Coronary Calcium as a Predictor of Coronary Events in Four Racial or Ethnic Groups (MESA)

This is one of the defining studies of coronary calcium scoring — the MESA analysis that proved the test predicts heart attacks across racial and ethnic lines, not just in the white populations where it was first validated.

Following 6,722 participants from four backgrounds (white, Black, Hispanic, and Chinese American), the investigators found that higher calcium scores strongly predicted coronary events in every group, with each doubling of the score raising the risk of a major event by 15 to 35 percent. The calcium score added predictive power beyond the standard risk factors uniformly.

The breadth of the finding is its importance. By demonstrating that calcium scoring works across diverse populations, MESA helped establish it as a broadly applicable tool for refining risk — confirming disease where the standard calculators are uncertain.

We rate the evidence strong. A large, diverse, well-conducted prospective cohort published in a top journal, it is a cornerstone of the evidence base for coronary calcium scoring.