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Risk of cardiac valve regurgitation with dopamine agonist use in Parkinson's disease and hyperprolactinaemia: a multi-country, nested case-control study

(2012) DRUG SAFETY. 35(2). p.159-171
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Abstract
Background: There is growing evidence that ergot dopamine agonists may induce cardiac valve regurgitation (CVR) in persons with Parkinson's disease. It is unclear whether the CVR risk is increased with ergot-dopamine agonist use in persons with hyperprolactinaemia, in whom the dose is much lower. Objective: The aim of the study was to explore the association between different dopamine agonists and CVR in patients with Parkinson's disease or hyperprolactinaemia. Design: Nested case-control studies conducted separately in cohorts of Parkinson's disease and hyperprolactinaemia patients. Cases were patients who developed newly diagnosed CVR. Controls were CVR-free patients from the same cohorts and were matched to cases by age, sex, database and calendar year. Setting and Patients: Study patients were identified from over 4.5 million persons in The Health Improvement Network (THIN; UK), Health Search (Italy), and Integrated Primary Care Information (IPCI; the Netherlands) general practice databases in the years 1996-2007. The Parkinson's disease cohort included new users of dopamine agonists or levodopa, while the hyperprolactinaemia cohort included new users or non-users of dopamine agonists. Main Outcome Measure: Risk of newly diagnosed CVR with dopamine agonist use compared with levodopa use in the Parkinson's disease cohort, and dopamine agonist-naive patients in the hyperprolactinaemia cohort. Results: In the Parkinson's disease cohort (7893 dopamine agonist users, 11 766 levodopa users), 85 incident CVR cases were identified. Increased CVR risk was observed for ergot dopamine agonists (adjusted OR [ORadj] 3.82; 95% CI 2.14, 6.81), but not for non-ergot dopamine agonists (ORadj 1.20; 95% CI 0.63, 2.29). In the hyperprolactinaemia cohort (6740 dopamine agonist users and 14 299 dopamine agonist-naive patients), 37 CVR cases were identified during a mean follow-up of 4.5 years and 3.5 years for new users and non-users of dopamine agonists, respectively. However, no association with ever use of ergot dopamine agonists was observed (ORadj 0.47; 95% CI 0.20, 1.19). Conclusion: Ergot-derived dopamine agonists are associated with an increased risk of CVR in Parkinson's disease but not in hyperprolactinaemia patients.
Keywords
VALVULAR HEART-DISEASE, TRICUSPID REGURGITATION, INCREASED PREVALENCE, CABERGOLINE, PERGOLIDE, PROLACTINOMAS

