Prevent Heart Attacks with a Simple Blood Test

“There’s more to the story than just cholesterol”

Clinical professor Dr. Doug Harrington at the University of Southern California’s Keck School of Medicine and CEO of GD Biosciences speaks about an early warning system called PULS that could prevent heart attacks. The PULS (Protein Unstable Lesion Signature) Test measures the most clinically significant protein biomarkers that measure the body’s immune system response to arterial injury. It can provide your physician with valuable information that can be used to determine the most appropriate course of action according to clinical guidelines that may save your life.

In this episode, Dr. Harrington talks about the if the PULS test is right for you and how it may help prevent your next heart attack. He also discusses common causes of atherosclerosis and the correlation between heart attack patients with cholesterol, high blood pressure and pollution. Listen to the end to hear about how a patient lost 16 pounds, normalized his A1C levels and rejuvenated his health.

Show Notes:

03:25 – Becoming a heart surgeon

05:30 – Cholesterol, high blood pressure and pollution

07:00 – Cause of Atherosclerosis

08:13 – Are you at risk for a heart attack?

12:29 – Silent Heart attacks

13:15 – PULS cardiac test

15:50 – Should you take the test?

18:55 – Lose 16 lbs and normalize A1C levels

22:56 – Does stress cause heart disease?

Full Transcript

Female VO: Welcome to the Wellness Revolution Podcast, the radio show all about wellness in your mind, body, spirit, personal growth, sex, and relationships. Stay tuned for weekly interviews featuring guests that have achieved physical, mental, and spiritual health in their lives.

If you’d like to have access to our entire back catalog visit drveronica.com for instant access. Here’s your host, Dr. Veronica.

Dr. Veronica: Welcome to another episode of Dr. Veronica’s Wellness Revolution. Today we’re going to talk about something near and dear to all of us. We’re going to talk about the heart. Heart disease and cancer kill more people every year than anything else. Cancer, it’s preventable, in case you didn’t know that but we’re not going to talk about cancer today. We’re going to talk about heart disease.

Heart disease is preventable and people are saying, “How do you prevent it?” Because most people they get sick from heart disease and they don’t even know what’s going on. So I always go to the horse’s mouth and I got a heart guy to come talk to you.

When you’re a doctor your heart guy is not your boyfriend but your doctor, or a doctor who is a cardiac guy, a cardiac surgeon, a cardiologist, a cardiac transplant guy. Guess what, the doctor I have on today has been on heart transplant teams way back in the day when it wasn’t even sexy, way back in the day.

He had a revelation that he was in the wrong field. Can you imagine, you’re a cardiologist, you’re a heart surgeon. You’re working all those type of people. You’re saving lives every day yet you feel, “I’m being useless.” We all have our revelation. One day I walked out of my office, said I’m never coming back to this because I felt useless because what I was doing for me to stay well I wasn’t giving to my clients. And so then I said, we got to change this. And this is what this doctor did. Dr. Doug Harrington.

I got to tell you, the man’s a heart surgeon but he’s a stud too. I hope he doesn’t mind saying that, but he’s got six kids so I can’t even figure out… Guys that I know that do anything at heart they don’t have time to have all these kids. He’s got six kids and a grandkid, can you believe that? But Dr. Doug Harrington like I told you, been on a heart transplant team and has actually founded a company and developed some innovative ways to figure out what’s going on with people’s hearts. You have to know about this.

I’m going to jump right in, introduce Dr. Doug Harrington. I’m going to let him give you some of the background of his story because it’s quite interesting what made him have… I don’t know what religion you are out there, but the come to Jesus moment where he said, “This ain’t it and I got to do something else. Dr. Doug Harrington, welcome.

Dr. Doug: Thank you Dr. Veronica. It’s great to be here again. I love talking to you.

Dr. Veronica: This is fun because I get to talk to people like you. Tell me about your story. Start a little bit back, what made you decide to go into the heart matters in the first place.

