A cross-sectional study of the prevalence of cardiac valvular abnormalities in hyperprolactinemic patients treated with ergot-derived dopamine agonists

W M Drake; C E Stiles; T A Howlett; A A Toogood; J S Bevan; R P Steeds; UK Dopamine Agonist Valvulopathy Group; Niki Karavitaki

doi:10.1210/jc.2013-2254

A cross-sectional study of the prevalence of cardiac valvular abnormalities in hyperprolactinemic patients treated with ergot-derived dopamine agonists

W M Drake, C E Stiles, T A Howlett, A A Toogood, J S Bevan, R P Steeds, UK Dopamine Agonist Valvulopathy Group, Niki Karavitaki

Research output: Contribution to journal › Article › peer-review

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Abstract

CONTEXT: Concern exists in the literature that the long-term use of ergot-derived dopamine agonist drugs for the treatment of hyperprolactinemia may be associated with clinically significant valvular heart disease.

OBJECTIVE: The aim of the study was to determine the prevalence of valvular heart abnormalities in patients taking dopamine agonists as treatment for lactotrope pituitary tumors and to explore any associations with the cumulative dose of drug used.

DESIGN: A cross-sectional echocardiographic study was performed in a large group of patients who were receiving dopamine agonist therapy for hyperprolactinemia. Studies were performed in accordance with the British Society of Echocardiography minimum dataset for a standard adult transthoracic echocardiogram. Poisson regression was used to calculate relative risks according to quartiles of dopamine agonist cumulative dose using the lowest cumulative dose quartile as the reference group.

SETTING: Twenty-eight centers of secondary/tertiary endocrine care across the United Kingdom participated in the study.

RESULTS: Data from 747 patients (251 males; median age, 42 y; interquartile range [IQR], 34-52 y) were collected. A total of 601 patients had taken cabergoline alone; 36 had been treated with bromocriptine alone; and 110 had received both drugs at some stage. The median cumulative dose for cabergoline was 152 mg (IQR, 50-348 mg), and for bromocriptine it was 7815 mg (IQR, 1764-20 477 mg). A total of 28 cases of moderate valvular stenosis or regurgitation were observed in 24 (3.2%) patients. No associations were observed between cumulative doses of dopamine agonist used and the age-corrected prevalence of any valvular abnormality.

CONCLUSION: This large UK cross-sectional study does not support a clinically concerning association between the use of dopamine agonists for the treatment of hyperprolactinemia and cardiac valvulopathy.

Original language	English
Pages (from-to)	90-6
Number of pages	7
Journal	The Journal of clinical endocrinology and metabolism
Volume	99
Issue number	1
DOIs	https://doi.org/10.1210/jc.2013-2254
Publication status	Published - Jan 2014

Keywords

Adult
Cross-Sectional Studies
Dopamine Agonists
Echocardiography
Ergolines
Ergot Alkaloids
Female
Great Britain
Heart Valve Diseases
Humans
Hyperprolactinemia
Male
Middle Aged
Prevalence

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10.1210/jc.2013-2254

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Drake, W. M., Stiles, C. E., Howlett, T. A., Toogood, A. A., Bevan, J. S., Steeds, R. P., UK Dopamine Agonist Valvulopathy Group, & Karavitaki, N. (2014). A cross-sectional study of the prevalence of cardiac valvular abnormalities in hyperprolactinemic patients treated with ergot-derived dopamine agonists. The Journal of clinical endocrinology and metabolism, 99(1), 90-6. https://doi.org/10.1210/jc.2013-2254

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title = "A cross-sectional study of the prevalence of cardiac valvular abnormalities in hyperprolactinemic patients treated with ergot-derived dopamine agonists",

abstract = "CONTEXT: Concern exists in the literature that the long-term use of ergot-derived dopamine agonist drugs for the treatment of hyperprolactinemia may be associated with clinically significant valvular heart disease.OBJECTIVE: The aim of the study was to determine the prevalence of valvular heart abnormalities in patients taking dopamine agonists as treatment for lactotrope pituitary tumors and to explore any associations with the cumulative dose of drug used.DESIGN: A cross-sectional echocardiographic study was performed in a large group of patients who were receiving dopamine agonist therapy for hyperprolactinemia. Studies were performed in accordance with the British Society of Echocardiography minimum dataset for a standard adult transthoracic echocardiogram. Poisson regression was used to calculate relative risks according to quartiles of dopamine agonist cumulative dose using the lowest cumulative dose quartile as the reference group.SETTING: Twenty-eight centers of secondary/tertiary endocrine care across the United Kingdom participated in the study.RESULTS: Data from 747 patients (251 males; median age, 42 y; interquartile range [IQR], 34-52 y) were collected. A total of 601 patients had taken cabergoline alone; 36 had been treated with bromocriptine alone; and 110 had received both drugs at some stage. The median cumulative dose for cabergoline was 152 mg (IQR, 50-348 mg), and for bromocriptine it was 7815 mg (IQR, 1764-20 477 mg). A total of 28 cases of moderate valvular stenosis or regurgitation were observed in 24 (3.2%) patients. No associations were observed between cumulative doses of dopamine agonist used and the age-corrected prevalence of any valvular abnormality.CONCLUSION: This large UK cross-sectional study does not support a clinically concerning association between the use of dopamine agonists for the treatment of hyperprolactinemia and cardiac valvulopathy.",

keywords = "Adult, Cross-Sectional Studies, Dopamine Agonists, Echocardiography, Ergolines, Ergot Alkaloids, Female, Great Britain, Heart Valve Diseases, Humans, Hyperprolactinemia, Male, Middle Aged, Prevalence",

author = "Drake, {W M} and Stiles, {C E} and Howlett, {T A} and Toogood, {A A} and Bevan, {J S} and Steeds, {R P} and {UK Dopamine Agonist Valvulopathy Group} and Niki Karavitaki",

year = "2014",

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doi = "10.1210/jc.2013-2254",

