The risk of valvular regurgitation in patients with Parkinson's disease treated with dopamine receptor agonists

Objectives: Several observational studies suggest an association between treatment with ergoline‐derived dopamine agonists and valvular regurgitation. In this article, we present an overview of the literature and conduct a meta‐analysis. Methods: Observational studies addressing the frequency of moderate or severe valvular regurgitation among ergoline‐treated patients with Parkinson's disease were considered for a meta‐analysis. Pooled risk estimates and the risk of increased pulmonary artery pressure were calculated. Results: The pooling of data from well‐designed observational studies documented that both pergolide (RR = 3.05 [1.71–5.44]) and cabergoline (RR = 6.38 [3.17–12.81]) represent a substantially increased risk of developing moderate to severe valvular regurgitation. In addition, pergolide, but not cabergoline, was associated with an increase in pulmonary artery pressure. Conclusions: The present meta‐analysis confirmed a statistically significant association between pergolide and cabergoline treatment and the risk of moderate to severe valvular regurgitation. An association between bromocriptine and valvular regurgitation cannot be entirely ruled out. © 2011 Movement Disorder Society