This review included 7 cross-sectional studies (967 patients) of heart valve abnormalities in Parkinson's disease patients receiving DA treatment.
Based on analysis of all 7 studies (841 patients), patients treated with Ergot-DA were at a statistically significantly increased risk of moderate to severe valvular disease compared with patients receiving a control (RR 2.77, 95% confidence interval, CI: 1.72, 4.47, p<0.0001). No evidence of statistical heterogeneity was found (I2=29.4%).
Subgroup analysis (4 studies, 413 patients) comparing Ergot-DA with non-Ergot-DA treatment found no increased risk of valvular disease for Ergot-DA-treated patients (RR 3.41, 95% CI: 0.83, 14.02, p=0.09). These studies were statistically significantly heterogeneous (I2=77.0%).
Patients treated with cabergoline were at a statistically significantly higher risk of valvular heart disease than those receiving pergolide (RR 1.73, 95% CI: 1.23, 2.44, p=0.002; 4 studies, 187 patients). No evidence of statistical heterogeneity was found (I2=5.1%).
Dose dependency of Ergot-DA treatment effects on valvular changes was not assessed statistically, owing to the variation in reported end points. Four out of 7 studies found some dose dependency for pergolide, and two out of four found similar effects in patients treated with cabergoline.
The authors also reported summary data on the overall incidence of valvular heart disease in Parkinson's disease patients treated with Ergot-DA.