JACC Focus Seminar: The Best of Population Research Studies
JACC Focus Seminar
Multi-Ethnic Study of Atherosclerosis (MESA): JACC Focus Seminar 5/8

https://doi.org/10.1016/j.jacc.2021.05.006Get rights and content
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Highlights

  • MESA was the first NHLBI-sponsored prospective cohort study to address the incidence, prevalence, and progression of subclinical cardiovascular disease.

  • Data from MESA informed guidelines on the appropriate use of imaging for identification and surveillance of subclinical atherosclerosis, particularly coronary artery calcification.

  • The MESA infrastructure, now focused on atrial fibrillation, heart failure, and cognition, remains a vital population-based laboratory for research.

Abstract

The MESA (Multi-Ethnic Study of Atherosclerosis) is a National Heart, Lung, and Blood Institute–sponsored prospective study aimed at studying the prevalence, progression, determinants, and prognostic significance of subclinical cardiovascular disease in a sex-balanced, multiethnic, community-dwelling U.S. cohort. MESA helped usher in an era of noninvasive evaluation of subclinical atherosclerosis presence, burden, and progression for the evaluation of atherosclerotic cardiovascular disease risk, beyond what could be predicted by traditional risk factors alone. Concepts developed in MESA have informed international patient care guidelines, providing new tools to effectively guide public health policy, population screening, and clinical decision-making. MESA is grounded in an open science model that continues to be a beacon for collaborative science. In this review, we detail the original goals of MESA, and describe how the scope of MESA has evolved over time. We highlight 10 significant MESA contributions to cardiovascular medicine, and chart the path forward for MESA in the year 2021 and beyond.

Key Words

atherosclerosis
epidemiology
risk prediction
subclinical disease

Abbreviations and Acronyms

ASCVD
atherosclerotic cardiovascular disease
AVC
aortic valve calcium
CAC
coronary artery calcium
CHF
congestive heart failure
cIMT
carotid intima-media thickness
CMR
cardiac magnetic resonance
cTn
cardiac troponin
hsCRP
high-sensitivity C-reactive protein
LV
left ventricle/ventricular
MI
myocardial infarction
PCE
pooled cohort equations
RV
right ventricle

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Listen to this manuscript's audio summary by Editor-in-Chief Dr. Valentin Fuster on JACC.org.

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