing the presence of coronary artery disease (CAD) with imaging techniques such as coronary artery calcium (CAC scoring, CTA, or angiography (if indicated).


If you need further assistance with regards to getting an PULS (Protein Unstable Lesion Signature) Cardiac Test, you can always talk to your doctor via the WeHealth App or visit AG Urgent Care.