Heart valve regurgitation, pergolide use, and parkinson disease: an observational study and meta-analysis.
OBJECTIVE
To investigate the prevalence and risk factors of heart valve disease in patients having PD treated with pergolide.


METHODS
Prospective observational study.


METHODS
Patients were recruited at the Hôpital de la Pitié-Salpêtrière, Paris, France. Patients Ninety-six patients having PD treated with pergolide for longer than 3 months vs 50 control subjects. Intervention Standardized echocardiography performed by an investigator blinded to treatment status. Main Outcome Measure Moderate to severe regurgitation in at least 1 heart valve.


RESULTS
One hundred thirty-three echocardiograms (86 in the pergolide-treated group and 47 in the control group) were analyzed in the study. Moderate to severe regurgitation was found in 15 patients treated with pergolide (17.4%) and in 2 control subjects (4.3%) (odds ratio [OR], 4.75; 95% confidence interval [CI], 1.02-22.1; P = .03). Moderate to severe regurgitation was associated with the cumulative dose of pergolide (OR, 1.37; 95% CI, 1.04-1.81 per 10-mg/kg increase; P =.03). Including the present study, the meta-analysis comprised 7 trials (394 patients treated with pergolide and 280 controls). The overall OR for moderate to severe regurgitation was 3.1 (95% CI, 1.7-5.6; P < .001) in the pergolide-treated group. Risk differences were correlated with the mean cumulative dose of pergolide (r = 0.90, P < .001).


METHODS
Using an end point of moderate to severe heart valve regurgitation, we performed a meta-analysis of patients having Parkinson disease (PD) treated with pergolide mesylate vs control subjects by searching PubMed (January 1, 1966, to April 1, 2007) and the Cochrane databases to identify English-language prospective observational studies that reported echocardiographic data.


CONCLUSIONS
Heart valve disease is independently associated with the use of pergolide treatment in patients having PD and correlates with its cumulative dose. Trial Registration clinicaltrials.gov Identifier: NCT00202657.
Corvol
Jean-Christophe
JC
Service de Pharmacologie, Hôpital de la Pitié-Salpêtrière, 45/83 Boulevard de l'Hôpital, 75651, Paris Cedex 13, France. jean-christophe.corvol@psl.aphp.fr
Anzouan-Kacou
Jean-Baptiste
JB
Fauveau
Elodie
E
Bonnet
Anne-Marie
AM
Lebrun-Vignes
Bénédicte
B
Girault
Camille
C
Agid
Yves
Y
Lechat
Philippe
P
Isnard
Richard
R
Lacomblez
Lucette
L
D000978:Antiparkinson Agents / Q000009:adverse effects* / Q000627:therapeutic use; D001022:Aortic Valve Insufficiency / Q000139:chemically induced / Q000453:epidemiology; D004305:Dose-Response Relationship, Drug; D004452:Echocardiography; D005260:Female; D006349:Heart Valve Diseases / Q000139:chemically induced* / Q000453:epidemiology; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D008944:Mitral Valve Insufficiency / Q000139:chemically induced / Q000453:epidemiology; D016017:Odds Ratio; D010300:Parkinson Disease / Q000150:complications* / Q000188:drug therapy; D010479:Pergolide / Q000009:adverse effects* / Q000627:therapeutic use; D011446:Prospective Studies; D012307:Risk Factors; D014262:Tricuspid Valve Insufficiency / Q000139:chemically induced / Q000453:epidemiology
D000978:Antiparkinson Agents; D010479:Pergolide