title: Risk of heart failure following treatment with dopamine agonists in Parkinson's disease patients.
abstract: BACKGROUND
  Dopamine agonists (DAs) are frequently used to treat early or advanced Parkinson's disease (PD) patients. They have been shown to be efficacious for the treatment of motor symptoms and for delaying levodopa-induced dyskinesias. However, their utilization is limited by the risk of adverse drug reactions, some of which affect the cardiovascular system. Recently, the US FDA identified a possible association between exposure to pramipexole and the risk of heart failure.
  
  
  METHODS
  This article begins by reviewing the pharmacodynamic and cardiovascular effects of DAs on PD patients. Pharmacoepidemiological studies about the association between DAs and heart failure are then evaluated.
  
  
  CONCLUSIONS
  Four nested case-control studies were reviewed. In general, results showed higher heart failure risk following use of pramipexole or cabergoline. Although the effects of cabergoline may be explained by the induction of cardiac valve fibrosis, the basis for the significantly increased risk associated with pramipexole is unclear. It remains to be determined if these are dose-related effects, at what point they occur during the course of treatment, and if the risk is the same for all patients irrespective of other potential modifying factors, such as age and sex.
authors.affiliation: Hospital and University Paul Sabatier of Toulouse, France and INSERM CIC9023 and UMR 825, Department of Clinical Pharmacology and Neurosciences , Toulouse , France.
authors.forename: Santiago
authors.initials: S
authors.lastname: Perez-Lloret
authors.forename: María Verónica
authors.initials: MV
authors.lastname: Rey
authors.forename: James
authors.initials: J
authors.lastname: Crispo
authors.forename: Daniel
authors.initials: D
authors.lastname: Krewski
authors.forename: Marise
authors.initials: M
authors.lastname: Lapeyre-Mestre
authors.forename: Jean-Louis
authors.initials: JL
authors.lastname: Montastruc
authors.forename: Olivier
authors.initials: O
authors.lastname: Rascol
mesh_terms: D016022:Case-Control Studies; D018491:Dopamine Agonists / Q000009:adverse effects* / Q000627:therapeutic use*; D006333:Heart Failure / Q000139:chemically induced*; D006801:Humans; D010300:Parkinson Disease / Q000188:drug therapy*
chemical_list: D018491:Dopamine Agonists