Non-Ergot Dopamine Agonists and the Risk of Heart Failure and Other Adverse Cardiovascular Reactions in Parkinson's Disease

• Published in: Brain sciences Vol. 14; no. 8; p. 776
• Main Authors: Crispo, James A G, Farhat, Nawal, Fortin, Yannick, Perez-Lloret, Santiago, Sikora, Lindsey, Morgan, Rebecca L, Habash, Mara, Gogna, Priyanka, Kelly, Shannon E, Elliott, Jesse, Kohen, Dafna E, Bjerre, Lise M, Mattison, Donald R, Hessian, Renée C, Willis, Allison W, Krewski, Daniel
• Format: Journal Article
• Language: English
• Published: Switzerland MDPI AG 31.07.2024; MDPI
• Subjects: Agonists; Bias; Bromocriptine; Canada; Cardiac glycosides; Cardiac patients; Cardiotonic agents; Cardiovascular disease; Cardiovascular diseases; cardiovascular reactions; Clinical trials; Comparative analysis; Complications and side effects; Congestive heart failure; Diseases; Dopamine; Drug dosages; Edema; Enzymes; Ergot; Heart diseases; Heart failure; Intervention; medication safety; Movement disorders; Neurodegenerative diseases; non-ergot dopamine agonists; Online databases; Ontario; Orthostatic hypotension; Parkinson's disease; Phenols; Restless legs syndrome; Risk factors; Ropinirole; Systematic Review; Canada; Ontario; United States > US; heart failure; non-ergot dopamine agonists; medication safety; meta-analysis; non-randomized studies; cardiovascular reactions; randomized controlled trials; systematic review; Parkinson’s disease
• ISSN: 2076-3425; 2076-3425
• DOI: 10.3390/brainsci14080776

Reports suggest possible risks of adverse cardiovascular reactions, including heart failure, associated with non-ergot dopamine agonist (DA) use in Parkinson's disease (PD). The objectives of our review were to evaluate the risk of heart failure and other adverse cardiovascular reactions in PD patients who received a non-ergot DA compared with other anti-PD pharmacological interventions, placebo, or no intervention. Studies were identified via searches of six bibliographic databases. Randomized controlled trials (RCTs) and non-randomized studies (NRS) were eligible for study inclusion. Random-effect meta-analyses were performed to estimate adverse cardiovascular reaction risks. Quality of evidence was assessed using GRADE. In total, forty-four studies (thirty-six RCTs and eight NRS) satisfied our inclusion criteria. A single RCT found no significant difference in the risk of heart failure with ropinirole compared with bromocriptine (odds ratio (OR) 0.39, 95% confidence interval (CI) 0.07 to 2.04; low certainty). Conversely, three case-control studies reported a risk of heart failure with non-ergot DA treatment. The quality of evidence for the risk of heart failure was judged as low or very low. Findings suggest that non-ergot DA use may be associated with adverse cardiovascular outcomes, including heart failure. Studies are needed to better understand cardiovascular risks associated with PD treatment.