Dr. Doug: It was a very exciting time back 30 years ago when heart transplants are going on and it was kind of like if you could be a part of that it was like, wow, this is so cool. It’s really interesting to sit there with a patient in the operating room table. And the old heart comes out and it looks like a big bag of worms. And you have this empty chest there for a few minutes and then you put this new heart in and that looks so tiny compared to the old heart. You sow it in and then you give it a gentle thud, and boom, it’s beating again. It was a very amazing experience.

But as you’ve pointed out after about 30 of these I realized that the majority of them were preventable disease. I looked at myself in the mirror one day and I said, “You know what, it’s really amazing that we can do all these things. But wouldn’t it be more amazing if we never got to that point in the first place?”

That was my epiphany of prevention is really the way to do these things. And so I left surgery and started studying things like cancer and heart disease and other immune diseases to see what’s going on. And it was really a friend of mine who I was working on a breast cancer test to try and figure out what shouldn’t get chemo.

He’s a very famous oncologist and he was about 50. He wanted to go scuba diving with his youngest son in Mexico. He went to get a complete work-up, got a stress test, the whole kit and caboodle. He’s totally as healthy as a horse. He went on a week later scuba diving with his youngest son and he died in the water of a massive heart attack.

And I just said, you know what, we’re deceiving ourselves. There’s more to this story than cholesterol. We need to do a better job on this. So it started me looking at what was really going on there. And that’s how I got involved in developing this blood test that we may talk about in a few minutes.

Dr. Veronica: You say there’s more to the story than cholesterol. And I variably have people come to me, everybody’s stressed about their cholesterol. It’s too high. What do you mean there’s more to the story. Because in conventional medicine, the Holy Grail is what’s that total cholesterol, what’s that LDL?

Dr. Doug: You nailed it right there. And that’s the biggest false sense of security that we perpetrate on people. Here’s the deal. The American Heart Association did a study on people, their first hospitalization for coronary artery disease. Their looked on a 137,000 hospitalizations, 83% of those people had normal LDL cholesterol. So you know right out of the hat that if all you’re looking at is cholesterol you’re missing this boat load of people that are severely at risk and they don’t know it. So that didn’t seem right. That was another story that basically said we need to take another look at this. What’s really going on here.

Dr. Veronica: Now we know cholesterol really indicates something else and is not the main marker for heart disease. What should people be thinking about now? Everybody’s fixated on the cholesterol still. Statins I think are the number one prescribed drugs in people. What’s the matter with those? Talk about that from the perspective of a heart doc.

Dr. Doug: Things like cholesterol, cholesterol is just one risk factor of many. Things like family history if you’re diabetic, high blood, pressure, you don’t eat right, you don’t exercise, you live in an environment that’s very polluted, they all impact you. So all you focus on is cholesterol a lot of things correlate with heart disease. A handshake correlates with heart disease. But that doesn’t really tell you that you have any damage.

What is the real cause of atherosclerosis? It’s actually free radical damage to the lining of the arteries and the heart. And free radicals come from a lot of places, cholesterol is just one of them. If you have excess sugar in your diet it induces free radicals and other things in your body. Like vitamin C, if it’s not recycled can be a free radical. Glutathione if it’s not recycled can be a free radical.

Oxidized hemoglobin is a very common free radical found in your blood. I tell people it’s like a Velcro ball that you throw at the wall and it sticks because they have an electric charge. And what happens is when they try to peel off they damage the lining of the artery. And at that point your body says, “Hey, something’s wrong here. Come and fix it.” So it activates your immune system. That is the inciting event for atherosclerosis.

Dr. Veronica: If people cannot look at cholesterol at this point how do you know if you’re at risk for having a heart attack?

Dr. Doug: I’m glad you asked, because I spent 15 years looking at that problem. I do want to say that it’s important to know what your cholesterol levels are because the higher it is the more it correlates with the development of disease. But it doesn’t tell you you have disease.

