Bromocriptine use and the risk of valvular heart disease
Identifieur interne : 002C79 ( Main/Merge ); précédent : 002C78; suivant : 002C80Bromocriptine use and the risk of valvular heart disease
Auteurs : Louis C. S. Tan [Singapour] ; Kenneth K. C. Ng [Singapour] ; Wing-Lok Au [Singapour] ; Raymond K. K. Lee [Singapour] ; Yiong-Huak Chan [Singapour] ; Nigel C. K. Tan [Singapour]Source :
- Movement Disorders [ 0885-3185 ] ; 2009-02-15.
English descriptors
- KwdEn :
- 5‐HT2 serotonin receptors, Aged, Aortic Valve Insufficiency (chemically induced), Aortic Valve Insufficiency (diagnosis), Aortic Valve Insufficiency (genetics), Bromocriptine (administration & dosage), Bromocriptine (adverse effects), Dopamine Agonists (administration & dosage), Dopamine Agonists (adverse effects), Dose-Response Relationship, Drug, Echocardiography, Doppler, Female, Heart Valve Diseases (chemically induced), Heart Valve Diseases (diagnosis), Heart Valve Diseases (genetics), Humans, Male, Mitral Valve Insufficiency (chemically induced), Mitral Valve Insufficiency (diagnosis), Mitral Valve Insufficiency (genetics), Parkinson Disease, Receptor, Serotonin, 5-HT2B (drug effects), Receptor, Serotonin, 5-HT2B (genetics), Risk Factors, Severity of Illness Index, Tricuspid Valve Insufficiency (chemically induced), Tricuspid Valve Insufficiency (diagnosis), Tricuspid Valve Insufficiency (genetics), bromocriptine, dopamine agonists, ergotamines, pergolide, valvular heart disease.
- MESH :
- chemical , administration & dosage : Bromocriptine, Dopamine Agonists.
- chemical , adverse effects : Bromocriptine, Dopamine Agonists.
- chemically induced : Aortic Valve Insufficiency, Heart Valve Diseases, Mitral Valve Insufficiency, Tricuspid Valve Insufficiency.
- diagnosis : Aortic Valve Insufficiency, Heart Valve Diseases, Mitral Valve Insufficiency, Tricuspid Valve Insufficiency.
- chemical , drug effects : Receptor, Serotonin, 5-HT2B.
- genetics : Aortic Valve Insufficiency, Heart Valve Diseases, Mitral Valve Insufficiency, Receptor, Serotonin, 5-HT2B, Tricuspid Valve Insufficiency.
- Aged, Dose-Response Relationship, Drug, Echocardiography, Doppler, Female, Humans, Male, Parkinson Disease, Risk Factors, Severity of Illness Index.
Abstract
It has been reported that patients on pergolide and carbergoline have an increased risk of developing valvular heart disease. It is uncertain if bromocriptine, an ergot‐derived dopamine agonist (DA) with partial 5‐HT2B activity, is associated with a similar risk. We assessed the frequency of valvular heart disease in Parkinson's disease (PD) patients on bromocriptine compared to pergolide and a control group of PD patients who had not been treated on any DA. Seventy‐two PD patients on bromocriptine, 21 patients on pergolide, and 47 control PD patients were recruited. Transthoracic echocardiographic studies were performed and reviewed by a blinded cardiologist. The risk for the bromocriptine group to develop any abnormal valvular regurgitation was 3.32 (adjusted OR, 95% CI: 1.11–9.92, P = 0.03) compared to controls, whereas the risk for the pergolide group was 3.66 (adjusted OR, 95% CI: 1.22–10.97, P = 0.02). When cumulative dose of bromocriptine was analyzed by quartiles, patients with a greater exposure to bromocriptine had significantly higher risk of developing both mild and moderate‐severe regurgitations (P for trend, 0.005 and 0.019, respectively). This study demonstrated that bromocriptine use was associated with an increased risk of developing valvular heart disease, which occurred in a cumulative dose‐dependent manner. © 2008 Movement Disorder Society
Url:
DOI: 10.1002/mds.22228
