Bromocriptine Use and the Risk of Valvular Heart Disease
Identifieur interne : 003057 ( Main/Merge ); précédent : 003056; suivant : 003058Bromocriptine Use and the Risk of Valvular Heart Disease
Auteurs : Louis C. S. Tan [Singapour, États-Unis] ; Kenneth K. C. Ng [Singapour] ; Wing-Lok Au [Singapour, États-Unis] ; Raymond K. K. Lee [Singapour] ; Yiong-Huak Chan [Singapour] ; Nigel C. K. Tan [Singapour]Source :
- Movement disorders [ 0885-3185 ] ; 2009.
Descripteurs français
- Pascal (Inist)
English descriptors
- KwdEn :
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.
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<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>
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<series><title level="j" type="main">Movement disorders</title>
<title level="j" type="abbreviated">Mov. disord.</title>
<idno type="ISSN">0885-3185</idno>
<imprint><date when="2009">2009</date>
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<seriesStmt><title level="j" type="main">Movement disorders</title>
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<profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>5-HT2 Serotonine receptor</term>
<term>Bromocriptine</term>
<term>Cardiac valvular disease</term>
<term>Dopamine agonist</term>
<term>Ergotamine</term>
<term>Nervous system diseases</term>
<term>Pergolide</term>
<term>Risk factor</term>
</keywords>
<keywords scheme="Pascal" xml:lang="fr"><term>Cardiopathie valvulaire</term>
<term>Pathologie du système nerveux</term>
<term>Bromocriptine</term>
<term>Facteur risque</term>
<term>Récepteur sérotoninergique 5-HT2</term>
<term>Ergotamine</term>
<term>Pergolide</term>
<term>Stimulant dopaminergique</term>
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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<sub>2B</sub>
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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<affiliations><list><country><li>Singapour</li>
<li>États-Unis</li>
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<orgName><li>Université nationale de Singapour</li>
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<tree><country name="Singapour"><noRegion><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>
</noRegion>
<name sortKey="Au, Wing Lok" sort="Au, Wing Lok" uniqKey="Au W" first="Wing-Lok" last="Au">Wing-Lok Au</name>
<name sortKey="Au, Wing Lok" sort="Au, Wing Lok" uniqKey="Au W" first="Wing-Lok" last="Au">Wing-Lok Au</name>
<name sortKey="Chan, Yiong Huak" sort="Chan, Yiong Huak" uniqKey="Chan Y" first="Yiong-Huak" last="Chan">Yiong-Huak Chan</name>
<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>
<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>
<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>
<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>
</country>
<country name="États-Unis"><noRegion><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>
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<name sortKey="Au, Wing Lok" sort="Au, Wing Lok" uniqKey="Au W" first="Wing-Lok" last="Au">Wing-Lok Au</name>
</country>
</tree>
</affiliations>
</record>
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