title: The Progression and Early detection of Subclinical Atherosclerosis (PESA) study: rationale and design.
abstract: BACKGROUND
  The presence of subclinical atherosclerosis is a likely predictor of cardiovascular events; however, factors associated with the early stages and progression of atherosclerosis are poorly defined.
  
  
  OBJECTIVE
  The PESA study examines the presence of subclinical atherosclerosis by means of noninvasive imaging and prospectively analyzes the determinants associated with its development and progression in a middle-aged population.
  
  
  METHODS
  The PESA study is an observational, longitudinal and prospective cohort study in a target population of 4000 healthy subjects (40-54 years old, 35% women) based in Madrid (Spain). Recruitment began in June 2010 and will be completed by the end of 2013. Baseline examination consists of (1) assessment for cardiovascular risk factors (including lifestyle and psychosocial factors); (2) screening for subclinical atherosclerosis using 2D/3D ultrasound in carotid, abdominal aorta and iliofemoral arteries, and coronary artery calcium score (CACS) by computed tomography; and (3) blood sampling for determination of traditional risk factors, advanced "omics" and biobanking. In addition, a subgroup of 1300 participants with evidence of atherosclerosis on 2D/3D ultrasound or CACS will undergo a combined (18)F-fluorodeoxyglucose-positron emission tomography/magnetic resonance imaging ((18)FDG PET/MRI) study of carotid and iliofemoral arteries. Follow-up at 3 and 6 years will include a repetition of baseline measurements, except for the (18)FDG PET/MRI study, which will be repeated at 6 years.
  
  
  CONCLUSIONS
  The PESA study is expected to identify new imaging and biological factors associated with the presence and progression of atherosclerosis in asymptomatic people and will help to establish a more personalized management of medical care.
authors.affiliation: Centro Nacional de Investigaciones Cardiovasculares Carlos III (CNIC), Madrid, Spain; Hospital Clínico San Carlos, Madrid, Spain.
authors.forename: Antonio
authors.initials: A
authors.lastname: Fernández-Ortiz
authors.forename: L Jesús
authors.initials: LJ
authors.lastname: Jiménez-Borreguero
authors.forename: José L
authors.initials: JL
authors.lastname: Peñalvo
authors.forename: José M
authors.initials: JM
authors.lastname: Ordovás
authors.forename: Agustín
authors.initials: A
authors.lastname: Mocoroa
authors.forename: Leticia
authors.initials: L
authors.lastname: Fernández-Friera
authors.forename: Martín
authors.initials: M
authors.lastname: Laclaustra
authors.forename: Laura
authors.initials: L
authors.lastname: García
authors.forename: Jesús
authors.initials: J
authors.lastname: Molina
authors.forename: José M
authors.initials: JM
authors.lastname: Mendiguren
authors.forename: Beatriz
authors.initials: B
authors.lastname: López-Melgar
authors.forename: Vicente Martínez
authors.initials: VM
authors.lastname: de Vega
authors.forename: Juan C
authors.initials: JC
authors.lastname: Alonso-Farto
authors.forename: Eliseo
authors.initials: E
authors.lastname: Guallar
authors.forename: Henrik
authors.initials: H
authors.lastname: Sillesen
authors.forename: James H F
authors.initials: JH
authors.lastname: Rudd
authors.forename: Zahi A
authors.initials: ZA
authors.lastname: Fayad
authors.forename: Borja
authors.initials: B
authors.lastname: Ibañez
authors.forename: Ginés
authors.initials: G
authors.lastname: Sanz
authors.forename: Valentín
authors.initials: V
authors.lastname: Fuster
mesh_terms: D000328:Adult; D001012:Aorta, Abdominal / Q000000981:diagnostic imaging; D001158:Arteries / Q000000981:diagnostic imaging; D058070:Asymptomatic Diseases; D050197:Atherosclerosis / Q000175:diagnosis*; D002339:Carotid Arteries / Q000000981:diagnostic imaging; D015331:Cohort Studies; D018450:Disease Progression; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D008137:Longitudinal Studies; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D049268:Positron-Emission Tomography; D011446:Prospective Studies; D019275:Radiopharmaceuticals; D018570:Risk Assessment; D013030:Spain; D014057:Tomography, X-Ray Computed; D014463:Ultrasonography; D061205:Vascular Calcification / Q000000981:diagnostic imaging
chemical_list: D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18