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<front><div type="abstract" xml:lang="en">It has been reported that patients on pergolide and carbergoline have an increased risk of developing valvular heart disease. It is uncertain if bromocriptine, an ergot‐derived dopamine agonist (DA) with partial 5‐HT2B activity, is associated with a similar risk. We assessed the frequency of valvular heart disease in Parkinson's disease (PD) patients on bromocriptine compared to pergolide and a control group of PD patients who had not been treated on any DA. Seventy‐two PD patients on bromocriptine, 21 patients on pergolide, and 47 control PD patients were recruited. Transthoracic echocardiographic studies were performed and reviewed by a blinded cardiologist. The risk for the bromocriptine group to develop any abnormal valvular regurgitation was 3.32 (adjusted OR, 95% CI: 1.11–9.92, P = 0.03) compared to controls, whereas the risk for the pergolide group was 3.66 (adjusted OR, 95% CI: 1.22–10.97, P = 0.02). When cumulative dose of bromocriptine was analyzed by quartiles, patients with a greater exposure to bromocriptine had significantly higher risk of developing both mild and moderate‐severe regurgitations (P for trend, 0.005 and 0.019, respectively). This study demonstrated that bromocriptine use was associated with an increased risk of developing valvular heart disease, which occurred in a cumulative dose‐dependent manner. © 2008 Movement Disorder Society</div>
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<front><div type="abstract" xml:lang="en">It has been reported that patients on pergolide and carbergoline have an increased risk of developing valvular heart disease. It is uncertain if bromocriptine, an ergot‐derived dopamine agonist (DA) with partial 5‐HT2B activity, is associated with a similar risk. We assessed the frequency of valvular heart disease in Parkinson's disease (PD) patients on bromocriptine compared to pergolide and a control group of PD patients who had not been treated on any DA. Seventy‐two PD patients on bromocriptine, 21 patients on pergolide, and 47 control PD patients were recruited. Transthoracic echocardiographic studies were performed and reviewed by a blinded cardiologist. The risk for the bromocriptine group to develop any abnormal valvular regurgitation was 3.32 (adjusted OR, 95% CI: 1.11–9.92, P = 0.03) compared to controls, whereas the risk for the pergolide group was 3.66 (adjusted OR, 95% CI: 1.22–10.97, P = 0.02). When cumulative dose of bromocriptine was analyzed by quartiles, patients with a greater exposure to bromocriptine had significantly higher risk of developing both mild and moderate‐severe regurgitations (P for trend, 0.005 and 0.019, respectively). This study demonstrated that bromocriptine use was associated with an increased risk of developing valvular heart disease, which occurred in a cumulative dose‐dependent manner. © 2008 Movement Disorder Society</div>
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<sourceDesc><biblStruct><analytic><title xml:lang="en">Bromocriptine use and the risk of valvular heart disease.</title>
<author><name sortKey="Tan, Louis C S" sort="Tan, Louis C S" uniqKey="Tan L" first="Louis C S" last="Tan">Louis C S. Tan</name>
<affiliation wicri:level="1"><nlm:affiliation>Parkinson's Disease and Movement Disorders Centre, National Neuroscience Institute, Singapore. louis_tan@nni.com.sg</nlm:affiliation>
<country xml:lang="fr">Singapour</country>
<wicri:regionArea>Parkinson's Disease and Movement Disorders Centre, National Neuroscience Institute</wicri:regionArea>
<wicri:noRegion>National Neuroscience Institute</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Ng, Kenneth K C" sort="Ng, Kenneth K C" uniqKey="Ng K" first="Kenneth K C" last="Ng">Kenneth K C. Ng</name>
</author>
<author><name sortKey="Au, Wing Lok" sort="Au, Wing Lok" uniqKey="Au W" first="Wing-Lok" last="Au">Wing-Lok Au</name>
</author>
<author><name sortKey="Lee, Raymond K K" sort="Lee, Raymond K K" uniqKey="Lee R" first="Raymond K K" last="Lee">Raymond K K. Lee</name>
</author>
<author><name sortKey="Chan, Yiong Huak" sort="Chan, Yiong Huak" uniqKey="Chan Y" first="Yiong-Huak" last="Chan">Yiong-Huak Chan</name>
</author>
<author><name sortKey="Tan, Nigel C K" sort="Tan, Nigel C K" uniqKey="Tan N" first="Nigel C K" last="Tan">Nigel C K. Tan</name>
</author>
</analytic>
<series><title level="j">Movement disorders : official journal of the Movement Disorder Society</title>
<idno type="eISSN">1531-8257</idno>
<imprint><date when="2009" type="published">2009</date>
</imprint>
</series>
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<profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Aged</term>