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MLA
Trifirò, Gianluca, M Mostafa Mokhles, Jeanne P Dieleman, et al. “Risk of Cardiac Valve Regurgitation with Dopamine Agonist Use in Parkinson’s Disease and Hyperprolactinaemia: a Multi-country, Nested Case-control Study.” DRUG SAFETY 35.2 (2012): 159–171. Print.
APA
Trifirò, G., Mokhles, M. M., Dieleman, J. P., van Soest, E. M., Verhamme, K., Mazzaglia, G., Herings, R., et al. (2012). Risk of cardiac valve regurgitation with dopamine agonist use in Parkinson’s disease and hyperprolactinaemia: a multi-country, nested case-control study. DRUG SAFETY, 35(2), 159–171.
Chicago author-date
Trifirò, Gianluca, M Mostafa Mokhles, Jeanne P Dieleman, Eva M van Soest, Katia Verhamme, Giampiero Mazzaglia, Ron Herings, et al. 2012. “Risk of Cardiac Valve Regurgitation with Dopamine Agonist Use in Parkinson’s Disease and Hyperprolactinaemia: a Multi-country, Nested Case-control Study.” Drug Safety 35 (2): 159–171.
Chicago author-date (all authors)
Trifirò, Gianluca, M Mostafa Mokhles, Jeanne P Dieleman, Eva M van Soest, Katia Verhamme, Giampiero Mazzaglia, Ron Herings, Cynthia de Luise, Douglas Ross, Guy Brusselle, Annamaria Colao, Wilhelm Haverkamp, Rene Schade, Guy van Camp, Renzo Zanettini, and Miriam C Sturkenboom. 2012. “Risk of Cardiac Valve Regurgitation with Dopamine Agonist Use in Parkinson’s Disease and Hyperprolactinaemia: a Multi-country, Nested Case-control Study.” Drug Safety 35 (2): 159–171.
Vancouver
1.
Trifirò G, Mokhles MM, Dieleman JP, van Soest EM, Verhamme K, Mazzaglia G, et al. Risk of cardiac valve regurgitation with dopamine agonist use in Parkinson’s disease and hyperprolactinaemia: a multi-country, nested case-control study. DRUG SAFETY. 2012;35(2):159–71.
IEEE
[1]
G. Trifirò et al., “Risk of cardiac valve regurgitation with dopamine agonist use in Parkinson’s disease and hyperprolactinaemia: a multi-country, nested case-control study,” DRUG SAFETY, vol. 35, no. 2, pp. 159–171, 2012.
@article{3029047,
  abstract     = {Background: There is growing evidence that ergot dopamine agonists may induce cardiac valve regurgitation (CVR) in persons with Parkinson's disease. It is unclear whether the CVR risk is increased with ergot-dopamine agonist use in persons with hyperprolactinaemia, in whom the dose is much lower. 
Objective: The aim of the study was to explore the association between different dopamine agonists and CVR in patients with Parkinson's disease or hyperprolactinaemia. 
Design: Nested case-control studies conducted separately in cohorts of Parkinson's disease and hyperprolactinaemia patients. Cases were patients who developed newly diagnosed CVR. Controls were CVR-free patients from the same cohorts and were matched to cases by age, sex, database and calendar year. 
Setting and Patients: Study patients were identified from over 4.5 million persons in The Health Improvement Network (THIN; UK), Health Search (Italy), and Integrated Primary Care Information (IPCI; the Netherlands) general practice databases in the years 1996-2007. The Parkinson's disease cohort included new users of dopamine agonists or levodopa, while the hyperprolactinaemia cohort included new users or non-users of dopamine agonists. 
Main Outcome Measure: Risk of newly diagnosed CVR with dopamine agonist use compared with levodopa use in the Parkinson's disease cohort, and dopamine agonist-naive patients in the hyperprolactinaemia cohort. 
Results: In the Parkinson's disease cohort (7893 dopamine agonist users, 11 766 levodopa users), 85 incident CVR cases were identified. Increased CVR risk was observed for ergot dopamine agonists (adjusted OR [ORadj] 3.82; 95% CI 2.14, 6.81), but not for non-ergot dopamine agonists (ORadj 1.20; 95% CI 0.63, 2.29). 
In the hyperprolactinaemia cohort (6740 dopamine agonist users and 14 299 dopamine agonist-naive patients), 37 CVR cases were identified during a mean follow-up of 4.5 years and 3.5 years for new users and non-users of dopamine agonists, respectively. However, no association with ever use of ergot dopamine agonists was observed (ORadj 0.47; 95% CI 0.20, 1.19). 
Conclusion: Ergot-derived dopamine agonists are associated with an increased risk of CVR in Parkinson's disease but not in hyperprolactinaemia patients.},
  author       = {Trifirò, Gianluca and Mokhles, M Mostafa and Dieleman, Jeanne P and van Soest, Eva M and Verhamme, Katia and Mazzaglia, Giampiero and Herings, Ron and de Luise, Cynthia and Ross, Douglas and Brusselle, Guy and Colao, Annamaria and Haverkamp, Wilhelm and Schade, Rene and van Camp, Guy and Zanettini, Renzo and Sturkenboom, Miriam C},
  issn         = {0114-5916},
  journal      = {DRUG SAFETY},
  keywords     = {VALVULAR HEART-DISEASE,TRICUSPID REGURGITATION,INCREASED PREVALENCE,CABERGOLINE,PERGOLIDE,PROLACTINOMAS},
  language     = {eng},
  number       = {2},
  pages        = {159--171},
  title        = {Risk of cardiac valve regurgitation with dopamine agonist use in Parkinson's disease and hyperprolactinaemia: a multi-country, nested case-control study},
  volume       = {35},
  year         = {2012},
}

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