What we did is we started with mice. Because the lesions that kill you are soft. They don’t have calcium and they’re usually asymptomatic. And mice don’t get hard plaque. They don’t get the hard lesions that humans get when they’ve been around for a while.

We looked at them and we identified 250 proteins in mice that were up regulated or down regulated when these lesions formed. And then what we did is during coronary artery bypass surgery, we biopsied human lesions and showed that most of those proteins were concerned.

And then what we did is we said we can’t create a clinical useful test with 250 proteins. Let’s narrow it down. We narrowed it down. And then we did something that’s way different than anybody else. We said the biggest killer of people is acute coronary syndrome. We said let’s take all those biomarkers that we found, let’s take all the global risk factors like age, sex, do you smoke, and all the biomarkers that were currently and clinically used like CRP and myeloperoxidase. And we’re going to let software determine which of those permutations of those 60 or so items are best at predicting whether you’re going to have an acute coronary syndrome.

We used three different software symptoms to test all of those, thinking that if two of them agreed that was a good thing. It turns that all three agreed. They picked the same nine biomarkers and the same four clinical risk factors which were age, sex, diabetic status, and family history.

And we were able to in a cohort of patients, and I’m using our last study which was done independently at the National Institute of Health. They took blood that was drawn eight years before the patient’s blood was given to us. It was stored at minus 80. And they measured it with us test system and said, “Can we predict who went on to have an acute coronary syndrome.”

That serum blood test predicted 61% of the patients that actually went on to develop an acute coronary syndrome. That’s okay because we were testing the blood way after the fact, but that’s called a retrospective prospective study. What that means is since we took blood at the beginning when there was no clinical evidence of disease, if we identified that they had a risk at that time we could’ve intervened with lifestyle. And when you give data people and they can understand it they’re more likely to pay attention to it. They’re more likely to lose weight, eat better exercise, and in some cases they need drugs and interventions.

And so we waited until we did that study and then we published it and we decided to get it into clinical use. And I’m skipping a whole bunch of other things here just to get to the main topic. Now what we have is we have a blood test which it identifies that endothelial damage. Endothelium is the cells lining the arteries in your coronary arteries. When that gets damaged by a free radical we can quantify that by measuring the body’s immune response to it.

We’re not testing cholesterol, we’re testing something different that complements cholesterol. And it turns out that that has given us a lot of power to identify people who are at risk of disease and don’t know it. And we’ve seen a lot of successful interventions and lifestyle changes in people.

Dr. Veronica: Is this in people who have elevated cholesterol or are these in people who do not have elevated cholesterol. Because there’s that percent of people who don’t have elevated cholesterol and still have cardiac events. So what are you looking for?

Dr. Doug: Right. The majority of these people have normal cholesterol levels. And they can even be on some medication. And most of them are asymptomatic. The bottom line is these are people… As you know, half the people who have heart disease their first presentation is they either die or they have a heart attack. They have no symptoms.

And this year there was a paper that came out of Baylor on a cohort of patients called Eric that showed that half of all heart attacks are violent. That means those people did not experience the usual symptoms that you get when you have a heart attack. They used MRI’s and CT scanners to look at these people to determine if they had scarring in their heart muscle that indicated a past event. That’s important because those silent heart attacks mean that those people were twice as likely to die in the next 12 months and they didn’t know it.

Dr. Veronica: I’m liking on the name of… I want to say cardiac calcium scanning or something like that. I hear all the radiology groups advertising on the radio, “Come up and have this scan done.” What about that?

Dr. Doug: Calcium is actually a great measure of total plaque burden. And it correlates with long-term heart disease. But the lesions that killed people are not detected by calcium scores. They’re soft lesions. They’re called fibro-fatty lesions. The test I’m talking about is called a PULS Cardiac Test. It stands for Protein Unstable Lesion Signature and it detects those fatty and fibro-fatty lesions.

