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Frequency of drug-induced valvular heart disease in patients previously exposd to benfluorex: a multicentre prospective study

European heart journal, 2013-12, Vol.34 (46), p.3580-3587 [Peer Reviewed Journal]

Distributed under a Creative Commons Attribution 4.0 International License ;ISSN: 0195-668X ;EISSN: 1522-9645 ;DOI: 10.1093/eurheartj/eht266 ;PMID: 24014218

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Title:
Frequency of drug-induced valvular heart disease in patients previously exposd to benfluorex: a multicentre prospective study
Author: Tribouilloy, Christophe ; Maréchaux, Sylvestre ; Jobic, Yannick ; Jeu, Antoine ; Ederhy, Stéphane ; Donal, Erwan ; Réant, Patricia ; Arnalsteen, Elise ; Boulanger, Jacques ; Garban, Thierry ; Ennezat, Pierre-Vladimir ; Andréjak, Michel ; Rusinaru, Dan
Subjects: Analysis of Variance ; Aortic Valve Insufficiency - chemically induced ; Appetite Depressants - adverse effects ; Biochemistry, Molecular Biology ; Cardiology and cardiovascular system ; Case-Control Studies ; Computer Science ; Diabetes Mellitus - drug therapy ; Dyslipidemias - drug therapy ; Echocardiography ; Engineering Sciences ; Female ; Fenfluramine - adverse effects ; Fenfluramine - analogs & derivatives ; Human health and pathology ; Humans ; Hypolipidemic Agents - adverse effects ; Life Sciences ; Male ; Middle Aged ; Mitral Valve Insufficiency - chemically induced ; Obesity - drug therapy ; Prospective Studies ; Risk Factors ; Signal and Image processing
Is Part Of: European heart journal, 2013-12, Vol.34 (46), p.3580-3587
Description: The epidemiologic link between benfluorex use and an increased global frequency of left heart valve regurgitation has been well documented. However, no data linking previous drug exposure to the frequency of diagnosis of drug-induced valvular heart disease (DI-VHD) are available. The present study was conducted to address this issue. This echocardiography reader-blinded, controlled study conducted in 10 centres between February 2010 and February 2012 prospectively included 835 subjects previously exposed to benfluorex referred by primary care physicians for echocardiography. Based on blinded off-line analysis, echocardiography findings were classified as: (i) DI-VHD⁺ for patients with an echocardiographic diagnosis of DI-VHD, (ii) inconclusive, and (iii) DI-VHD⁻ for patients without signs of DI-VHD. Fifty-seven (6.8%) patients exposed to benfluorex were classified as DI-VHD⁺, 733 (87.8%) patients were classified as DI-VHD⁻, and 45 (5.4%) were classified as inconclusive. Mitral and aortic DI-VHD were reported in 43 patients (5.1%) and 30 (3.6%) patients, respectively. Longer duration of exposure, female gender, smoking, and lower BMI were independently associated with a diagnosis of DI-VHD. Good inter-observer reproducibility was observed for the echocardiography classification (Kappa = 0.83, P < 0.00001). About 7% of patients without a history of heart valve disease previously exposed to benfluorex present echocardiography features of DI-VHD. Further studies are needed to study the natural history of DI-VHD and to identify risk factors for the development of drug-induced valve lesions.
Publisher: England: Oxford University Press (OUP)
Language: English
Identifier: ISSN: 0195-668X
EISSN: 1522-9645
DOI: 10.1093/eurheartj/eht266
PMID: 24014218
Source: Geneva Foundation Free Medical Journals at publisher websites
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Frequency of drug-induced valvular heart disease in patients previously exposd to benfluorex: a multicentre prospective study

Distributed under a Creative Commons Attribution 4.0 International License ;ISSN: 0195-668X ;EISSN: 1522-9645 ;DOI: 10.1093/eurheartj/eht266 ;PMID: 24014218

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