title: High risk factors for valvular heart disease from dopamine agonists in patients with Parkinson's disease.
abstract: An association between ergot-derived dopamine agonists and asymptomatic valvular heart disease in Parkinson's disease has been established. For safe use of these agonists, it is important to specify those at high risk for valvular heart disease among patients with Parkinson's disease. We performed a nested case-control study of 223 patients with Parkinson's disease. In results of multivariable logistic analyses, use of pergolide, use of cabergoline, age, male sex, and hypertension were independent significant risk factors for left-sided valvular regurgitation. In patients receiving cabergoline or pergolide, elderly (>or=70 years) hypertensive patients had a markedly high risk for valvular regurgitation (odds ratio 94.5) as compared to non-elderly (<70 years) patients without hypertension. The risk of valvular regurgitation caused by pergolide or cabergoline was found to be highly enhanced by comorbid hypertension or aging, suggesting that special attention should be paid when prescribing cabergoline or pergolide for those patients.
authors.affiliation: Clinical Research Center, Utano National Hospital, Kyoto, Japan.
authors.forename: Tomoko
authors.initials: T
authors.lastname: Oeda
authors.forename: Motoko
authors.initials: M
authors.lastname: Masaki
authors.forename: Kenji
authors.initials: K
authors.lastname: Yamamoto
authors.forename: Eiji
authors.initials: E
authors.lastname: Mizuta
authors.forename: Naoyuki
authors.initials: N
authors.lastname: Kitagawa
authors.forename: Tsuyoshi
authors.initials: T
authors.lastname: Isono
authors.forename: Satoshi
authors.initials: S
authors.lastname: Taniguchi
authors.forename: Kiyoshi
authors.initials: K
authors.lastname: Doi
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Yaku
authors.forename: Chikao
authors.initials: C
authors.lastname: Yutani
authors.forename: Takashi
authors.initials: T
authors.lastname: Kawamura
authors.forename: Sadako
authors.initials: S
authors.lastname: Kuno
authors.forename: Hideyuki
authors.initials: H
authors.lastname: Sawada
mesh_terms: D000367:Age Factors; D000368:Aged; D052160:Benzothiazoles / Q000627:therapeutic use; D001971:Bromocriptine / Q000627:therapeutic use; D000077465:Cabergoline; D016022:Case-Control Studies; D018491:Dopamine Agonists / Q000009:adverse effects*; D004452:Echocardiography; D004873:Ergolines / Q000009:adverse effects*; D005260:Female; D006349:Heart Valve Diseases / Q000139:chemically induced*; D006801:Humans; D006973:Hypertension / Q000150:complications; D008297:Male; D010300:Parkinson Disease / Q000188:drug therapy*; D010479:Pergolide / Q000009:adverse effects*; D000077487:Pramipexole; D012307:Risk Factors
chemical_list: D052160:Benzothiazoles; D018491:Dopamine Agonists; D004873:Ergolines; D010479:Pergolide; D001971:Bromocriptine; D000077487:Pramipexole; D000077465:Cabergoline