Associations Between Cardiovascular Events and Nonergot Dopamine Agonists in Parkinson's Disease
Bibliographic record
Abstract
BACKGROUND: Knowledge of possible cardiovascular risks from Parkinson's disease (PD) medications is critical to informing safe and effective treatment decisions. The objective of our study was to determine whether PD patients treated with nonergot dopamine agonists (DAs) are at increased risk of adverse cardiovascular or cerebrovascular outcomes, relative to PD patients receiving other treatments. METHODS: Matched case-control studies were conducted within a cohort of 14,122 inpatients receiving treatment for PD who were identified in the Cerner Health Facts database. Primary outcomes were associations between nonergot DA use and diagnosis of adverse cardiovascular events (acute myocardial infarction, heart failure [HF], hypotension, and valvulopathy). Secondary outcomes included associations between nonergot DA use and diagnosis of adverse cerebrovascular events (cerebrovascular accident and ischemic stroke) and odds of significant exposure-outcome relationships by patient factors. RESULTS: HF was the only adverse event that demonstrated a significant association with nonergot DA use. Individuals treated with pramipexole were more likely to be diagnosed with HF, relative to no use (adjusted odds ratio [AOR]: 1.28; 95% confidence interval [CI]: 1.07-1.53). The association between pramipexole and HF was greater among individuals treated with pramipexole monotherapy (relative to levodopa monotherapy) (AOR, 1.50; 95% CI: 1.09-2.06). Compared to nonusers, men and older individuals treated with pramipexole were more likely to be diagnosed with HF. CONCLUSIONS: Results from our study suggest an association between pramipexole use and HF. Findings warrant replication; however, individuals with PD and independent risk factors for, or a history of, HF may benefit from limited use of this drug.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.003 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".