Valvular heart disease in patients taking pergolide
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Published on: March 31, 2022
E Andrew Waller1, Joseph Kaplan, Michael G Heckman
1Department of Internal Medicine, Mayo Clinic College of Medicine, Jacksonville, Fl 32224, USA.
Insights
Pergolide use was associated with an increased frequency of aortic regurgitation (AR). While moderate to severe valvular disease showed no statistical difference, higher pergolide dosage may link to AR.
Area of Science:
- Cardiology
- Pharmacology
Background:
- Pergolide is a dopamine agonist used for Parkinson's disease.
- Valvular heart disease (VHD) is a potential adverse effect of certain medications.
Purpose of the Study:
- To investigate the frequency of valvular heart disease in patients taking pergolide.
- To assess the association between pergolide dosage and VHD.
Main Methods:
- Retrospective review of medical records for patients treated with pergolide and controls.
- Two-dimensional echocardiograms were analyzed for valvular regurgitation.
- Comparison of VHD frequency between pergolide users and controls.
Main Results:
- 45% of pergolide users had any degree of aortic regurgitation (AR) compared to 21% of controls (P=.006).
- No significant difference in moderate to severe mitral, tricuspid, or aortic regurgitation between groups.
- Marginal evidence suggests a link between higher pergolide dosage and moderate to severe AR (P=.05).
Conclusions:
- Pergolide use appears to increase the frequency of AR.
- A potential causal relationship between pergolide and VHD may occur at a low incidence.
- Dosage may be a factor in the development of pergolide-associated VHD.
Objective:
To Investigate the frequency of valvular heart disease in patients taking pergolide.
Patients And Methods:
The medical records of patients seen at the Mayo Clinic in Jacksonville, Fla, between 1998 and 2003 were searched electronically for the word pergolide and the presence of a 2-dimensional echocardiogram. Patients who had not taken pergolide before undergoing echocardlography served as the control group. Echocardiograms were reviewed for the presence of valvular regurgitation. The frequency of valvular disease in patients taking pergolide was calculated and compared with controls. Associations with dosage and years of treatment also were examined.
Results:
Fifty-five patients made up the pergolide group, and 63 served as controls. When looking at aortic regurgitation (AR) of any degree, 45% of patients in the pergolide group had AR, compared with 21% of controls (P = .006). The frequency of moderate to severe valvular regurgitation in the pergolide group was 11% (95% confidence interval [CI], 4%-22%), 13% (95% CI, 5%-24%), and 13% (95% CI, 5%-24%) for the tricuspid, mitral, and aortic valves, respectively. No statistical difference was identified in the frequency of moderate to severe valvular regurgitation (mitral, tricuspid, or aortic) when compared with controls. There was marginal evidence of an association between a higher daily dosage of pergolide and moderate to severe AR (P = .05).
Conclusion:
The frequency of AR appears to be Increased in patients taking pergolide. Our study suggests that if a cause-effect relationship exists between pergolide and valvular heart disease, it likely occurs at a low but clinically important Incidence and may be associated with dosage.
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