Domenico Pagano

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INTRODUCTION Inflammation contributes to cardiovascular disease and is exacerbated with increased adiposity, particularly omental adiposity; however, the role of epicardial fat is poorly understood. METHODS For these studies the expression of inflammatory markers was assessed in epicardial fat biopsies from coronary artery bypass grafting (CABG) patients(More)
INTRODUCTION Acute kidney injury (AKI) risk prediction scores are an objective and transparent means to enable cohort enrichment in clinical trials or to risk stratify patients preoperatively. Existing scores are limited in that they have been designed to predict only severe, or non-consensus AKI definitions and not less severe stages of AKI, which also(More)
OBJECTIVE To assess the effects of social deprivation on survival after cardiac surgery and to examine the influence of potentially modifiable risk factors. DESIGN Analysis of prospectively collected data. Prognostic models used to examine the additional effect of social deprivation on the end points. SETTING Birmingham and north west England. (More)
OBJECTIVES Perhexiline is thought to modulate metabolism by inhibiting mitochondrial carnitine palmitoyltransferase-1, reducing fatty acid uptake and increasing carbohydrate utilization. This study assessed whether preoperative perhexiline improves markers of myocardial protection in patients undergoing coronary artery bypass graft surgery and analysed its(More)
In the hypertrophied human heart, fatty acid metabolism is decreased and glucose utilisation is increased. We hypothesized that the sarcolemmal and mitochondrial proteins involved in these key metabolic pathways would mirror these changes, providing a mechanism to account for the modified metabolic flux measured in the human heart. Echocardiography was(More)
Perhexiline is a prophylactic anti-ischaemic agent with weak calcium antagonist effect which has been increasingly utilised in the management of refractory angina. The metabolic clearance of perhexiline is modulated by CYP2D6 metaboliser status and stereoselectivity. The current study sought to (1) determine whether the acute accumulation of perhexiline in(More)
OBJECTIVE To advance methods for the estimation of hospital performance based upon mortality ratios. DESIGN Observational study estimating trust performance in a year derived according to comparative standards from a 3-year period, accounting for patient-level case-mix and overdispersion (unexplained variability). PARTICIPANTS 23 363 630 admissions to(More)
OBJECTIVE The use of aprotinin in cardiac surgery to improve haemostasis and reduce blood loss particularly in patient groups at increased risk of bleeding is well established. Previous retrospective studies in profound hypothermic surgery have highlighted concerns that in this circumstances aprotinin may paradoxically cause increased bleeding and(More)
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