Among 174 participants (mean age 49 ± 13 years, 63% women) without known structural
heart disease before starting
therapy, 62 received only
cabergoline, 63 received only
bromocriptine, and 49 received both. Median
cabergoline use was 2.8 years in
cabergoline only users and 3.2 years for those exposed to both
cabergoline and
bromocriptine; median
bromocriptine use was 5.5 years in
bromocriptine only users and 1.1 years for those exposed to both
cabergoline and
bromocriptine. Compared with
bromocriptine only users (17.5%), regurgitation of ≥1 valve was more common for
cabergoline only (37.1%, P = 0.02) but not for combined exposure (26.5%, P = 0.26). Compared with
bromocriptine only exposure (1.6%), regurgitation of ≥2 valves was more common for
cabergoline only (11.3%, P = 0.03) and combined exposure (12.2%, P = 0.04).
Cabergoline only users had higher age-sex-adjusted odds for ≥1 valve with grade 2+ regurgitation compared to
bromocriptine only users (adjusted odds ratio [aOR] 3.2, 95% confidence interval [CI]:1.3-7.5, P = 0.008), but the association for combined exposure to
cabergoline and
bromocriptine was not significant (aOR 1.7, 95%CI:0.7-4.3, P = 0.26). Compared to
bromocriptine only, age-sex-adjusted odds of ≥2 valves with grade 2+ regurgitation were higher for both
cabergoline only (aOR 8.4, 95% CI:1.0-72.2, P = 0.05) and combined exposure (aOR 8.8, 95% CI:1.0-75.8, P = 0.05). Cumulative
cabergoline exposure > 115 mg was associated with a higher age-sex adjusted odds of ≥2 valves with grade 2+ regurgitation (aOR 9.6, 95%CI:1.1-81.3, P = 0.04) compared to
bromocriptine only.
CONCLUSIONS: Among community-based adults treated for
hyperprolactinemia,
cabergoline use and greater cumulative
cabergoline exposure were associated with a higher prevalence of primarily mild valvular regurgitation compared with
bromocriptine. Research is needed to clarify which patients treated with
dopamine agonists may benefit from echocardiographic screening and surveillance.