Progression of Early Subclinical Atherosclerosis (PESA) Study
Key result
Serial noninvasive imaging in the PESA cohort tracks early subclinical atherosclerosis progression in asymptomatic adults.
- n=4,184
Why the study?
Atherosclerosis starts early and progresses silently, motivating the noninvasive detection of systemic subclinical disease across multiple vascular beds before symptoms appear.
Study Design
Type
Cohort (n=4,184)
Structured PICO
P
Population
4,184 asymptomatic middle-aged participants
O
Outcome
Presence and progression of early subclinical atherosclerosissurrogate
The PESA study is an ongoing prospective cohort tracking the progression of subclinical atherosclerosis in asymptomatic middle-aged individuals using noninvasive multiterritorial imaging.
Key expert perspectives
Captured external expert commentary on this paper, strongest first. Original sources are linked where available.
VFValentín FusterDirector, Mount Sinai Fuster Heart Hospital
“The long asymptomatic phase of the disease presents a window of opportunity that has not been exploited in the younger population.”
“This study is the first to analyze the progression of atherosclerosis at frequent intervals. The previous view was that the disease progressed very slowly throughout life. However, the new results show that the disease progressed very rapidly in 40% of the individuals analyzed. Future data from the PESA study will show whether this progression is associated with subsequent cardiovascular events. Until now, the speed of atherosclerosis progression has not been a factor in assessing individual risk.”
VFValentín FusterDirector, Mount Sinai Fuster Heart Hospital
“Today for the first time, we present, with very advanced imaging technology, how atherosclerotic disease develops in people.”
Implication
Offers window for early prevention in asymptomatic middle-aged adults; leaves open optimal serial imaging intervals and outcome impact.
Abstract
Atherosclerosis starts early in life and progresses silently for decades. Considering atherosclerosis as a "systemic disease" invites the use of noninvasive methodologies to detect disease in various regions before symptoms appear. The PESA-(Progression of Early Subclinical Atherosclerosis) CNIC-SANTANDER study is an ongoing prospective cohort study examining imaging, biological, and behavioral parameters associated with the presence and progression of early subclinical atherosclerosis. Between 2010 and 2014, PESA enrolled 4,184 asymptomatic middle-aged participants who undergo serial 3-yearly follow-up examinations including clinical interviews, lifestyle questionnaires, sampling, and noninvasive imaging assessment of multiterritorial subclinical atherosclerosis (carotids, iliofemorals, aorta, and coronaries). PESA tracks the trajectories of atherosclerosis and associated disorders from early stages to the transition to symptomatic phases. A joint venture between the CNIC and the Santander Bank, PESA is expected to run until at least 2029, and its significant contributions to date are presented in this review paper.
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Cite This Study
Ibáñez et al. (2021) conducted a cohort in Early subclinical atherosclerosis (n=4,184). Noninvasive imaging assessment and clinical follow-up was evaluated on Presence and progression of early subclinical atherosclerosis. Serial noninvasive imaging and clinical follow-up in the PESA prospective cohort study will track the progression of early subclinical atherosclerosis in 4,184 asymptomatic middle-aged participants.