# Contemporary Classification of Myocardial Injury Events in MESA: Defining Distinct Risk Factor Associations with Myocardial Infarction Type 1-5 and Acute Non-Ischemic Myocardial Injury

> **NIH NIH R01** · VANDERBILT UNIVERSITY MEDICAL CENTER · 2022 · $896,650

## Abstract

PROJECT SUMMARY/ABSTRACT
Despite marked declines, atherosclerotic cardiovascular disease (ASCVD) is the leading cause of death
worldwide. Fatal or non-fatal acute myocardial infarction (MI) remains the initial presentation in at least half of
these patients. In recent years, reflective of the greater understanding of the many diverse causes of myocardial
injury, international consensus definition now includes non-ischemic causes of myocardial injury and several
etiologically distinct subtypes of myocardial injury, including subtypes of MI. However, the basic epidemiology of
MI subtypes and non-ischemic myocardial injury and how risk factors differ between these categories is
conspicuously lacking and critically needed. A fundamental understanding of the epidemiology of myocardial
injury events, including differential relationship of traditional and nontraditional risk factors to the different MI
subtypes, is needed to advance the prediction, prevention, and treatment of these leading causes of death.
The Multi-Ethnic Study of Atherosclerosis (MESA) is a gender balanced contemporary NHLBI cardiovascular
cohort with extensive baseline participant phenotyping and event surveillance. In this proposal, we aim to
systematically re-adjudicate more than 18,000 clinical events collected in MESA over 14 years. We have
developed innovative tools to enhance accuracy and efficiency of the adjudication process. We will use this data
to ascertain the incidence of specific acute MI subtypes. We will delineate the size and strength of association
between baseline traditional and novel cardiovascular risk factors with individual acute MI subtypes and acute
non-ischemic myocardial injury. In addition to analyzing the impact of individual risk factors on specific
myocardial injury subtypes, we will utilize factor analyses to leverage information gained from how multiple risk
factors within a domain (e.g., thrombogenicity, atherosclerosis and myocardial damage) interact with each other
to impact specific myocardial injury subtype.
Successful completion of the proposed study will define the type and frequency of acute MI events in a cohort
representative of the US target prevention population. By first characterizing and quantifying the risk factor
profile, we expect the findings of this project to enable development of more specific individual patient risk
prediction and effective tailoring of prevention efforts (precision medicine). Such knowledge will result in the
evaluation of more judicious application of current therapies—e.g., limiting aggressive anti-thrombotic therapy
for those at greatest risk for Type 1 versus Type 2 MI to maximize benefit and limit risk while more efficiently
utilizing healthcare resources. Furthermore, identification of new risk factors will support exploration of novel
therapeutic avenues that specifically target individual myocardial injury subtypes.

## Key facts

- **NIH application ID:** 10471434
- **Project number:** 5R01HL158976-02
- **Recipient organization:** VANDERBILT UNIVERSITY MEDICAL CENTER
- **Principal Investigator:** Andrew DeFilippis
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2022
- **Award amount:** $896,650
- **Award type:** 5
- **Project period:** 2021-08-20 → 2026-07-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10471434

## Citation

> US National Institutes of Health, RePORTER application 10471434, Contemporary Classification of Myocardial Injury Events in MESA: Defining Distinct Risk Factor Associations with Myocardial Infarction Type 1-5 and Acute Non-Ischemic Myocardial Injury (5R01HL158976-02). Retrieved via AI Analytics 2026-05-28 from https://api.ai-analytics.org/grant/nih/10471434. Licensed CC0.

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