We're already reading some level of alarm in the media about heart valve problems that have appeared in two studies with two older dopamine agonists. For the vast majority of people with Parkinson's, they are not in any kind of danger. If you have taken pergolide (brand name Permax) or cabergoline (brand name Dostinex) , you run a higher risk of developing significant heart valve damage. Nevertheless, most people taking pergolide and cabergoline will not have heart valve damage. In the group of 11,417 study patients who took these two agonists, twelve had heart valve damage. So, it is by no means a danger to all.
We should note that if you have only taken the newer ropinirole (brand name Requip) or pramipexole (brand name Mirapex), the heart valve damage was not observed with these medications. We're still scouring the stats, but it actually appears that people taking the newer agonists had less heart valve damage then the general population. Wouldn't it be strange if the community that has been searching so hard for neuroprotection actually stumbles across cardioprotection? Not likely, but interesting to consider.
This all started with two studies that the New England Journal of Medicine published in today's edition that measured the risk of heart valve damage in people taking these older dopamine agonists. If you have taken pergolide or cabergoline, the studies found that the odds of developing heart valve damage are roughly five-fold higher than the general population. We can speculate that people who used higher doses, and took it for many years, run a greater risk; but, that has not yet been proven.
If you have taken pergolide and cabergoline, and you are concerned about your heart's health, you should talk to your doctor and have them schedule an echocardiogram.
For a good news overview of the story we highly recommend this HealthDay article. It is valuable because:
- 1 - It explains the relationship pergolide and cabergoline share with f en-phen, the weight loss drug also linked to heart-valve damage.
- 2 - It references the rotigotine patch that the Parkinson's community is anticipating. The agonist in the rotigotine patch is very different from the agonist found in pergolide or cabergoline. It has more in common with the newer medicines ropinirole and pramipexole.
For a more in-depth analysis written for health care providers, click on this MedPage Today story.
