Background
Methods
Source population and study sample
Characterizing exposure to dopamine agonists
Evaluation of valvular morphology and function
Statistical approach
Results
Baseline characteristics
Characteristic | Overall (n = 174) | Type of Hyperprolactinemia Therapy | ||
---|---|---|---|---|
Bromocriptine (N = 63) | Cabergoline (N = 62) | Cabergoline and Bromocriptine (N = 49) | ||
Age, years | ||||
Median (IQR) | 47.3 (39.8, 56.8) | 48.2 (42.3, 59.3) | 46.7 (39.4, 57.7) | 48.2 (36.7, 54.6) |
Mean ± SD | 48.9 ± 12.6 | 50.3 ± 12.6 | 48.7 ± 13.1 | 47.2 ± 12.1 |
Age Group, n (%) | p = 0.0743 | |||
21–40 years | 50 (28.7) | 13 (20.6) | 19 (30.7) | 18 (36.7) |
41–60 years | 90 (51.7) | 35 (55.6) | 32 (51.6) | 23 (46.9) |
> 60 years | 34 (19.5) | 15 (23.8) | 11 (17.7) | 8 (16.3) |
Women (%) | 110 (63.2) | 43 (68.3) | 29 (46.8) * | 38 (77.6) |
Race, n (%) | ‡ | |||
White / European | 75 (43.1) | 29 (46.0) | 28 (45.2) | 18 (36.7) |
African American / Black | 33 (19.0) | 5 (7.9) | 9 (14.5) | 19 (38.8) |
Hispanic / Latino | 26 (14.9) | 13 (20.6) | 10 (16.1) | 3 (6.1) |
Asian | 32 (18.4) | 11 (17.5) | 12 (19.4) | 9 (18.4) |
Native American | 2 (1.2) | 1 (1.6) | 1 (1.6) | 0 |
Other | 6 (3.5) | 4 (6.4) | 2 (3.2) | 0 |
Body-Mass Index, kg/m2, n (%) | ||||
< 20 | 7 (4.1) | 1 (3.2) | 1 (1.6) | 5 (8.2) |
20–24.9 | 46 (26.4) | 16 (25.4) | 17 (27.4) | 13 (26.5) |
25–29.9 | 41 (23.6) | 15 (23.8) | 21 (33.9) | 5 (10.2) |
≥ 30 | 79 (45.4) | 29 (46.0) | 23 (37.1) | 27 (55.1) |
Unknown | 1 (0.6) | 1 (1.6) | 0 | 0 |
Smoking History | ||||
Currently smoking, n (%) | 9 (5.2) | 3 (4.8) | 3 (4.8) | 3 (6.1) |
Cigarettes per day, median (IQR)b | 18.0 (6.0, 20.0) | 18.0 (2.5, 20.0) | 20.0 (20.0, 20.0) | 6.0 (1.0, 10.0) |
Years of smoking, median (IQR)c | 15.0 (6.0, 30.0) | 6.0 (3.0, 15.0) | 30.0 (20.0, 32.0) | 15.0 (1.0, 43.0) |
Previously smoked, n (%) | 54 (31.0) | 22 (34.9) | 21 (33.9) | 11 (22.5) |
Medication History | ||||
Filled prescriptions, n (%)d | 160 (92.0) | 60 (95.2) | 54 (87.1) | 46 (93.9) |
Cabergoline, median (IQR) | ||||
Weekly Dose prescribed (mg) | 1.0 (0.5, 1.0) | n/a | 0.75 (0.5, 1.0) | 1.0 (0.5, 1.0) ‡ a |
Estimated Cumulative Dose (mg) | 115.3 (52.2, 259.1) | n/a | 98.0 (56.7, 214.0) | 147.6 (45.4, 321.0) |
Length of time, in years | 2.9 (1.6, 5.2) | n/a | 2.8 (1.9, 4.8) | 3.2 (1.4, 6.1) |
No. of prescriptions filled (per person) | 15.0 (8.0, 24.0) | n/a | 15.0 (10.0, 20.0) | 14.0 (6.0, 29.0) *a |
Bromocriptine, median (IQR) | ||||
Daily Dose prescribed (mg) | 2.5 (2.5, 5.0) | 2.5 (2.5, 5.0) | n/a | 5.0 (2.5, 7.5) ‡ |
Estimated Cumulative Dose (mg) | 3711.9 (1023.8, 10,026.7) | 6065.0 (2413.5, 11,630.0) | n/a | 1127.5 (392.5, 4305.0) ‡ |
Length of time, in years | 2.9 (1.1, 7.2) | 5.5 (2.4, 9.8) | n/a | 1.1 (0.5, 2.5) ‡ |
No. of prescriptions filled (per person) | 14.5 (5.0, 36.0) | 26.0 (10.0, 44.0) | n/a | 5.0 (2.0, 16.0) ‡ |
