title: Heart valve disease among patients with hyperprolactinemia: a nationwide population-based cohort study.
abstract: BACKGROUND
  Increased risk of heart valve disease during treatment with certain dopamine agonists, such as cabergoline, has been observed in patients with Parkinson's disease. The same compound is used to treat hyperprolactinemia, but it is unknown whether this also associates with heart valve disease.
  
  
  OBJECTIVE
  The objective of the study was to assess the incidence of diagnosed heart valve disease and cardiac valve surgery among patients with hyperprolactinemia, compared with a general population cohort in Denmark.
  
  
  METHODS
  This was a nationwide, population-based, cohort study based on a nationwide hospital registry.
  
  
  METHODS
  We identified 2381 hyperprolactinemia patients with a first-time diagnosis recorded from 1994 through 2010 in the registry, with no previous hospital diagnosis of heart valve disease. Each patient was compared with 10 age- and gender-matched comparison cohort members from the general population. The association between hyperprolactinemia and heart valve disease was analyzed with Cox's proportional hazards regression, controlling for potential confounding factors. To assess the risk of cardiac valve surgery and avoid ascertainment bias, a subanalysis was made in a cohort of 2,387 hyperprolactinemia patients with no previous cardiac valve surgery and 23,870 comparison cohort members.
  
  
  RESULTS
  Nineteen hyperprolactinemic patients (0.80%) were diagnosed with heart valve disease during a total of 17,759.8 yr of follow-up, compared with 75 persons (0.31%) in the comparison cohort during 179,940.6 yr of follow-up [adjusted hazard ratio 2.27 (95% confidence interval 1.35-3.82)]. Seven of the 10 patients treated with cabergoline and diagnosed with heart valve disease were asymptomatic and diagnosed on the basis of an echocardiography performed as a safety measure. However, only two patients with hyperprolactinemia (0.08%) underwent surgery, compared with 28 persons in the general population cohort (0.12%) [adjusted hazard ratio 0.55 (95% confidence interval 0.13-2.42)].
  
  
  CONCLUSIONS
  Data from the present register-based study do not support that hyperprolactinemia or its treatment is associated with an increased risk of clinically significant heart valve disease.
authors.affiliation: Medical Department MEA, Aarhus University Hospital, DK-8000 Aarhus C, Denmark.
authors.forename: Charlotte
authors.initials: C
authors.lastname: Steffensen
authors.forename: Merete Lund
authors.initials: ML
authors.lastname: Maegbaek
authors.forename: Peter
authors.initials: P
authors.lastname: Laurberg
authors.forename: Marianne
authors.initials: M
authors.lastname: Andersen
authors.forename: Caroline Micheala Nervil
authors.initials: CM
authors.lastname: Kistorp
authors.forename: Helene
authors.initials: H
authors.lastname: Norrelund
authors.forename: Henrik Toft
authors.initials: HT
authors.lastname: Sørensen
authors.forename: Jens Otto Lunde
authors.initials: JO
authors.lastname: Jorgensen
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003718:Denmark / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D006349:Heart Valve Diseases / Q000150:complications / Q000453:epidemiology* / Q000601:surgery; D006801:Humans; D006966:Hyperprolactinemia / Q000150:complications* / Q000453:epidemiology; D015994:Incidence; D008297:Male; D008875:Middle Aged; D012307:Risk Factors