MESA CHD Risk (with CAC)
MESA 10-Year CHD Risk Score with Coronary Artery Calcium
#4
coverage rank
United States (multi-ethnic)201510-yearCoronary heart disease (MI, CHD death, resuscitated arrest, revascularization)12 inputs
Adults 45-85, 4 race/ethnic groups, no known CVD (MESA)
10
atlas factors covered
8
strongly-evidenced (A/B)
7
of 15 categories
Strengths
- Adds coronary artery calcium to traditional factors, substantially improving discrimination and reclassification
- Multi-ethnic derivation (White, Black, Hispanic, Chinese); includes family history of MI
- Directly quantifies subclinical atherosclerosis rather than inferring it
Weaknesses
- Requires a CT calcium scan (cost, radiation, access)
- Predicts CHD rather than global CVD/stroke in the primary model
- No renal, inflammatory, or lipid-subfraction inputs; medication flags used
Input variables (12)
| Input | Maps to atlas factor | Category | Grade | Note |
|---|---|---|---|---|
| Age | Age | Demographic & Social | A | |
| Sex | Sex | Demographic & Social | C | |
| Race/ethnicity | Race/ethnicity | Demographic & Social | A | |
| Total cholesterol | Total cholesterol | Lipids & Lipoproteins | A | |
| HDL cholesterol | HDL cholesterol | Lipids & Lipoproteins | A | |
| Lipid-lowering medication | — derived / not in atlas | — | — | treatment/medication-use variable; not a factor in atlas |
| Systolic blood pressure | Systolic blood pressure | Blood Pressure & Hemodynamics | A | |
| Antihypertensive medication | — derived / not in atlas | — | — | treatment/medication-use variable; not a factor in atlas |
| Current smoking | Cigarette smoking | Lifestyle & Behavioral | A | |
| Diabetes mellitus | Type 2 diabetes mellitus | Glycemic & Metabolic | A | |
| Family history of heart attack | Family history of myocardial infarction | Genetic & Family History | D | |
| Coronary artery calcium (Agatston) | Coronary artery calcium score | Imaging & Subclinical Disease | A |
References
- 10-Year Coronary Heart Disease Risk Prediction Using Coronary Artery Calcium and Traditional Risk Factors (MESA) — J Am Coll Cardiol 2015 · PMID 26449133