title: The risk of new onset heart failure associated with dopamine agonist use in Parkinson's disease.
abstract: The aim of present study was to investigate the risk of heart failure associated with dopamine agonist use in patients with Parkinson's disease. The data sources of this study were four different population-based, healthcare databases in United Kingdom, Italy and Netherlands. A case control study nested within a cohort of Parkinson's disease patients who were new users of either dopamine agonist or levodopa was conducted. Incident cases of heart failure were identified and validated, using Framingham criteria. Controls were matched to cases on age, gender and database. To estimate the risk of newly diagnosed heart failure with ergot and non-ergot derived dopamine agonists, as compared to levodopa, odds ratios and 95% confidence intervals were calculated through conditional logistic regression. In the cohort of 25,459 Parkinson's disease patients (11,151 new users of dopamine agonists, 14,308 new users of levodopa), 518 incident heart failure cases were identified during follow-up. Compared to levodopa, no increased risk of heart failure was found for ergot dopamine agonists (odds ratio: 1.03; 95% confidence interval: 0.69-1.55). Among non-ergot dopamine agonists, only pramipexole was associated with an increased risk of heart failure (odds ratio: 1.61; 95%confidence interval: 1.09-2.38), especially in the first three months of therapy (odds ratio: 3.06; 95% confidence interval: 1.74-5.39) and in patients aged 80 years and older (odds ratio: 3.30; 95% confidence interval: 1.62-7.13). The results of this study indicate that ergot dopamine agonist use in Parkinson's disease patients was not associated with an increased risk of newly diagnosed heart failure. Among non-ergot dopamine agonists, we observed a statistically significant association between pramipexole use and heart failure, especially during the first months of therapy and in very old patients.
authors: Department of Medical Informatics, Erasmus University Medical Center, Rotterdam, Netherlands.
authors: M Mostafa
authors: MM
authors: Mokhles
authors: Gianluca
authors: G
authors: Trifirò
authors: Jeanne P
authors: JP
authors: Dieleman
authors: Mendel D
authors: MD
authors: Haag
authors: Eva M
authors: EM
authors: van Soest
authors: Katia M C
authors: KM
authors: Verhamme
authors: Giampiero
authors: G
authors: Mazzaglia
authors: Ron
authors: R
authors: Herings
authors: Cynthia de
authors: Cd
authors: Luise
authors: Douglas
authors: D
authors: Ross
authors: Guy
authors: G
authors: Brusselle
authors: Annamaria
authors: A
authors: Colao
authors: Willem
authors: W
authors: Haverkamp
authors: Rene
authors: R
authors: Schade
authors: Guy van
authors: Gv
authors: Camp
authors: Renzo
authors: R
authors: Zanettini
authors: Miriam C J M
authors: MC
authors: Sturkenboom
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000978:Antiparkinson Agents / Q000627:therapeutic use; D016022:Case-Control Studies; D015331:Cohort Studies; D018491:Dopamine Agonists / Q000009:adverse effects* / Q000627:therapeutic use; D005260:Female; D006333:Heart Failure / Q000139:chemically induced* / Q000453:epidemiology; D006801:Humans; D007980:Levodopa / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D010300:Parkinson Disease / Q000150:complications / Q000188:drug therapy*; D012307:Risk Factors
chemical_list: D000978:Antiparkinson Agents; D018491:Dopamine Agonists; D007980:Levodopa