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GENERAL CARDIOLOGY

Previous studies have suggested that the ergot-derived dopamine agonists pergolide and cabergoline may be associated with an increased risk of cardiac valve regurgitation. In addition, histological series have demonstrated valve abnormalities similar to those observed in carcinoid heart disease. Data from the UK General Practice Research Database were used to identify 11 417 individuals aged 4080 years prescribed anti-parkinsonian dopamine agonist drugs over a 17-year period from 1988 to 2005. A total of 81 patients with newly diagnosed cardiac valve regurgitation were identified, of whom 50 were excluded. Of the remaining 31, six were currently taking pergolide, six cabergoline and 19 had not been exposed to a dopamine agonist within the preceding year. When compared with controls, the rate of cardiac valve regurgitation was increased with current use of pergolide (incident rate ratio 7.1, 95% CI 2.3 to 22.3) and cabergoline (incident rate ratio 4.9, 95% CI 1.5 to 15.6),
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