Table 3.
Multivariable logistic regression for factors associated with the utilization of disease-modifying treatment in 10,091 individuals administered digoxin and diuretics for chronic heart failure
|
Predictors of utilization |
Disease-modifying treatments group |
ACEI or ARB and Beta-blockers |
ACEI or ARB |
Beta-blockers |
Aldosterone antagonist |
|---|---|---|---|---|---|
| |
(84.8% total) |
(26.9% total) |
(40.4% total) |
(8.5% total) |
(9.0% total) |
| aPR (95% CI) | aPR (95% CI) | aPR (95% CI) | aPR (95% CI) | aPR (95% CI) | |
| Older Age group |
|
0.91 (0.84-0.97) |
1.07 (1.01-1.14) |
0.87 (0.78-0.96) |
|
| Women |
|
1.16 (1.05-1.29) |
|
|
0.83 (0.71-0.97) |
| Specialty of healthcare providers being internal medicine |
1.37 (1.09-1.71) |
|
1.23 (1.01-1.49) |
|
|
| Tertiary hospital |
1.78 (1.49-2.12) |
1.94 (1.73-2.16) |
1.12 (1.03-1.22) |
0.78 (0.68-0.88) |
0.55 (0.48-0.64) |
| Urban residence |
1.46 (1.23-1.74) |
|
1.19 (1.09-1.29) |
|
0.72 (0.62-0.84) |
| Outpatient prescription |
3.87(2.95-4.57) |
2.19 (1.95-2.46) |
3.17 (2.75-3.64) |
2.18 (1.80-2.64) |
2.30 (1.69-3.05) |
| Cardiovascular disease | |||||
| Myocardial infarction |
|
1.19 (1.03-1.36) |
|
|
|
| Transient ischemic stroke |
|
|
0.78 (0.68-0.86) |
|
1.51 (1.25-1.83) |
| Arterial fibrillation or flutter |
1.54 (1.28-1.84) |
1.37 (1.24-1.51) |
0.90 (0.83-0.99) |
|
|
| Valvular heart disease |
|
1.23 (1.08-1.41) |
|
|
0.71 (0.54-0.93) |
| Medical history | |||||
| Hypertension |
|
|
1.10(1.02-1.22) |
|
0.62 (0.53-0.73) |
| Diabetes mellitus |
1.32 (1.10-1.56) |
|
1.09 (1.01-1.20) |
|
0.84 (0.71-0.98) |
| Hyperlipidemia or dyslipidemia |
|
|
|
0.78 (0.65-0.93) |
|
| End-stage renal disease |
|
|
0.78 (0.68-0.86) |
|
|
| Chronic lung disease |
|
0.84 (0.76-0.93) |
1.13 (1.03-1.23) |
0.86 (0.74-0.93) |
1.15 (1.00-1.34) |
| Dementia |
0.61 (0.42-0.90) |
|
0.84 (0.70-0.99) |
|
1.41 (1.09-1.82) |
| Depression |
|
|
|
|
|
| Concomitant medication | |||||
| CCB* |
|
1.28 (1.15-1.42) |
0.82 (0.75-0.90) |
1.31 (1.13-1.53) |
0.76 (0.64-0.90) |
| Nitrates |
1.39 (1.21-1.60) |
1.33 (1.20-1.47) |
|
|
0.73 (0.61-0.87) |
| Inotropics |
1.78 (1.48-2.16) |
1.53 (1.37-1.69) |
|
0.72 (0.60-0.86) |
0.68 (0.56-0.83) |
| Hydralazine |
|
1.64 (1.14-2.37) |
|
|
|
| Lipid-lowering agents |
1.93 (1.52-2.48) |
1.61 (1.43-1.83) |
|
|
0.46 (0.34-0.62) |
| Anti-diabetic medication |
|
1.14 (1.01-1.25) |
|
|
|
| Anti-thrombotics | 1.63 (1.35-1.96) | 1.55 (1.37-1.75) | 0.59 (0.49-0.67) | ||
Adjusted for demographic factors (age, gender, residence area, utilization of hospital type, specialty of health care providers and type of prescription resources), previous cardiovascular diseases (angina, myocardial infarction, valvular heart disease, atrial fibrillation or flutter, transient ischemic attack), systemic medical diseases (hypertension, hyperlipidemia, chronic lung disease, end stage renal disease) and concomitant medications (heart failure medication, antidiabetic drugs).
aPR; adjusted Prevalent Ratio, CI: Confidence Interval, CCB: Calcium channel blockers.