Valvular heart disease in patients exposed to pergolide: insights from the clinical presentation
Article first published online: 9 JAN 2012
Copyright © 2012 John Wiley & Sons, Ltd.
Pharmacoepidemiology and Drug Safety
Volume 21, Issue 3, pages 276–280, March 2012
How to Cite
Krishnaswami, A., Albers, K. B., Fross, R. D., Jang, J. J., Berkheimer, S. B., Kwai Ben, V. C. and VanDenEeden, S. K. (2012), Valvular heart disease in patients exposed to pergolide: insights from the clinical presentation. Pharmacoepidem. Drug Safe., 21: 276–280. doi: 10.1002/pds.2274
- Issue published online: 8 MAR 2012
- Article first published online: 9 JAN 2012
- Manuscript Revised: 12 OCT 2011
- Manuscript Accepted: 12 OCT 2011
- Manuscript Received: 17 JUN 2011
- valvular heart disease;
- drug-induced valvular heart disease;
The aim of this study was to determine whether the presence of symptoms would aid in the detection of valvular heart disease (VHD) in those exposed to pergolide.
Utilizing a prospective, cross-sectional study design, patients with an exposure to pergolide were asked regarding the presence or absence of chest pain, shortness of breath or lower extremity edema through a questionnaire. Echocardiograms were obtained on the same day as the questionnaire and were blinded to all staff involved in the study. The sensitivity, specificity, positive and negative predictive value of the reported symptoms towards the outcome moderate or severe valvular regurgitation were obtained. Using the area under the receiver-operating characteristic curve, we also ascertained whether a relationship existed between symptoms, pergolide dose and presence of VHD. To understand the associations between symptoms and echocardiographic covariates, a logistic regression analysis was performed adjusted for age and gender.
The sensitivity, specificity, positive and negative predictive value of symptom presentation and total dose was sufficiently low that it did not aid in the determination whether significant valvular regurgitation was present. Multivariable analysis noted a significant association with indexed left atrial volume (p = 0.011), estimated pulmonary artery pressure (p = 0.047) and shortness of breath.
The presence or absence of symptoms does not help guide whether valvular regurgitation is present or absent in individuals exposed to pergolide. Therefore, echocardiography is needed to confirm or refute pergolide-associated VHD. Copyright © 2012 John Wiley & Sons, Ltd.