title: Dopamine agonists and ischemic complications in Parkinson's disease: a nested case-control study.
abstract: BACKGROUND
  It has been suggested that ergoline dopamine agonists can cause ischemic complications. The effect of dopamine agonists in general on the prevalence of ischemic events in patients with Parkinson's disease (PD) has not been studied.
  
  
  OBJECTIVE
  Our aim was to investigate the association between the use of dopamine agonists and hospitalization due to ischemic events in patients with PD.
  
  
  METHODS
  We performed a nested case-control study using the PHARMO Institute for Drug Outcome Research database. All patients issued at least one prescription for levodopa after the age of 55 years between 1994 and 2006 were initially identified. Cases were patients who were hospitalized for the first time after November 1997 for an ischemic event and were matched to as many as four controls. Exposure to dopamine agonists during the year preceding the index date was identified.
  
  
  RESULTS
  The study population consisted of 542 cases and 2,155 controls. The mean effect of dopamine agonist use 1 year prior to the index date on ischemic events requiring hospitalization is shown with 95% probability in the 0.95-1.49 range. Stratified results according to the type of dopamine agonist showed no risk differences between ergoline and nonergoline agonists.
  
  
  CONCLUSIONS
  This study does not support an association between dopamine agonist use and an increased risk of ischemic events requiring hospitalization.
authors.affiliation: Department of Clinical Pharmacy, Division Laboratory and Pharmacy, University Medical Center Utrecht, PO Box 85500, 3508 GA, Utrecht, The Netherlands.
authors.forename: Maurits E L
authors.initials: ME
authors.lastname: Arbouw
authors.forename: Kris L L
authors.initials: KL
authors.lastname: Movig
authors.forename: Henk-Jan
authors.initials: HJ
authors.lastname: Guchelaar
authors.forename: Cees
authors.initials: C
authors.lastname: Neef
authors.forename: Toine C G
authors.initials: TC
authors.lastname: Egberts
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000978:Antiparkinson Agents / Q000009:adverse effects* / Q000627:therapeutic use; D002545:Brain Ischemia / Q000139:chemically induced / Q000209:etiology / Q000628:therapy; D016022:Case-Control Studies; D016208:Databases, Factual; D018491:Dopamine Agonists / Q000009:adverse effects* / Q000627:therapeutic use; D011307:Drug Prescriptions; D004873:Ergolines / Q000009:adverse effects / Q000627:therapeutic use; D005260:Female; D006760:Hospitalization; D006801:Humans; D007511:Ischemia / Q000139:chemically induced* / Q000209:etiology / Q000628:therapy; D007980:Levodopa / Q000627:therapeutic use; D008297:Male; D017202:Myocardial Ischemia / Q000139:chemically induced / Q000209:etiology / Q000628:therapy; D009426:Netherlands / Q000453:epidemiology; D010300:Parkinson Disease / Q000188:drug therapy* / Q000503:physiopathology; D010818:Practice Patterns, Physicians'; D015995:Prevalence; D011928:Raynaud Disease / Q000139:chemically induced / Q000209:etiology / Q000628:therapy; D012720:Severity of Illness Index
chemical_list: D000978:Antiparkinson Agents; D018491:Dopamine Agonists; D004873:Ergolines; D007980:Levodopa