Current Medication Usage (self-reported) | ||||
Cabergoline current user, n (%) | 96 (55.2) | n/a | 57 (91.9) | 39 (79.6) |
Length of time (years), median (IQR) e | 5.0 (2.0, 6.9) | n/a | 4.3 (2.0, 6.4) | 5.0 (2.1, 8.0) |
No. of days per week, median (IQR) f | 2.0 (1.0, 2.0) | n/a | 2.0 (1.0, 2.0) | 2.0 (1.0, 2.0) |
Days per week varies, n (%)g | 20 (11.5) | n/a | 8 (14.5) | 11 (22.5) |
Bromocriptine current user, n (%) | 63 (36.2) | 57 (90.5) | n/a | 6 (12.2) ‡ |
Length of time (years), median (IQR) | 9.0 (4.5, 15.0) | 9.0 (4.5, 15.0) | n/a | 9.0 (4.8, 10.0) |
No. of days per week, median (IQR) | 7.0 (7.0, 7.0) | 7.0 (7.0, 7.0) | n/a | 7.0 (7.0, 7.0) |
No. of days per week varies, n (%) | 7 (4.0) | 5 (7.9) | n/a | 2 (4.1) |
Amount taken varies, n (%)h | 12 (6.9) | 11 (17.5) | n/a | 1 (2.0) |
Pregnancy | n = 110 women | n = 43 women | n = 29 women | n = 38 women |
Stopped taking due to pregnancy, n (%) | 23 (20.9) | 10 (23.3) | 5 (17.2) | 8 (21.1) |
No. of times pregnant, median (IQR) | 2.0 (1.0, 2.0) | 2.0 (1.0, 2.0) | 1.0 (1.0, 2.0) | 2.0 (1.0, 3.0) |
Breastfeeding duration, mos, median (IQR) | 2.0 (0, 4.0) | 2.0 (0, 5.5) | 3.0 (2.0, 3.0) | 1.0 (0.0, 4.3) |
Risk Factors | ||||
Migraines | ||||
Treated, n (%) | 24 (13.8) | 8 (12.7) | 7 (11.3) | 9 (18.4) |
Type of drugs taken, n (%) | ||||
Dihydroergotamine, DHE 45 | 0 | 0 | 0 | 0 |
Ergotomone, Ergomar | 1 (0.6) | 0 | 1 (1.6) | 0 |
Unknown | 7 (4.0) | 2 (3.2) | 3 (4.8) | 2 (4.1) |
Weight Loss / Appetite Suppressant Drugs | ||||
Taken to Suppress Appetite, n (%) | 8 (4.6) | 2 (3.2) | 2 (3.2) | 4 (8.2) |
Type of drugs taken, n (%) | ||||
Phentermine | 0 | 0 | 0 | 0 |
Dexfenfluramine | 0 | 0 | 0 | 0 |
Other | 8 (4.6) | 2 (3.2) | 2 (3.2) | 4 (8.2) |
Unknown / forgot | 5 (62.5) | 2 (100.0) | 0 | 3 (75.0) |
Nano Slim Haudia | 1 (12.5) | 0 | 1 (50.0) | 0 |
GNC BNRN 60 | 1 (12.5) | 0 | 0 | 1 (25.0) |
Hydroxycut | 1 (12.5) | 0 | 1 (50.0) | 0 |
None | 166 (95.4) | 61 (96.8) | 58 (93.6) | 47 (95.9) |
Medical History, n (%) | ||||
Endocarditis | 0 | 0 | 0 | 0 |
Rheumatic Fever | 1 (0.6) | 1 (1.6) | 0 | 0 |
Mitral Valve Prolapse | 2 (1.2) | 0 | 1 (1.6) | 1 (2.0) |
Heart Failure | 1 (0.6) | 1 (1.6) | 0 | 0 |
Myocardial Infarction | 1 (0.6) | 1 (1.6) | 0 | 0 |
High blood pressure | 23 (13.2) | 8 (12.9) | 7 (11.1) | 8 (16.3) |
Echocardiographic abnormalities
Valve location | Valvular Thickening N (%) | Valvular Regurgitation N (%) | |||||||
---|---|---|---|---|---|---|---|---|---|
None | Mild | >Mild | Inconclusive | 0 | 1 | 2 | 3 | 4 | |
Aortic | 155 (89.1) | 19 (10.9) | 0 | 0 | 14 (8.1) | 154 (88.5) | 6 (3.5) | 0 | 0 |
Mitral | 157 (90.2) | 17 (9.8) | 0 | 0 | 3 (1.7) | 164 (94.3) | 6 (3.5) | 1 (0.6) | 0 |
Pulmonic | 150 (86.2) | 1 (0.6) | 0 | 23 (13.2) | 15 (8.6) | 133 (76.4) | 26 (14.9) | 0 | 0 |
Tricuspid | 174 (100.0) | 0 | 0 | 0 | 12 (6.9) | 136 (78.2) | 26 (14.9) | 0 | 0 |