New Heart Test Offers Early Warning, But Raises Access Questions

EVANSTON, IL – June 01, 2026 – Researchers at Endeavor Health have developed a groundbreaking genetic test that promises to provide a far more complete picture of a person's risk for coronary artery disease (CAD), the leading cause of death in the United States. The new test, however, highlights a growing tension in modern medicine between cutting-edge innovation and equitable patient access.

The test, named GenProb-CAD, is being hailed as one of the first integrated genomic risk models to be translated directly into routine patient care. Based on a massive study of 450,000 individuals, the findings, published in the peer-reviewed journal Circulation: Genomic and Precision Medicine, suggest this new approach can identify significantly more people at high risk for heart disease than existing methods. It is currently available exclusively within the Chicagoland-based Endeavor Health system.

A Floodlight on Genetic Risk

For years, genetic testing for heart disease risk has operated on two separate tracks. Monogenic tests act like a focused beam, searching for rare but powerful single-gene mutations that can dramatically increase risk, often for conditions like familial hypercholesterolemia. In contrast, polygenic risk scores (PRS) act more like a wide-angle lens, calculating a person's overall risk by analyzing the small, cumulative effects of thousands or even millions of common genetic variants across the genome.

Endeavor Health's GenProb-CAD test combines these two methods into a single, unified assessment. Furthermore, it integrates a specific screening for Lipoprotein(a), an inherited and often-overlooked type of cholesterol that is a significant independent risk factor for heart attacks and strokes.

"Each of these tests – monogenic and polygenic – are incredibly valuable on their own," said Jianfeng Xu, the study's lead author and Vice President of Translational Research at Endeavor Health, in a statement. "But when combined, they're even more powerful and can give us a broader view of risk. Think of it like a flashlight vs. a flood light – the flashlight can help you see part of the picture, while a floodlight illuminates the whole landscape."

The results of the study are striking. The integrated GenProb-CAD model identified 16% of study participants as being at high risk for coronary artery disease. This is a 46-fold increase compared to the 0.35% of individuals who would have been flagged by monogenic testing alone. Crucially, the researchers found that the overall risk of having heart disease was comparable between the two groups, suggesting the new test is effectively widening the net to catch at-risk individuals who were previously flying under the radar.

This expanded detection capability is critical, given that CAD was responsible for nearly 1 million deaths in the U.S. in 2023, equating to one death every 34 seconds. An estimated 1 in 20 adults has the disease, but many more may be undiagnosed.

From Prevention Theory to Clinical Practice

The true innovation of GenProb-CAD may lie not just in its scientific design, but in its implementation. Endeavor Health, Illinois' third-largest health system, has integrated the test into its clinical offerings, making it a tool for proactive, preventative care rather than a purely academic exercise.

"This new test can help us spot people at high risk for coronary artery disease long before symptoms appear," explained Dr. Arman Qamar, a senior author on the study and director of Endeavor Health's Center for Cardiovascular Personalized Medicine. "It's like having an early warning system that gives us a real chance to prevent a heart attack rather than just treating one after it happens. Waiting until it happens might be too late."

This move is part of a larger strategic focus for the health system. Since 2014, its Advanced Primary Care program has enrolled over 80,000 patients in one of the nation's largest clinical genomics programs. By embedding advanced diagnostics like GenProb-CAD directly into primary care, the organization aims to shift the paradigm from reactive treatment to personalized prevention, using a patient's unique genetic blueprint to guide lifestyle changes and medical interventions. The study showed the test's predictive power held true even after accounting for traditional risk factors like cholesterol levels, reinforcing its utility as an independent tool for early risk stratification.

The Life-Saving Test Not Covered by Insurance

Despite its promise, the new test's immediate impact will be limited by a significant hurdle: accessibility. The press release explicitly states that GenProb-CAD is not currently covered by insurance companies, and it is only available to patients within the Endeavor Health network.

This creates a difficult reality where a potentially life-saving "early warning system" is available only to those who can afford to pay for it out-of-pocket. While Endeavor Health has not disclosed the price, similar comprehensive genetic panels from commercial labs can cost several hundred dollars. For many patients, even a cost of $250 can be a significant barrier to care.

This lack of coverage is a common challenge for novel genomic technologies. Insurers often classify new tests as "experimental" or "investigational" until a larger body of evidence demonstrates their clinical utility and cost-effectiveness over several years. Professional medical societies, like the American Heart Association (AHA), must also formally incorporate the technology into their official clinical guidelines—a process that can be slow.

The situation places GenProb-CAD at the center of a larger debate about healthcare equity. While Endeavor Health positions itself as a pioneer, the exclusivity and out-of-pocket cost structure risk creating a two-tiered system of preventative care. It raises ethical questions about whether the most advanced medical tools should be accessible only to a select few, especially when they target the nation's number one killer.

A Glimpse into the Future of Cardiology

The development of GenProb-CAD is part of a broader shift in cardiovascular medicine. The AHA has acknowledged the growing role of genomics, with a 2022 scientific statement highlighting the promise of polygenic risk scores in improving risk prediction, particularly for younger individuals. While companies like Invitae and Color Genomics offer various genetic tests for inherited heart conditions, Endeavor's model of integrating a combined monogenic and polygenic score directly into routine care within a large health system is a novel strategic approach.

However, independent experts caution that the path to widespread adoption is complex. Integrating such sophisticated data into routine primary care presents major hurdles. Many primary care physicians report feeling ill-equipped to interpret complex genetic results and counsel patients appropriately. This "knowledge gap" is compounded by systemic challenges, including the lack of genetic counselors, the difficulty of integrating genomic data into electronic health records, and the time constraints of a typical office visit.

For now, the GenProb-CAD test represents both the immense promise and the pressing challenges of personalized medicine. It offers a powerful, more holistic tool for identifying hidden cardiovascular risk, potentially saving countless lives through early intervention. Yet, its journey from a breakthrough in a single health system to an accessible, equitable standard of care for all has only just begun.