The test I’m talking about complements calcium score. The problem with the calcium score is it’s not very good in women because women get soft plaque mostly. It’s not very good in men between 40 and 50. But it is a valuable test for looking at plaque burden and that sort of thing. We actually support the use of it but we don’t think that it should be the major determinant of your risk. I have to be careful because I have a lot of friends who do calcium scores.

Dr. Veronica: I know. My opinion is that we have to use all these pieces of information in concert. I think there’s just so much focus on cholesterol. And we’re saying cholesterol is not what we need to be looking at exactly right now. Tell us again, you have the PULS Cardiac Test. PULS stands for?

Dr. Doug: Protein Unstable Lesion Signature and it’s a play on the word pulse obviously. Last time we were just this little, tiny group of people here that were dedicated in preventing heart disease. We now have two national distributors in Canada and the United States.

In Canada the test can be obtained through Life Labs. They’re the fourth largest laboratory in the world. And in the United States Cleveland Heart Lab which is a spin out of Cleveland Clinic is our distributor for physician’s offices and naturopaths. They go into integrative medicine and concierge medicine and stuff like that.

We spent a lot of time doing the research. And the goal was to find a simple way to identify these people. Get a clean bill of health than go out, drop dead of a heart attack before that happens. And that’s…

Dr. Veronica: Who do you recommend to get this type of test?

Dr. Doug: It should be done on men and women aged 40 or older. And if it’s normal it has a 98% negative predictive value, which means you just have to maintain a healthy lifestyle and you’ll be fine. However if it is elevated you have to take it serious. It doesn’t mean you need to have surgery or you’re going to have a heart attack, it’s more akin to your check engine light went on and you need to do a tune-up on that engine.

I can tell you that the majority of people that come in and I see, and we’ve done thousands of these now. They’ll something like, “I eat right. I exercise.” You know what, a lot of times they’re not telling the truth. And that’s not a criticism of people, it’s just you don’t want to admit that you’re eating those Cheetos at night, watching TV, and not moving your rear end, you know what I mean?

You can give them some information in the form of our test that basically says, “You know what, this says you’re not doing the right thing.” And we can even be more specific. We can say, “You know what, I know that you think that you’re eating a good diet, but this particular component here tells me that you’re eating too much sugar and refined carbs, and probably deep fat fried foods, or drinking too much, and it’s damaging your arteries. So you need to back off on that.” We have great compliance once we give people that information.

Dr. Veronica: The PULS test is meant to be screening test of sorts?

Dr. Doug: Well, it’s both diagnostic and predictive. And it’s a little different because… For instance if you take the Framingham Risk Score which is supposed to be gold standard for cardiac risk assessment, it doesn’t actually tell you that you have disease, it just tells you that you have the risk of developing disease.

The PULS Cardiac Test, it can be considered a risk score because it is predictive of a future event, but it’s also diagnostic because it’s quantifying the damage to your coronary arteries. So it’s diagnosing subclinical disease.

I would prefer to call it preventive because we’re catching people before they end up with an event. I have so many patients that we’ve caught just in time by doing this blood test. And then oftentimes it’s the only thing that was abnormal. And it precipitated a closer look at those patients and they’re doing very well.

You complement everything that people are doing. It doesn’t replace anything. And it doesn’t replace coronary calcium because it’s a different look at the patient.

Dr. Veronica: If someone does have a high score does that simply say you’re eating too many McDonald’s French fries? I shouldn’t say McDonald’s French fries, French fries in general, too much fried food. Can you get more precise with giving the person recommendations? And once you give the recommendations can this score be used to follow how they’re doing clinically?

Dr. Doug: Absolutely, and I’m going to give you an example because this is more commonly what we see. One of my patients is a 52-year old physician. His lipids were normal. He was taking a statin once or twice a week, not in high dose, just kind of a homeopathic dose. He had been pre-diabetic for about 10 years and he was changing his practice to a different type of practice.

