Table 4.
Baseline characteristics of dose trajectories for beta‐blockers at 6 months
| Factor | Stay low | Up‐titrate | Down‐titrate | Stay high | P value |
|---|---|---|---|---|---|
| N | 382 | 125 | 46 | 242 | |
| Demographics | |||||
| Age (years), mean (SD) | 63.1 (12.8) | 58.9 (12.2) | 63.3 (13.9) | 61.4 (12.0) | 0.009 |
| Women | 62 (16.2%) | 19 (15.2%) | 4 (8.7%) | 38 (15.7%) | 0.61 |
| Enrolled in SG (vs. NZ) | 274 (71.7%) | 65 (52.0%) | 24 (52.2%) | 128 (52.9%) | <0.001 |
| Enrolled as inpatient | 227 (59.4%) | 86 (68.8%) | 33 (71.7%) | 130 (53.7%) | 0.014 |
| History of prior HF hospitalization | 223 (58.4%) | 59 (47.2%) | 29 (63.0%) | 145 (59.9%) | 0.082 |
| Clinical exam/signs and symptoms | |||||
| NYHA class | 80 (21.3%) | 34 (27.4%) | 12 (26.1%) | 56 (23.4%) | 0.52 |
| BMI (kg/m2), mean (SD) | 25.6 (5.2) | 28.2 (6.0) | 27.0 (6.2) | 28.0 (5.4) | <0.001 |
| BSA (m2), mean (SD) | 1.78 (0.23) | 1.91 (0.25) | 1.87 (0.25) | 1.90 (0.22) | <0.001 |
| Systolic BP (mmHg), mean (SD) | 115.6 (18.5) | 120.7 (21.4) | 121.3 (23.4) | 124.0 (20.7) | <0.001 |
| Diastolic BP (mmHg), mean (SD) | 69.9 (12.1) | 73.3 (14.3) | 70.7 (11.8) | 74.5 (13.3) | <0.001 |
| Heart rate (b.p.m.), mean (SD) | 75.2 (13.1) | 79.2 (14.1) | 73.5 (15.2) | 76.7 (15.1) | 0.022 |
| LVEF (%), median (IQR) | 25 (20, 30) | 25 (21, 30) | 28 (25, 35) | 28 (23, 35) | 0.001 |
| Ischaemic aetiology | 232 (60.7%) | 64 (51.2%) | 24 (52.2%) | 133 (55.0%) | 0.19 |
| Shortness of breath at rest | 40 (10.5%) | 16 (12.8%) | 8 (17.4%) | 34 (14.1%) | 0.39 |
| Reduction in exercise tolerance | 239 (62.6%) | 88 (70.4%) | 33 (71.7%) | 153 (63.2%) | 0.29 |
| Orthopnoea | 92 (24.1%) | 34 (27.2%) | 11 (23.9%) | 53 (21.9%) | 0.73 |
| Paroxysmal nocturnal dyspnoea | 62 (16.2%) | 26 (21.0%) | 5 (10.9%) | 37 (15.3%) | 0.37 |
| Peripheral oedema | 118 (31.1%) | 34 (27.2%) | 25 (55.6%) | 77 (32.0%) | 0.005 |
| Laboratory values | |||||
| NT‐proBNP (ng/L), median (IQR) | 2439 (1122, 5193) | 2041 (1040, 4263) | 2495 (1562, 6500) | 1947 (1040, 4078) | 0.073 |
| Potassium (mmol/L), median (IQR) | 4.1 (3.7, 4.4) | 4.1 (3.7, 4.4) | 4.0 (3.8, 4.5) | 4.2 (3.8, 4.5) | 0.7 |
| eGFR (mL/min/1.73 m2), median (IQR) | 59.9 (47.0, 76.0) | 61.5 (48.0, 75.4) | 58.9 (41.1, 71.4) | 56.8 (44.6, 73.9) | 0.36 |
| Shortness of breath on exertion | 246 (64.4%) | 86 (68.8%) | 37 (80.4%) | 158 (65.6%) | 0.16 |
| Medical history | |||||
| Hypertension | 214 (56.6%) | 80 (66.1%) | 28 (62.2%) | 155 (64.9%) | 0.12 |
| Diabetes | 163 (42.7%) | 60 (48.4%) | 18 (40.0%) | 119 (49.2%) | 0.32 |
| Atrial fibrillation | 99 (25.9%) | 38 (30.4%) | 22 (47.8%) | 99 (40.9%) | <0.001 |
| Anaemia | 124 (36.4%) | 44 (37.9%) | 22 (50.0%) | 58 (27.0%) | 0.011 |
| Charlson comorbidity index, mean (SD) | 2.3 (1.4) | 2.4 (1.5) | 2.6 (1.8) | 2.6 (1.5) | 0.2 |
| Medications at baseline | |||||
| ACEi/ARB at baseline | 331 (86.6%) | 117 (93.6%) | 40 (87.0%) | 217 (89.7%) | 0.18 |
| ACEi/ARB dose (%GRD) at baseline, median (IQR) | 20 (13, 38) | 25 (13, 50) | 38 (20, 100) | 50 (25, 100) | <0.001 |
| MRA at baseline | 211 (55.2%) | 60 (48.0%) | 22 (47.8%) | 129 (53.3%) | 0.47 |
| Loop diuretic at baseline | 357 (93.5%) | 114 (91.2%) | 43 (93.5%) | 228 (94.2%) | 0.75 |
| Statin at baseline | 283 (74.1%) | 89 (71.2%) | 28 (60.9%) | 185 (76.4%) | 0.15 |
| Outcomes | |||||
| Composite outcome at 1 year | 114 (29.8%) | 21 (16.8%) | 18 (39.1%) | 73 (30.2%) | 0.009 |
%GRD, per cent guideline‐recommended dose; ACEi, angiotensin‐converting enzyme inhibitor; ARB, angiotensin receptor blocker; BMI, body mass index; BP, blood pressure; BSA, body surface area; eGFR, estimated glomerular filtration rate; HF, heart failure; IQR, interquartile range; LVEF, left ventricular ejection fraction; MRA, mineralocorticoid receptor antagonist; NT‐proBNP, N‐terminal pro‐beta‐type natriuretic peptide; NYHA, New York Heart Association; NZ, New Zealand; SD, standard deviation; SG, Singapore.