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Coronary Artery Disease: HELP
Articles by Tibor Schuster
Based on 6 articles published since 2008

Between 2008 and 2019, Tibor Schuster wrote the following 6 articles about Coronary Artery Disease.
+ Citations + Abstracts
1 Article Biodegradable polymer drug-eluting stents: caveat emptor. 2017

Byrne, Robert A / Schuster, Tibor. ·Deutsches Herzzentrum München, Technische Universität München, D-80636 Munich, Germany; DZHK (German Centre for Cardiovascular Research), partner site Munich Heart Alliance, Munich, Germany. Electronic address: byrne@dhm.mhn.de. · Department of Family Medicine, McGill University, Montreal, QC, Canada. ·Lancet · Pubmed #29082870.

ABSTRACT: -- No abstract --

2 Article Tissue characterization after drug-eluting stent implantation using optical coherence tomography. 2013

Malle, Caroline / Tada, Tomohisa / Steigerwald, Kristin / Ughi, Giovanni J / Schuster, Tibor / Nakano, Masataka / Massberg, Steffen / Jehle, Johannes / Guagliumi, Giulio / Kastrati, Adnan / Virmani, Renu / Byrne, Robert A / Joner, Michael. ·Deutsches Herzzentrum and 1. Medizinische Klinik, Klinikum rechts der Isar, Technische Universität, Munich, Germany. ·Arterioscler Thromb Vasc Biol · Pubmed #23539216.

ABSTRACT: OBJECTIVE: To validate optical coherence tomography (OCT) imaging for assessment of vascular healing in a preclinical animal model and human autopsy cases and to translate the findings to the assessment of vascular healing after drug-eluting stent implantation in clinical practice. APPROACH AND RESULTS: Drug-eluting and bare metal stents were imaged 28 and 42 days after implantation in atherosclerotic rabbits using OCT and simultaneously evaluated by histology. After coregistration with histology, gray-scale signal intensity (GSI) was measured for identified mature or immature neointimal tissue. Autopsy specimens were imaged with OCT and GSI values correlated with histology. Finally, prospective OCT imaging and GSI measurements were acquired in 10 patients undergoing follow-up 6 months after stenting with drug-eluting stents. Histopathologic and OCT morphometric analysis of implanted stents showed excellent correlation. Neointimal growth and vessel healing at 28 days in the animal model best correlated with human stented arteries at 6 months. In animal and human autopsy specimens, mature neointimal tissue consistently showed higher GSI values. Receiver operating characteristic curve analysis displayed high sensitivity and specificity for detection of mature neointima in animal (96% and 79%, respectively) and human autopsy (89% and 71%, respectively) data. In patients undergoing OCT follow-up 6 months after drug-eluting stent implantation, prospective GSI analysis revealed that a minimum of 27.7% of areas above stent struts represented mature neointima. CONCLUSIONS: Novel GSI analysis of OCT imaging data allows distinction between mature and immature neointimal tissue in animal models, autopsy specimens, and patients undergoing invasive surveillance in simple atherosclerotic lesions.

3 Article Validation of the Bleeding Academic Research Consortium definition of bleeding in patients with coronary artery disease undergoing percutaneous coronary intervention. 2012

Ndrepepa, Gjin / Schuster, Tibor / Hadamitzky, Martin / Byrne, Robert A / Mehilli, Julinda / Neumann, Franz-Josef / Richardt, Gert / Schulz, Stefanie / Laugwitz, Karl-Ludwig / Massberg, Steffen / Schömig, Albert / Kastrati, Adnan. ·Deutsches Herzzentrum, Lazarettstrasse 36, Munich, Germany. ·Circulation · Pubmed #22344040.

