The PULS test (stands for Protein Unstable Lesion Signature) is a new test for heart attack and stroke risk assessment from Cleveland Heart Labs and GD BioSciences. It's probably a better test than the stress test. Why do I say that? There are two reasons. 1. The stress test only tells us that you currently have flow. It's a flow study. It doesn't tell us whether we have the bad actor - an inflamed, unstable plaque. 2. Unfortunately, it is not that clear what the predictive value of the PULS test will be.

They basically took a lot of indicators and risks - like HDL and HgA1c, and indicators of plaque inflammation - like HGF ( human Growth Factor), IL( INterleukins), etc. Again, there is insufficient data now for any single indicator. Putting them all together will help in some ways, and complicate things for others. There are some critical inflammatory markers missing - like MPO, LP-PLA2, and MACR. I would have included these in an overall evaluation of cardiovascular inflammation ( not so much everyone's favorite - hsCRP). In fact, that's what I do for my patients. I get an inflammation panel. It does include Lp-PLA2, MPO, hsCRP, and MACR. I look forward to future predictive results from the PULS test. I don't use it at this point.