Coronary heart disease (CHD) remains the leading cause of death worldwide, a persistent and complex clinical challenge that demands sophisticated tools for risk assessment, detection, and management.
For decades, doctors have used tools like cholesterol tests, stress exams, and Computed Tomography (CT) scans to try to catch heart disease early. These tools have saved lives, but they aren’t perfect. Some come with risks. Others can miss early signs of disease.
With advances in science, we now have new ways to look at heart health, ways that are safer, more precise, and easier to use. One of the most exciting is epigenetics, the study of how your lifestyle and environment affect your genes. At Cardio Diagnostics, we’ve built breakthrough tests that use this approach to improve how we detect and manage heart disease.
CT scans, especially coronary CT angiography (CCTA), have become popular because they give doctors a detailed view of the heart’s arteries. But they come with downsides:
Radiation Exposure: CT scans use ionizing radiation; high-energy rays that can remove electrons from atoms in the body, potentially damaging cells and DNA. This type of radiation can increase the risk of cancer over a person’s lifetime, especially with repeated exposure. In 2023, 93 million CT scans were performed in the U.S., with an estimated 103,000 future radiation-related cancers projected (Smith-Bindman et al., 2025).
Contrast Risks: Some CT scans use iodinated contrast agents that can damage kidneys, especially in people with chronic kidney disease or diabetes (McCullough, 2008).
Missed Diagnoses: Up to 25% of people who experience heart attacks don’t show major blockages on angiograms, especially women, who more often have INOCA (Ischemia with No Obstructed Coronary Arteries) (Sucato et al., 2021; Hansen et al., 2023).
These limitations show us that anatomy alone doesn’t tell the full story. Heart disease is complex and driven by more than just clogged arteries.
That’s where epigenetics comes in. Unlike genetics, which are fixed from birth, epigenetics reflects how our environment and behaviors influence gene expression over time. Our bodies carry biological “memories” of things like smoking, diet, stress, and exercise. These experiences leave marks on our DNA, especially in white blood cells, which circulate through the cardiovascular system (Broyles & Philibert, 2023).
By combining genetic and epigenetic insights, we gain a dynamic, more complete view of heart disease risk, one that accounts for both inherited predispositions and lived experience.
At Cardio Diagnostics, we’ve developed two tests that analyze these epigenetic signals:
Epi+Gen CHD™ uses a combined genetic-epigenetic model to estimate an individual’s future risk for a heart attack, enabling risk management to prevent a heart attack.
PrecisionCHD™ also uses a combined genetic-epigenetic approach to detect the presence of CHD, providing a powerful tool for both diagnosing and managing CHD over time.
These tools are radiation-free, non-invasive, and cost-effective, requiring only a blood sample. Unlike traditional imaging, they’re accessible even in settings with limited infrastructure, bringing precision care to more people, earlier in their health journey.
Epigenetic testing complements other testing methods and fills gaps by:
Capturing signal associated with disease at the molecular level. This is especially valuable in conditions like INOCA that can be missed by angiography imaging tests.
Offering personalized insights to better understand factors contributing to each patient’s disease, helping to guide management.
Tracking the impact of ongoing treatment and lifestyle changes. DNA methylation, which is the epigenetic biomarker captured by our solutions, can change in as little as 90 days in response to management (both clinical and lifestyle adjustments).
Offering a safe way to re-test with no exposure to radiation or contrast dye. This means patients can be monitored more frequently.
Traditional tools still matter. CT and angiography are important. But for early risk and disease detection, treatment monitoring, and long-term care, epigenetics adds a new layer of insight that traditional tools can’t provide. As we face rising costs, growing disparities in access, and increasing complexity in heart disease, we need more innovative, multi-dimensional tools.
Epigenetic testing offers that layer. As the field of cardiovascular diagnostics enters a more data-driven, personalized, and preventive era, epigenetics is well-placed to play a central role.
By complementing traditional methods, not replacing them, Epi+Gen CHD™ and PrecisionCHD™ provide a safer, more innovative path forward for both patients and providers.
References
Broyles, D., & Philibert, R. (2023). Precision epigenetics provides a scalable pathway for improving coronary heart disease care globally. Epigenomics, 15(16), 805–818.
Hansen, B., Holtzman, J. N., Juszczynski, C., et al. (2023). Ischemia with no obstructive arteries (INOCA): a review. Current Problems in Cardiology, 48(1), 101420.
McCullough, P. A. (2008). Contrast-Induced Acute Kidney Injury. Journal of the American College of Cardiology, 51(15), 1419–1428.
Smith-Bindman, R., et al. (2025). Projected Lifetime Cancer Risks From Current Computed Tomography Imaging. JAMA Internal Medicine.
Sucato, V., Testa, G., Puglisi, S., et al. (2021). Myocardial infarction with non-obstructive coronary arteries (MINOCA). Journal of Cardiology, 77(5), 444–451.
Article clinically reviewed by Dr Robert Philibert.