We ran his lipids. His lipids looked pretty good with one exception. And we ran his pulse test. For his age his pulse test was 8.75% which is almost five times expected for his age because we know what you should be if everything’s normal. That really scared him.

But the thing that caught his eye the most, because we also provide a heart age, he being 52 his heart age was greater than 80. That heart age is what captures people’s attention more than anything else we do. And so I said, “Would you like me to actually put you in a real statin does since you’re already taking one.” He said, “No. Doug, I know what I’m doing wrong. Give me four months.”

We said okay. He came back four months later. We measured him. And he went from 8.75% down to 2.34%. And we went from high risk to normal. Here’s what he did. What I didn’t tell you was when I went into his office he had a cake, candy, and cookies. He was indulging in sweet tooth because he thought his cholesterol was okay.

I swear, the biggest problem in the American diet is sugar. What he did during that four months is he walked 30 minutes, three times a week and he didn’t have time to go to a gym, and I don’t really particularly care for that. So we just said get some five pound dumbbells. And instead of sitting down watching TV, three times a week stand up for 20 or 30 minutes and go through range of motion exercises because resistance training is actually more effective at stabilizing these unstable cardiac lesions. And he cut out the refined carbs and the sugar.

And during that four months just doing that he dropped 16 pounds. And more importantly his heart age came down from greater than 80 to 53 and 55. I don’t remember exactly what it was but it was close to his age. But even more remarkably for the first time in 10 years he was no longer a pre-diabetic. His Hemoglobin A1c normalized and he was so impressed.

And this was just lifestyle modification. He was not taking a statin dose that was even homeopathic. It was like sprinkling, out into the wind or something. It wasn’t really going to make an impact. And the message there is that the score is one of a few that actually goes up or down. So there are several potential outcomes. One is with time annually if you do it every year because age is one of the inputs, it will go up a little bit. One of the good outcomes is if you stabilize it it doesn’t keep going up. A better outcome is if it goes down. What you don’t want to see that it goes up dramatically.

Dr. Veronica: That person just went hog wild. That’s what you know about them, is that it goes up…

Dr. Doug: Yeah. Another patient that is an example of how quickly these things can progress is we have somebody that’s 78 year old who is part of one of our clinical trials. And 78-year old should be in what’s called the borderline region under the American College of Cardiology guidelines. They have low, intermediate, and high risk. So they would be intermediate. That’s normal for a 78-year old, 78, 3.6%, a year earlier.

His daughter brought him back in a year later and said she didn’t think he was right. I talked to him I said, “Do you have any complaints?” She said no. She said, “He just doesn’t seem to have the energy that he did a few months ago.” That’s kind of what’s considered an atypical syndrome.

He went through his HMO and they did the cholesterol and everything was normal. And they did a carotid internal medial thickness ultrasound, it was normal. His blood pressure was normal. And because of all of that they discharged him but his daughter was just not happy with that so she took him to an out of network cardiologist. He ran the pulse test, he repeated the pulse test. The pulse test in that 12 months had gone from 3.6% to almost 46%.

Dr. Veronica: Wow.

Dr. Doug: The only difference during that period of time was his wife had almost died two or three times and he was the primary caregiver. He was very stressed. And the reason I bring this up is because everybody forgets about stress. And you’ll see actually in some of the associations like the American Heart Association, there are people who’ve actually said stress doesn’t cause heart disease. That is not true. Stress, it’s implicated in cancer, heart disease, and autoimmune diseases.

What happened was that a network cardiologist sent him back to his HMO and when they saw the results that took it very seriously. They went in and they did an angio on him because he had what his daughter was saying he didn’t have the energy. He was described as just getting older. And she said, “No, he’s not like that. That’s not right.” So they took it seriously. It’s an atypical symptom.

When they did the angio on him he had almost 100% occlusion of his [Unintelligible 00:24:26]. There was blood flowing through it and it was eminently going to rupture and probably would have killed him because it’s the artery of sudden death. They stented him and put him on medications. This is a little further along than lifestyle modification would allow. And today he’s doing very well. He looks like a much younger man.