ABSTRACT: BACKGROUND: The Bleeding Academic Research Consortium (BARC) has recently proposed a unified definition of bleeding in patients receiving antithrombotic therapy. We investigated the relationship between bleeding events as defined by BARC and 1-year mortality in patients undergoing percutaneous coronary intervention (PCI) and assessed whether the BARC bleeding definition is superior to existing bleeding definitions in regard to mortality prediction in patients after PCI procedures. METHODS AND RESULTS: This study represents a patient-level pooled analysis of 12 459 patients recruited in 6 randomized trials of patients undergoing PCI. Bleeding events were assessed with the use of BARC, Thrombolysis in Myocardial Infarction (TIMI), and Randomized Evaluation in PCI Linking Angiomax to Reduced Clinical Events (REPLACE-2) trial criteria. The primary outcome was 1-year mortality. Bleeding occurred in 1233 patients (9.9%) according to BARC (679 patients or 5.4% with BARC class ≥2 bleeding), in 374 patients (3.0%) according to TIMI, and in 491 patients (3.9%) according to REPLACE-2 criteria. There were 340 deaths (2.7%) over the first year after PCI. BARC class ≥2 bleeding was associated with a significant increase in 1-year mortality (adjusted hazard ratio 2.72; 95% confidence interval, 2.03-3.63). The predictivity of a multivariable model for 1-year mortality was significantly improved after inclusion of bleeding defined according to BARC to an extent comparable to that provided by TIMI and REPLACE-2 criteria. CONCLUSIONS: The present study demonstrated a close association between bleeding events defined according to BARC and 1-year mortality after PCI.

4 Article Association of midregional proadrenomedullin with coronary artery stenoses, soft atherosclerotic plaques and coronary artery calcium. 2012

Roos, Marcel / Schuster, Tibor / Ndrepepa, Gjin / Baumann, Marcus / Lutz, Jens / Braun, Siegmund / Martinof, Stefan / Schömig, Albert / Heemann, Uwe / Kastrati, Adnan / Hausleiter, Jörg. ·Abteilung für Nephrologie, Klinikum rechts der Isar, Ismaninger Str. 22, 81675 Munich, Germany. marphiro@hotmail.com ·Heart Vessels · Pubmed #21725669.

ABSTRACT: Midregional proadrenomedullin (MR-proADM) is elevated in patients with heart failure and myocardial infarction. The aim of this study was to evaluate the association of MR-proADM with the grade of coronary artery stenosis, presence of coronary artery soft plaques and coronary artery calcification score (CACS), determined by 64-multislice computed tomography (MSCT) in patients without known prior cardiovascular disease. This retrospective study included 107 patients undergoing MSCT for confirmation (or exclusion) of coronary artery disease. MR-proADM levels were measured in all patients. The assessment of coronary artery stenoses, CACS and soft coronary plaques was made by MSCT using known criteria. The MR-proADM [median (25th-75th percentiles)] level was 0.33 (0.21-0.43) nmol/l. The MR-proADM level was 0.28 (0.22-0.40) nmol/l in patients with coronary stenoses ≥50% (n = 23) versus 0.33 (0.27-0.40) nmol/l in patients with coronary stenoses <50% (n = 83, P = 0.59), 0.33 (0.26-0.40) nmol/l in patients with soft plaques (n = 56) versus 0.33 (0.25-0.41) nmol/l in patients without soft plaques (n = 50, P = 0.73) and 0.33 (0.25-0.39) nmol/l in patients with CACS <200 (n = 81) versus 0.32 (0.26-0.44) nmol/l in patients with CACS ≥200 (n = 26, P = 0.77). In multivariate analysis, the MR-proADM level was a significant correlate of coronary artery stenoses [odds ratio (OR) = 0.93; 95% confidence interval (CI) 0.86-0.99; P = 0.026] and soft plaques (OR = 0.94; 95% CI 0.90-0.99; P = 0.015) but not of CACS (OR = 0.98; 95% CI 0.93-1.03; P = 0.36). A decreased MR-proADM level is an independent correlate of the presence of coronary artery disease and of soft atherosclerotic plaques. Patients with decreased MR-proADM levels may need invasive examinations to diagnose more severe forms of coronary artery disease.

5 Article Cytochrome 2C19*17 allelic variant, platelet aggregation, bleeding events, and stent thrombosis in clopidogrel-treated patients with coronary stent placement. 2010

Sibbing, Dirk / Koch, Werner / Gebhard, Daniela / Schuster, Tibor / Braun, Siegmund / Stegherr, Julia / Morath, Tanja / Schömig, Albert / von Beckerath, Nicolas / Kastrati, Adnan. ·Deutsches Herzzentrum München, Lazarettstrasse 36, 80636 München, Germany. dirk@sibbing.net ·Circulation · Pubmed #20083681.