<term>Aortic Valve Insufficiency (chemically induced)</term>
<term>Aortic Valve Insufficiency (diagnosis)</term>
<term>Aortic Valve Insufficiency (genetics)</term>
<term>Bromocriptine (administration & dosage)</term>
<term>Bromocriptine (adverse effects)</term>
<term>Dopamine Agonists (administration & dosage)</term>
<term>Dopamine Agonists (adverse effects)</term>
<term>Dose-Response Relationship, Drug</term>
<term>Echocardiography, Doppler</term>
<term>Female</term>
<term>Heart Valve Diseases (chemically induced)</term>
<term>Heart Valve Diseases (diagnosis)</term>
<term>Heart Valve Diseases (genetics)</term>
<term>Humans</term>
<term>Male</term>
<term>Mitral Valve Insufficiency (chemically induced)</term>
<term>Mitral Valve Insufficiency (diagnosis)</term>
<term>Mitral Valve Insufficiency (genetics)</term>
<term>Parkinson Disease</term>
<term>Receptor, Serotonin, 5-HT2B (drug effects)</term>
<term>Receptor, Serotonin, 5-HT2B (genetics)</term>
<term>Risk Factors</term>
<term>Severity of Illness Index</term>
<term>Tricuspid Valve Insufficiency (chemically induced)</term>
<term>Tricuspid Valve Insufficiency (diagnosis)</term>
<term>Tricuspid Valve Insufficiency (genetics)</term>
</keywords>
<keywords scheme="MESH" type="chemical" qualifier="administration & dosage" xml:lang="en"><term>Bromocriptine</term>
<term>Dopamine Agonists</term>
</keywords>
<keywords scheme="MESH" type="chemical" qualifier="adverse effects" xml:lang="en"><term>Bromocriptine</term>
<term>Dopamine Agonists</term>
</keywords>
<keywords scheme="MESH" qualifier="chemically induced" xml:lang="en"><term>Aortic Valve Insufficiency</term>
<term>Heart Valve Diseases</term>
<term>Mitral Valve Insufficiency</term>
<term>Tricuspid Valve Insufficiency</term>
</keywords>
<keywords scheme="MESH" qualifier="diagnosis" xml:lang="en"><term>Aortic Valve Insufficiency</term>
<term>Heart Valve Diseases</term>
<term>Mitral Valve Insufficiency</term>
<term>Tricuspid Valve Insufficiency</term>
</keywords>
<keywords scheme="MESH" type="chemical" qualifier="drug effects" xml:lang="en"><term>Receptor, Serotonin, 5-HT2B</term>
</keywords>
<keywords scheme="MESH" qualifier="genetics" xml:lang="en"><term>Aortic Valve Insufficiency</term>
<term>Heart Valve Diseases</term>
<term>Mitral Valve Insufficiency</term>
<term>Receptor, Serotonin, 5-HT2B</term>
<term>Tricuspid Valve Insufficiency</term>
</keywords>
<keywords scheme="MESH" xml:lang="en"><term>Aged</term>
<term>Dose-Response Relationship, Drug</term>
<term>Echocardiography, Doppler</term>
<term>Female</term>
<term>Humans</term>
<term>Male</term>
<term>Parkinson Disease</term>
<term>Risk Factors</term>
<term>Severity of Illness Index</term>
</keywords>
</textClass>
</profileDesc>
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<front><div type="abstract" xml:lang="en">It has been reported that patients on pergolide and carbergoline have an increased risk of developing valvular heart disease. It is uncertain if bromocriptine, an ergot-derived dopamine agonist (DA) with partial 5-HT(2B) activity, is associated with a similar risk. We assessed the frequency of valvular heart disease in Parkinson's disease (PD) patients on bromocriptine compared to pergolide and a control group of PD patients who had not been treated on any DA. Seventy-two PD patients on bromocriptine, 21 patients on pergolide, and 47 control PD patients were recruited. Transthoracic echocardiographic studies were performed and reviewed by a blinded cardiologist. The risk for the bromocriptine group to develop any abnormal valvular regurgitation was 3.32 (adjusted OR, 95% CI: 1.11-9.92, P = 0.03) compared to controls, whereas the risk for the pergolide group was 3.66 (adjusted OR, 95% CI: 1.22-10.97, P = 0.02). When cumulative dose of bromocriptine was analyzed by quartiles, patients with a greater exposure to bromocriptine had significantly higher risk of developing both mild and moderate-severe regurgitations (P for trend, 0.005 and 0.019, respectively). This study demonstrated that bromocriptine use was associated with an increased risk of developing valvular heart disease, which occurred in a cumulative dose-dependent manner.</div>
</front>
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