Heart Valve Regurgitation, Pergolide Use, and Parkinson Disease.pdf

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2017-04-09 发布于江苏
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Heart Valve Regurgitation, Pergolide Use, and Parkinson Disease.pdf

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Heart Valve Regurgitation, Pergolide Use, and Parkinson Disease

ORIGINAL CONTRIBUTION Heart Valve Regurgitation, Pergolide Use, and Parkinson Disease An Observational Study and Meta-analysis Jean-Christophe Corvol, MD, PhD; Jean-Baptiste Anzouan-Kacou, MD; Elodie Fauveau, MD; Anne-Marie Bonnet, MD; Be?ne?dicte Lebrun-Vignes, MD; Camille Girault, PharmD; Yves Agid, MD, PhD; Philippe Lechat, MD, PhD; Richard Isnard, MD; Lucette Lacomblez, MD Objective: To investigate the prevalence and risk fac- tors of heart valve disease in patients having PD treated with pergolide. Design: Prospective observational study. Setting: Patients were recruited at the Ho?pital de la Pitie?- Salpe?trière, Paris, France. Patients: Ninety-six patients having PD treated with per- golide for longer than 3 months vs 50 control subjects. Intervention: Standardized echocardiography per- formed by an investigator blinded to treatment status. Main Outcome Measure: Moderate to severe regur- gitation in at least 1 heart valve. Results: One hundred thirty-three echocardiograms (86 in the pergolide-treated group and 47 in the control group) were analyzed in the study. Moderate to severe regurgi- tation was found in 15 patients treated with pergolide (17.4%) and in 2 control subjects (4.3%) (odds ratio [OR], 4.75; 95% confidence interval [CI], 1.02-22.1; P=.03). Moderate to severe regurgitation was associated with the cumulative dose of pergolide (OR, 1.37; 95% CI, 1.04- 1.81 per 10-mg/kg increase; P=.03). Including the present study, the meta-analysis comprised 7 trials (394 pa- tients treated with pergolide and 280 controls). The over- all OR for moderate to severe regurgitation was 3.1 (95% CI, 1.7-5.6; P .001) in the pergolide-treated group. Risk differences were correlated with the mean cumulative dose of pergolide (r=0.90, P .001). Data Sources: Using an end point of moderate to se- vere heart valve regurgitation, we performed a meta- analysis of patients having Parkinson disease (PD) treated with pergolide mesylate vs control subjects by search- ing PubMed