Excerpt

Over the past two decades, the concept of the “vulnerable plaque” has gained attention as a paradigm to improve risk stratification and potentially lead to newer invasive and non-invasive therapeutic options to prevent and treat atherothrombotic cardiovascular disease. The Effective Health Care Program at the Agency for Healthcare Research & Quality requested a technical brief on the diagnosis and treatment of “vulnerable plaques” of coronary and carotid arteries. Our report is based on a set of key questions designed to explore the concept of “vulnerable plaque” and how this concept could affect the use of existing or developing diagnostic and therapeutic technologies. This report also expands on a technical report on vulnerable plaque that we conducted in 2004.

Contents

• Preface
• Introduction
• Methods
  • Literature Search Strategy
  • Study Eligibility Criteria
  • Data Collection
• Results
  • Findings from Systematic Literature Overview
  • Answers to Key Questions (KQ)
• Discussion
• References
• List of Acronyms/Abbreviations

Prepared for: Agency for Healthcare Research and Quality, U.S. Department of Health and Human Services.¹ Contract No. 290-02-0022. Prepared by: Tufts Medical Center Evidence-based Practice Center.

Suggested citation:

Alsheikh-Ali A, Kitsios GD, Balk E, Mahoney A, Lau J, Ip S. Vulnerable Atherosclerotic Plaque. Technical Brief No. 3 (Prepared by Tufts Evidence-based Practice Center under Contract No. HHSA-290-02-0022-EPC II.) AHRQ Publication No. 10-EHC062-EF. Rockville, MD: Agency for Healthcare Research and Quality. August 2010. Available at: www.effectivehealthcare.ahrq.gov/reports/final.cfm.

This report is based on research conducted by the Tufts Evidence-based Practice Center (EPC) under contract to the Agency for Healthcare Research and Quality (AHRQ), Rockville, MD (Contract No. 290-02-0022). The findings and conclusions in this document are those of the author(s), who are responsible for its contents; the findings and conclusions do not necessarily represent the views of AHRQ. Therefore, no statement in this report should be construed as an official position of AHRQ or of the U.S. Department of Health and Human Services.

The information in this report is intended to help health care decisionmakers—patients and clinicians, health system leaders, and policymakers, among others—make well-informed decisions and thereby improve the quality of health care services. This report is not intended to be a substitute for the application of clinical judgment. Anyone who makes decisions concerning the provision of clinical care should consider this report in the same way as any medical reference and in conjunction with all other pertinent information, i.e., in the context of available resources and circumstances presented by individual patients.

This report may be used, in whole or in part, as the basis for development of clinical practice guidelines and other quality enhancement tools, or as a basis for reimbursement and coverage policies. AHRQ or U.S. Department of Health and Human Services endorsement of such derivative products may not be stated or implied.

No investigators have any affiliations or financial involvement (e.g., employment, consultancies, honoraria, stock options, expert testimony, grants or patents received or pending, or royalties) that conflict with material presented in this report.

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