I use that just to illustrate two points, it will go down and it will go up. And if you’re stressed it will go up. Mine went up when I was getting an IRS audit. It went up.

Dr. Veronica: Everybody’s would go up with an IRS on it. The PULS test sounds so wonderful and people are asking right about now, “Where do I get one?” How do we go about getting a pulse test because that’s what we’re interested in.

Dr. Doug: Since the roll out is just starting nationally the first thing I’d recommend is they go to pulstest.com to learn more about it. And then they can contact Cleveland Heart Lab. They can look it up online. Contact Cleveland Heart Lab and tell them that you’re interested in the PULS Cardiac Test and they will contact you. Alternatively you can send an email to the pulstest.com website and one of our client services people will contact them and help them find out where they can get it done.

Dr. Veronica: It was so funny, I was going to open an account with Cleveland Heart Lab and the guy came and visited me. I just never got around to it. So now I got to get my Cleveland Heart Lab account so I can offer it to my clients. That put a kick in my butt right there.

Dr. Doug: Okay, [Unintelligible 00:26:07] definitely wanted to do. They’re a very good partner and they’re very ethical. And we’re always available to consult on results. We deal with people all over the world now so it’s very gratifying.

Dr. Veronica: One last question. People always want to know this. Let me just say I don’t think this should make or break whether you save your life but are they covered by insurance at this point?

Dr. Doug: It is. It’s reimbursed by Medicare and most PPO. We haven’t had time to go to all the HMO’s. But if a doctor from the HMO orders it a lot of times it will get covered, so the answer is yes. And then cash price is actually not super high.

Dr. Veronica: Range of cash price? I know this is not your forte.

Dr. Doug: It’s around $150, or it’s about the same as an expanded lipid profile.

Dr. Veronica: Okay.

Dr. Doug: That’s Medicare. We don’t usually go below Medicare pricing for obvious reasons, because that becomes your new price. We do have a not for profit foundation, that if people do not have insurance or they have a ridiculously high deductible, they can fill out a financial assistance form and get sometimes a lot of it covered. So we don’t want to deny doing it just because of money.

Dr. Veronica: Wonderful to know that. It’s great that you did that. Dr. Doug Harrington who has a new life purpose in helping save people’s lives who we would know were even at risk for having a problem. It sounds like this test should be something that becomes a normal part of the screening for everybody versus the cholesterol, I got to say that.

Dr. Doug: Again, that’s our goal but we don’t want to remember cholesterol as still important just to determine your risk of developing disease. And it is something that is modifiable. And this doesn’t replace anything but this is a whole in what we’re looking at in a patient that we can’t see right now and this PULS Test lets us see that part of the patient and get a better idea of their true cardiac health.

Dr. Veronica: Yeah. It would be great to be able to see the problem when you can really do something on the lifestyle front that’s going to make a very big impact versus when you’re seeing them and you do… The gentleman was saved. You got the stent and everything but we would like to get people their way before that. So this sounds great.

Dr. Doug: And look at the gentleman that was 52, he didn’t have any surgery or anything, he just did lifestyle and took his risk from high to normal, and in only four months. So that should give people hope that you do have control over your bodies. You have to make those decisions. You have to get off the coach and exercise. You have to eat the right food. Stay away from processed foods and all that sugar and you’ll do well. Eat whole foods, that’s it.

Dr. Veronica: I don’t even think cholesterol is scary to people anymore at this point. This right here we know how predictive it is. Dr. Doug Harrington, thank you, pulstest.com if you want to find out where to get one.

Dr. Doug: Dr. Veronica thank you so much. It’s always a pleasure to talk to you.

Dr. Veronica: Thank you so much.

Dr. Doug: Okay, bye bye.

Female VO: Thank you for listening to the Wellness Revolution Podcast. If you want to hear more on how to bring wellness into your life visit drveronica.com. See you all next week. Take care.