Drugs with potential cardiac adverse effects: Retrospective study in a large cohort of parkinsonian patients

Rev Neurol (Paris). 2016 Apr-May;172(4-5):318-23. doi: 10.1016/j.neurol.2015.11.007. Epub 2016 Apr 7.

Abstract

Introduction/objective: Drugs with potential cardiac adverse effects are commonly prescribed in Parkinson's disease (PD). To describe demographic and clinical characteristics in a group of PD patients with cardiac events and to evaluate risk factors.

Patients and methods: We sampled 506 consecutive PD patients (211 women/295 men), median age 68.3±10.6 years (range 36-95) and median disease duration 11.2±6.5 years (range 1-49). Medications with potential cardiac effects, i.e. QT prolongation (citalopram, escitalopram, venlafaxine, sertraline, domperidone, amantadine, solifenacin), ventricular arrhythmia (rivastigmine, clozapine, midodrine, sildenafil, tadalafil) and ischemic heart disease (rasagiline, entacapone, tadalafil) were recorded. Demographic and clinical data were collected prospectively; cardiac events were obtained retrospectively.

Results: Twenty-four patients (4.7%) (9 women/15 men) presented a cardiac event. Fifteen (62.5%) patients had dysautonomia, 4 (16.6%) a history of heart disease and 8 (33.3%) were taking one or more drugs with a definite potential cardiac adverse effect. Age (75.9±6.6 yr vs. 67.8±11 yr), disease duration (14.7±3.6 yr vs. 11±6.5 yr), dysautonomia (62.5% vs. 24.5%) and dementia associated with PD (37.5% vs. 14.6%) were significantly higher in the group with cardiac events (P<0.05). Cofactors increasing the risk for cardiovascular events were age and dysautonomia.

Discussion/conclusion: Our results indicate that the neurodegenerative process in Parkinson's disease is associated with a higher risk of cardiovascular complications.

Keywords: Adverse effect; Cardiovascular; Parkinson's disease.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Antiparkinson Agents / adverse effects*
  • Antiparkinson Agents / therapeutic use
  • Arrhythmias, Cardiac / chemically induced
  • Arrhythmias, Cardiac / epidemiology
  • Brugada Syndrome / chemically induced
  • Brugada Syndrome / epidemiology
  • Cardiac Conduction System Disease
  • Cardiotoxicity
  • Cardiovascular Diseases / chemically induced*
  • Cardiovascular Diseases / epidemiology*
  • Female
  • France / epidemiology
  • Humans
  • Male
  • Middle Aged
  • Myocardial Ischemia / chemically induced
  • Myocardial Ischemia / epidemiology
  • Parkinson Disease / drug therapy*
  • Parkinson Disease / epidemiology*
  • Primary Dysautonomias / chemically induced
  • Primary Dysautonomias / epidemiology
  • Retrospective Studies

Substances

  • Antiparkinson Agents