Table 1.
Patient characteristics and 12-month adherence for each preventive therapy post AMI
| Baseline characteristics | β-blockers (n=64,939) | ACEIs/ARBs (n=47,124) | Statins (n= 52,185) | |||
|---|---|---|---|---|---|---|
|
| ||||||
| % of the characteristic | proportion (%) of the adherent | % of the characteristic | proportion (%) of the adherent | % of the characteristic | proportion (%) of the adherent | |
| Total | 100.0 | 66.2 | 100.0 | 62.7 | 100.0 | 66.3 |
|
| ||||||
| Demographics | ||||||
| Gender | ||||||
| Male | 42.5 | 64.5 | 41.0 | 60.9 | 44.1 | 66.6 |
| Female | 57.5 | 67.5 | 59.0 | 64.0 | 55.9 | 66.1 |
| Age | ||||||
| 65–74 | 36.1 | 64.8 | 36.3 | 61.7 | 38.5 | 65.3 |
| 75–84 | 38.1 | 66.4 | 38.6 | 63.1 | 39.0 | 66.5 |
| 85+ | 25.8 | 67.7 | 25.1 | 63.6 | 22.6 | 67.8 |
| Race | ||||||
| White | 85.4 | 67.1 | 84.5 | 63.1 | 85.0 | 67.2 |
| Black | 8.5 | 59.2 | 8.9 | 58.5 | 8.5 | 58.6 |
| Hispanic | 2.6 | 60.7 | 2.9 | 62.1 | 2.7 | 60.5 |
| Asian | 1.7 | 65.8 | 1.9 | 64.2 | 1.9 | 69.5 |
| Other | 1.7 | 63.4 | 1.8 | 64.0 | 1.9 | 65.8 |
| Median income among the age of 65+ at Census block groups of residence | ||||||
| $30,000 and below | 47.1 | 65.9 | 47.4 | 62.6 | 47.0 | 65.5 |
| $30,001–$60,000 | 41.9 | 66.8 | 41.5 | 62.4 | 41.5 | 66.8 |
| $60,001–$100,000 | 9.1 | 65.1 | 9.1 | 64.1 | 9.4 | 68.0 |
| $100,001–$150,000 | 1.5 | 63.9 | 1.6 | 64.4 | 1.6 | 67.6 |
| $150,001 and above | 0.5 | 66.8 | 0.5 | 66.8 | 0.5 | 71.4 |
|
| ||||||
| Prescription Benefit Gap | ||||||
| In Part D “doughnut-hole” prior to AMI admission | 11.2 | 69.1 | 11.7 | 65.5 | 11.4 | 71.8 |
|
| ||||||
| Baseline (12 months prior to index) co-morbidities and polypharmacy | ||||||
| AMI | 4.3 | 67.1 | 4.2 | 62.6 | 4.2 | 67.8 |
| CABG | 0.6 | 69.0 | 0.6 | 61.8 | 0.7 | 72.2 |
| Stent/PTCA | 3.2 | 64.8 | 3.3 | 61.6 | 3.4 | 66.8 |
| Stroke/TIA | 18.1 | 66.5 | 18.3 | 60.9 | 17.0 | 66.7 |
| Unstable Angina | 3.3 | 64.8 | 3.3 | 61.2 | 3.3 | 67.3 |
| IHD | 3.8 | 65.7 | 3.8 | 61.5 | 4.0 | 67.5 |
| HF | 15.0 | 67.1 | 14.9 | 60.5 | 13.7 | 67.0 |
| Atrial Fibrillation | 2.8 | 66.7 | 2.7 | 61.4 | 2.5 | 66.6 |
| PVD | 5.9 | 64.5 | 5.4 | 59.3 | 5.8 | 66.4 |
| Hypertension | 29.7 | 66.0 | 29.9 | 61.4 | 28.2 | 65.9 |
| Diabetes | 15.9 | 65.0 | 16.3 | 61.5 | 15.5 | 66.9 |
| Hyperlipidemia | 15.6 | 65.8 | 15.6 | 61.6 | 16.2 | 67.9 |
| Dementia | 15.9 | 65.0 | 16.3 | 61.5 | 15.5 | 66.9 |
| Charlson Comorbidity Index | ||||||
| 0 | 63.2 | 66.8 | 63.6 | 63.9 | 64.7 | 66.6 |
| 1–2 | 9.3 | 64.5 | 9.4 | 61.3 | 9.2 | 65.1 |
| 3–5 | 12.6 | 66.1 | 12.8 | 61.5 | 11.5 | 66.3 |
| 6–8 | 7.0 | 65.5 | 6.6 | 59.1 | 6.7 | 66.1 |
| 9+ | 3.6 | 64.7 | 3.3 | 58.5 | 3.3 | 67.8 |
| No. of Medications | ||||||
| 0–2 | 10.2 | 64.9 | 9.5 | 62.4 | 10.5 | 65.1 |
| 3–5 | 26.7 | 66.1 | 26.6 | 62.8 | 26.8 | 65.6 |
| 6–10 | 25.9 | 66.5 | 26.5 | 63.1 | 25.5 | 67.0 |
| 11–15 | 31.2 | 67.7 | 32.0 | 63.4 | 30.7 | 68.1 |
| 15+ | 9.9 | 65.9 | 8.4 | 57.5 | 9.3 | 67.0 |
|
| ||||||
| Baseline (12 months prior to index) potential contraindicative or intolerant conditions to the therapies | ||||||
