Multi-Ethnic Study of Atherosclerosis

Multi-Ethnic Study of Atherosclerosis
Name	Multi-Ethnic Study of Atherosclerosis
Acronym	MESA
Start year	2000
Investigators	National Heart, Lung, and Blood Institute, Johns Hopkins University, University of California, Los Angeles
Locations	Baltimore, Chicago, Forsyth County, Los Angeles, New York City, St. Paul (Minnesota)
Participants	6,814
Population	adults aged 45–84
Status	ongoing

Multi-Ethnic Study of Atherosclerosis is a large, prospective cohort study initiated to investigate the prevalence, correlates, and progression of subclinical cardiovascular disease in a diverse population, and to identify risk factors for clinical cardiovascular events. The study was launched by the National Heart, Lung, and Blood Institute with multi-center collaboration involving institutions such as Johns Hopkins University, University of California, Los Angeles, and Wake Forest School of Medicine; major analytic contributions have come from investigators at Columbia University, University of Minnesota, and Northwestern University.

Background and Objectives

MESA was conceived to address gaps left by earlier cohort studies including the Framingham Heart Study, Nurses' Health Study, and the Cardiovascular Health Study by enrolling a multi-ethnic sample drawn from communities associated with centers in Baltimore, Chicago, Forsyth County, Los Angeles, New York City, and St. Paul (Minnesota) and by applying advanced imaging and biomarker assays. Primary objectives included measuring the prevalence and progression of subclinical atherosclerosis across groups identified with roots in populations studied by Harvard University, Johns Hopkins University, and University of California, San Francisco and to relate these measures to incident events documented in registries linked to Centers for Disease Control and Prevention and Social Security Administration datasets.

Study Design and Methods

MESA enrolled 6,814 men and women aged 45–84 who were free of clinically apparent cardiovascular disease at baseline; the design parallels prospective cohort frameworks used by Framingham Heart Study and analytic approaches influenced by teams at Brigham and Women's Hospital and Massachusetts General Hospital. Baseline examinations included standardized questionnaires developed with input from researchers at Columbia University, physical measures calibrated in collaboration with University of Washington, and centralized laboratory panels run by specialists affiliated with Johns Hopkins University and Tufts University. Statistical methods used in MESA analyses often cite methods literature from Harvard School of Public Health, Stanford University, and Yale University.

Participant Characteristics and Recruitment

Participants were recruited to reflect four self-identified racial/ethnic groups modeled after sampling strategies used by U.S. Census Bureau studies and by teams at University of California, Los Angeles and Northwestern University; enrollment procedures included community outreach coordinated with partners such as Mount Sinai Medical Center and Montefiore Medical Center. The cohort includes individuals with ancestral ties referenced in comparative population work at University of Michigan, University of North Carolina at Chapel Hill, and University of Texas Southwestern Medical Center, and recruitment leveraged clinical networks including Kaiser Permanente in the Los Angeles site.

Key Findings and Contributions

MESA has produced influential findings on ethnic differences in subclinical atherosclerosis that have been cited alongside landmark results from Framingham Heart Study and Cardiovascular Health Study. Major contributions include characterization of coronary artery calcium distributions comparable to reference efforts from American College of Cardiology, demonstration of associations between novel biomarkers first evaluated in consortia including International HapMap Project and outcomes, and refinement of risk prediction integrating imaging with traditional risk scores used by American Heart Association and European Society of Cardiology. Results from MESA have informed guidelines and have been integrated into meta-analyses involving data from UK Biobank, Women's Health Initiative, and the Atherosclerosis Risk in Communities Study.

Imaging and Biomarker Assessments

MESA implemented advanced imaging platforms such as computed tomography scanners procured through institutional collaborations with Johns Hopkins University, magnetic resonance imaging protocols standardized across sites with expertise from University of California, Los Angeles and Wake Forest School of Medicine, and carotid ultrasound techniques harmonized with protocols from Mayo Clinic and Cleveland Clinic. Biomarker panels measured inflammatory, metabolic, and genetic markers with assays developed in laboratories at Broad Institute, Stanford University, and Yale University; genetic analyses have linked MESA data to reference panels used in studies at Wellcome Trust Sanger Institute and the International HapMap Project.

Data Access, Collaborations, and Ongoing Research

MESA maintains a data sharing and ancillary study program coordinated through the National Heart, Lung, and Blood Institute and in collaboration with academic partners including Johns Hopkins University, Columbia University, University of California, San Francisco, and University of Minnesota. Ongoing research leverages linkages to administrative databases such as the Social Security Administration and to consortia including CHARGE Consortium and TOPMed Program; investigators from institutions like Harvard Medical School, Stanford University School of Medicine, Yale School of Medicine, University of Pennsylvania, Duke University, University of Pittsburgh, Vanderbilt University Medical Center, University of California, San Diego, Emory University, University of Iowa, Oregon Health & Science University, University of Colorado, Brown University, Indiana University School of Medicine, University of Wisconsin–Madison, Rutgers University, Penn State College of Medicine, Icahn School of Medicine at Mount Sinai, University of Florida, University of Alabama at Birmingham, University of Cincinnati, Michigan State University, Boston University, University of Rochester, Saint Louis University, University of Kansas Medical Center, University of South Florida, Texas A&M University, University of Kentucky, University of Virginia, University of Arizona, University of New Mexico, University of Notre Dame, Rice University, CUNY Graduate School, Scripps Research, The Rockefeller University, Fred Hutchinson Cancer Research Center, Rosalind Franklin University continue to propose ancillary studies, driving cross-disciplinary investigations in epidemiology, imaging, genetics, and health disparities.

Category:Epidemiological studies