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Drake, WM, Stiles, CE, Howlett, TA, Toogood, AA, Bevan, JS, Steeds, RP, UK Dopamine Agonist Valvulopathy Group & Karavitaki, N 2014, 'A cross-sectional study of the prevalence of cardiac valvular abnormalities in hyperprolactinemic patients treated with ergot-derived dopamine agonists', The Journal of clinical endocrinology and metabolism, vol. 99, no. 1, pp. 90-6. https://doi.org/10.1210/jc.2013-2254

TY - JOUR

T1 - A cross-sectional study of the prevalence of cardiac valvular abnormalities in hyperprolactinemic patients treated with ergot-derived dopamine agonists

AU - Drake, W M

AU - Stiles, C E

AU - Howlett, T A

AU - Toogood, A A

AU - Bevan, J S

AU - Steeds, R P

AU - UK Dopamine Agonist Valvulopathy Group

AU - Karavitaki, Niki

PY - 2014/1

Y1 - 2014/1

N2 - CONTEXT: Concern exists in the literature that the long-term use of ergot-derived dopamine agonist drugs for the treatment of hyperprolactinemia may be associated with clinically significant valvular heart disease.OBJECTIVE: The aim of the study was to determine the prevalence of valvular heart abnormalities in patients taking dopamine agonists as treatment for lactotrope pituitary tumors and to explore any associations with the cumulative dose of drug used.DESIGN: A cross-sectional echocardiographic study was performed in a large group of patients who were receiving dopamine agonist therapy for hyperprolactinemia. Studies were performed in accordance with the British Society of Echocardiography minimum dataset for a standard adult transthoracic echocardiogram. Poisson regression was used to calculate relative risks according to quartiles of dopamine agonist cumulative dose using the lowest cumulative dose quartile as the reference group.SETTING: Twenty-eight centers of secondary/tertiary endocrine care across the United Kingdom participated in the study.RESULTS: Data from 747 patients (251 males; median age, 42 y; interquartile range [IQR], 34-52 y) were collected. A total of 601 patients had taken cabergoline alone; 36 had been treated with bromocriptine alone; and 110 had received both drugs at some stage. The median cumulative dose for cabergoline was 152 mg (IQR, 50-348 mg), and for bromocriptine it was 7815 mg (IQR, 1764-20 477 mg). A total of 28 cases of moderate valvular stenosis or regurgitation were observed in 24 (3.2%) patients. No associations were observed between cumulative doses of dopamine agonist used and the age-corrected prevalence of any valvular abnormality.CONCLUSION: This large UK cross-sectional study does not support a clinically concerning association between the use of dopamine agonists for the treatment of hyperprolactinemia and cardiac valvulopathy.

AB - CONTEXT: Concern exists in the literature that the long-term use of ergot-derived dopamine agonist drugs for the treatment of hyperprolactinemia may be associated with clinically significant valvular heart disease.OBJECTIVE: The aim of the study was to determine the prevalence of valvular heart abnormalities in patients taking dopamine agonists as treatment for lactotrope pituitary tumors and to explore any associations with the cumulative dose of drug used.DESIGN: A cross-sectional echocardiographic study was performed in a large group of patients who were receiving dopamine agonist therapy for hyperprolactinemia. Studies were performed in accordance with the British Society of Echocardiography minimum dataset for a standard adult transthoracic echocardiogram. Poisson regression was used to calculate relative risks according to quartiles of dopamine agonist cumulative dose using the lowest cumulative dose quartile as the reference group.SETTING: Twenty-eight centers of secondary/tertiary endocrine care across the United Kingdom participated in the study.RESULTS: Data from 747 patients (251 males; median age, 42 y; interquartile range [IQR], 34-52 y) were collected. A total of 601 patients had taken cabergoline alone; 36 had been treated with bromocriptine alone; and 110 had received both drugs at some stage. The median cumulative dose for cabergoline was 152 mg (IQR, 50-348 mg), and for bromocriptine it was 7815 mg (IQR, 1764-20 477 mg). A total of 28 cases of moderate valvular stenosis or regurgitation were observed in 24 (3.2%) patients. No associations were observed between cumulative doses of dopamine agonist used and the age-corrected prevalence of any valvular abnormality.CONCLUSION: This large UK cross-sectional study does not support a clinically concerning association between the use of dopamine agonists for the treatment of hyperprolactinemia and cardiac valvulopathy.

KW - Adult

KW - Cross-Sectional Studies

KW - Dopamine Agonists

KW - Echocardiography

KW - Ergolines

KW - Ergot Alkaloids

KW - Female

KW - Great Britain

KW - Heart Valve Diseases

KW - Humans

KW - Hyperprolactinemia

KW - Male

KW - Middle Aged

KW - Prevalence

U2 - 10.1210/jc.2013-2254

DO - 10.1210/jc.2013-2254

M3 - Article

C2 - 24187407

SN - 0021-972X

VL - 99

SP - 90

EP - 96

JO - The Journal of clinical endocrinology and metabolism

JF - The Journal of clinical endocrinology and metabolism

IS - 1

ER -

A cross-sectional study of the prevalence of cardiac valvular abnormalities in hyperprolactinemic patients treated with ergot-derived dopamine agonists

Abstract

Keywords

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