title: Drugs with potential cardiac adverse effects: Retrospective study in a large cohort of parkinsonian patients.
abstract: OBJECTIVE
  Drugs with potential cardiac adverse effects are commonly prescribed in Parkinson's disease (PD). To describe demographic and clinical characteristics in a group of PD patients with cardiac events and to evaluate risk factors.
  
  
  METHODS
  We sampled 506 consecutive PD patients (211 women/295 men), median age 68.3±10.6 years (range 36-95) and median disease duration 11.2±6.5 years (range 1-49). Medications with potential cardiac effects, i.e. QT prolongation (citalopram, escitalopram, venlafaxine, sertraline, domperidone, amantadine, solifenacin), ventricular arrhythmia (rivastigmine, clozapine, midodrine, sildenafil, tadalafil) and ischemic heart disease (rasagiline, entacapone, tadalafil) were recorded. Demographic and clinical data were collected prospectively; cardiac events were obtained retrospectively.
  
  
  RESULTS
  Twenty-four patients (4.7%) (9 women/15 men) presented a cardiac event. Fifteen (62.5%) patients had dysautonomia, 4 (16.6%) a history of heart disease and 8 (33.3%) were taking one or more drugs with a definite potential cardiac adverse effect. Age (75.9±6.6 yr vs. 67.8±11 yr), disease duration (14.7±3.6 yr vs. 11±6.5 yr), dysautonomia (62.5% vs. 24.5%) and dementia associated with PD (37.5% vs. 14.6%) were significantly higher in the group with cardiac events (P<0.05). Cofactors increasing the risk for cardiovascular events were age and dysautonomia.
  
  
  CONCLUSIONS
  Our results indicate that the neurodegenerative process in Parkinson's disease is associated with a higher risk of cardiovascular complications.
authors.affiliation: Department of Neurology, Rouen University Hospital, University of Rouen, 76031 Rouen, France.
authors.forename: A
authors.initials: A
authors.lastname: Heranval
authors.affiliation: Department of Neurology, Rouen University Hospital, University of Rouen, 76031 Rouen, France.
authors.forename: R
authors.initials: R
authors.lastname: Lefaucheur
authors.affiliation: Department of Neurology, Rouen University Hospital, University of Rouen, 76031 Rouen, France.
authors.forename: D
authors.initials: D
authors.lastname: Fetter
authors.affiliation: Department of Neurology, Rouen University Hospital, University of Rouen, 76031 Rouen, France.
authors.forename: A
authors.initials: A
authors.lastname: Rouillé
authors.affiliation: Department of Neurology, Rouen University Hospital, University of Rouen, 76031 Rouen, France.
authors.forename: F
authors.initials: F
authors.lastname: Le Goff
authors.affiliation: Department of Neurology, Rouen University Hospital, University of Rouen, 76031 Rouen, France; Inserm U 1073, 76031 Rouen, France. Electronic address: david.maltete@chu-rouen.fr.
authors.forename: D
authors.initials: D
authors.lastname: Maltête
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000978:Antiparkinson Agents / Q000009:adverse effects* / Q000627:therapeutic use; D001145:Arrhythmias, Cardiac / Q000139:chemically induced / Q000453:epidemiology; D053840:Brugada Syndrome / Q000139:chemically induced / Q000453:epidemiology; D000075224:Cardiac Conduction System Disease; D066126:Cardiotoxicity; D002318:Cardiovascular Diseases / Q000139:chemically induced* / Q000453:epidemiology*; D005260:Female; D005602:France / Q000453:epidemiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000139:chemically induced / Q000453:epidemiology; D010300:Parkinson Disease / Q000188:drug therapy* / Q000453:epidemiology*; D054969:Primary Dysautonomias / Q000139:chemically induced / Q000453:epidemiology; D012189:Retrospective Studies
chemical_list: D000978:Antiparkinson Agents
keywords: Adverse effect; Cardiovascular; Parkinson's disease