Dopamine agonists and valvular heart disease in Japanese patients with Parkinson's disease

Risks of Cardiac Valve Regurgitation and Heart Failure Associated with Ergot- and Non-Ergot-Derived Dopamine Agonist Use in Patients with Parkinson’s Disease: A Systematic Review of Observational Studies

“…All studies observed a significantly higher prevalence of CVR among ergot-derived DA users, especially in PD patients treated with pergolide and cabergoline, compared to users of non-ergotderived DAs, or other anti-parkinsonian drugs (Table 1). Five studies observed a higher prevalence of CVR among patients treated with a higher daily or cumulative dose of either pergolide or cabergoline [18,20,21,25,26], whereas four studies did not observe any differences, probably due to small sample size or overall low daily dose in the exposed group [19,[22][23][24]. Moreover, in two studies a higher prevalence of CVR was found with longer treatment duration with cabergoline [20,25].…”

“…Among the 13 studies that addressed the primary outcome CVR, two were nested case-control studies [15,16], one was a cohort study [17], and 10 were cross-sectional studies [18][19][20][21][22][23][24][25][26][27]. Their characteristics are presented in Table 1.…”

“…Ten studies that assessed the risk of CVR associated with DA treatment in PD were crosssectional studies. Nine of these studies were conducted at single centers [19][20][21][22][23][24][25][26][27]. PD severity was assessed by the Hoehn and Yahr score [28] in eight studies [19-24, 26, 27].…”

“…Pergolide use was an exposure of interest in all studies. Eight studies additionally investigated the association between the use of other DAs, such as cabergoline [19,20,[22][23][24][25]27], bromocriptine [21,25,26], or pramipexole [19,20,22,25], and the prevalence of CVR.…”