| CKD | 9.8 | 65.9 | 8.4 | 57.5 | 9.3 | 66.0 |
| COPD | 2.1 | 65.0 | 2.0 | 60.4 | 1.8 | 63.0 |
| Asthma | 2.5 | 63.6 | 2.7 | 60.5 | 2.6 | 64.7 |
| Liver Disease | 6.4 | 64.2 | 6.0 | 59.3 | 6.1 | 65.9 |
| Angioedema or Hyperkalemia | 4.2 | 66.8 | 3.6 | 58.3 | 4.0 | 66.5 |
| Hypotension | 5.0 | 64.9 | 4.6 | 58.2 | 4.8 | 66.8 |
| Sinus Bradycardia or Heart Block | 2.5 | 63.6 | 14.2 | 62.6 | 13.6 | 66.7 |
| Rhabdomyolysis or other myopathy | 6.4 | 64.2 | 0.4 | 57.7 | 0.4 | 65.0 |
|
| ||||||
| Baseline (6 months prior to index) prescriptions | ||||||
| β-blockers | 55.1 | 70.7 | 52.8 | 65.0 | 51.4 | 68.8 |
| ACEIs or ARBs | 53.8 | 68.8 | 67.2 | 66.8 | 54.5 | 68.3 |
| Statins | 46.5 | 68.9 | 48.5 | 65.2 | 56.7 | 71.9 |
|
| ||||||
| AMI type, complications & procedures during AMI admission | ||||||
| Subendocardial infarction (NSTEMI) | 73.3 | 65.8 | 72.5 | 62.7 | 72.1 | 66.3 |
| Complications | ||||||
| HF | 35.1 | 67.5 | 36.0 | 61.7 | 32.6 | 66.9 |
| Cardiogenic Shock | 2.4 | 69.8 | 2.5 | 59.2 | 2.5 | 69.7 |
| Acute Renal Failure | 12.7 | 33.3 | 10.8 | 58.5 | 12.0 | 66.3 |
| Hypotension | 4.9 | 63.9 | 4.7 | 58.8 | 5.1 | 66.9 |
| Cardiac dysrhythmias | 30.4 | 67.1 | 30.5 | 62.9 | 29.7 | 67.1 |
| Procedures | ||||||
| CABG | 7.2 | 65.2 | 6.0 | 61.1 | 7.9 | 68.1 |
| Stent/PTCA | 35.7 | 67.0 | 37.0 | 63.5 | 40.0 | 66.8 |
| Cardiac catheterization | 52.6 | 66.4 | 53.9 | 62.8 | 57.3 | 66.3 |
| Infusion of thrombolytic | 0.6 | 66.6 | 0.6 | 64.8 | 0.6 | 64.9 |
| Infusion of platelet inhibitors | 4.5 | 68.1 | 4.5 | 62.9 | 5.0 | 65.8 |
|
| ||||||
| Days of hospital stays for AMI admission | ||||||
| Days of ICU stays | ||||||
| 0 | 48.5 | 66.8 | 48.4 | 63.4 | 48.1 | 66.5 |
| 1–3 | 29.1 | 65.9 | 29.5 | 63.1 | 29.9 | 66.0 |
| 4–10 | 19.5 | 64.9 | 19.4 | 60.8 | 19.1 | 66.1 |
| 11+ | 3.0 | 67.4 | 2.8 | 59.8 | 3.0 | 68.6 |
| Days of total inpatient stays | ||||||
| 1 | 4.4 | 65.6 | 4.4 | 64.4 | 4.6 | 65.1 |
| 2–5 | 56.3 | 66.2 | 57.6 | 64.1 | 57.4 | 66.3 |
| 6–10 | 38.1 | 66.3 | 37.9 | 61.1 | 36.8 | 66.3 |
| 11+ | 12.0 | 66.0 | 11.0 | 59.7 | 11.8 | 67.1 |
|
| ||||||
| Discharge destination | ||||||
| Home | 81.0 | 65.7 | 81.8 | 62.7 | 83.1 | 66.1 |
| Skilled Nursing facilities | 19.0 | 68.4 | 18.2 | 62.7 | 16.9 | 67.7 |
|
| ||||||
| Concurrent treatments | ||||||
| β-blockers | – | – | 84.2 | 63.1 | 84.9 | 66.9 |
| ACEIs/ARBs | 61.1 | 68.0 | – | – | 63.4 | 67.8 |
| Statins | 68.8 | 67.8 | 70.2 | 64.1 | – | – |
Abbreviations: ACEI, angiotensin-converting enzyme inhibitor. ARBs, angiotensin-receptor blockers. Statins, hydroxymethylglutaryl coenzyme A reductase inhibitors. AMI, acute myocardial infarction. CABG, coronary artery bypass surgery. PTCA, percutaneous transluminal coronary angioplasty. TIA, transient ischemic attack. IHD, ischemic heart disease. HF, congestive heart failure. PVD, peripheral vascular disease. CKD, chronic kidney disease. COPD, chronic obstructive pulmonary disease. NSTEMI, non-ST elevated myocardial infarction. ICU, intensive care unit.