ABSTRACT: BACKGROUND: The cytochrome P450 (CYP) 2C19 isoenzyme plays an important role in clopidogrel metabolization. A recently explored CYP2C19*17 allelic variant has been linked to increased transcriptional activity, resulting in extensive metabolization of CYP2C19 substrates, which may lead to an enhanced platelet response to clopidogrel treatment. The aim of this study was to assess the impact of CYP2C19*17 on ADP-induced platelet aggregation, the risk of bleeding, and stent thrombosis in clopidogrel-treated patients undergoing percutaneous coronary intervention. METHODS AND RESULTS: The study population included 1524 patients undergoing percutaneous coronary intervention after pretreatment with 600 mg clopidogrel. Genotypes were determined with a TaqMan assay. ADP-induced platelet aggregation was assessed on a Multiplate analyzer. The primary clinical safety end point was the 30-day incidence of bleeding defined according to Thrombolysis in Myocardial Infarction criteria, and the primary clinical efficacy end point was the 30-day incidence of stent thrombosis. For both heterozygous (*wt/*17; n=546) and homozygous (*17/*17; n=76) allele carriers, significantly lower ADP-induced platelet aggregation values were found compared with wild-type homozygotes (*wt/*wt; n=902; P=0.039 and P=0.008, respectively). CYP2C19*17 allele carriage was significantly associated with an increased risk of bleeding; the highest risk was observed for CYP2C19*17 homozygous patients (P=0.01, chi(2) test for trend). Multivariate analysis confirmed the independent association of CYP2C19*17 allele carriage with platelet aggregation values (P<0.001) and the occurrence of bleeding (P=0.006). No significant influence of CYP2C19*17 on the occurrence of stent thrombosis was found (P=0.79). CONCLUSIONS: CYP2C19*17 carrier status is significantly associated with enhanced response to clopidogrel and an increased risk of bleeding.

6 Article Comparison of immunoassays for the selective measurement of human high-molecular weight adiponectin. 2009

Liu, Dan / Schuster, Tibor / Baumann, Marcus / Roos, Marcel / Sollinger, Daniel / Lutz, Jens / Heemann, Uwe / von Eynatten, Maximilian. ·Department of Nephrology, Technische Universitaet Muenchen, Munich, Germany. ·Clin Chem · Pubmed #19168560.

ABSTRACT: BACKGROUND: Adiponectin is an adipocyte-derived hormone circulating in different multimer complexes. The high-molecular-weight (HMW) complex is likely the active form of this protein and has been recognized as a risk marker for type 2 diabetes and coronary artery disease (CAD). Because quantification of HMW adiponectin by Western blot analysis is time-consuming, novel ELISAs have been developed to simplify measurements in clinical research. However, these enzyme immunoassays have not been cross-validated in larger patient groups. We evaluated 2 individual ELISA systems by comparison to Western blotting for measurement of the distribution of HMW adiponectin in healthy individuals and patients with CAD and type 2 diabetes. METHODS: We measured HMW adiponectin in 204 individuals (83 CAD patients, 81 type 2 diabetes patients, and 40 healthy controls). Correlations, range of agreement, and imprecision of HMW concentrations obtained using 2 commercial ELISAs (#1, ALPCO Diagnostics; #2, Millipore) were evaluated by comparison with quantitative Western blotting. RESULT: Adiponectin results of the ELISAs were significantly correlated with those obtained by Western blotting (both r > 0.75, P < 0.001). Deming regression and Bland-Altman analyses indicated high agreement among the 3 immunoassays. The median difference between HMW adiponectin concentrations measured by ELISA and by Western blot was +0.4 mg/L for ELISA #1 and -0.4 mg/L for ELISA #2 with 95% of value differences <3 mg/L. CONCLUSIONS: Selective measurement of HMW adiponectin by ELISA is feasible; however, individual differences among immunoassays must be considered. The evaluated ELISAs exhibit analytical characteristics that allow their use as equivalent for Western blot analysis in larger clinical and epidemiological groups.