Table 2.
Correlates of MRA Prescription in Ideal Candidates Within 90 Days of Hospital Discharge
| Received MRA (n=3408) | Did Not Receive MRA (n=5947) | Unadjusted P Value | |
|---|---|---|---|
| Demographics | |||
| Year | Overall trend P<0.001 | ||
| 2003, (%) | 41% | 59% | |
| 2004, (%) | 39% | 61% | |
| 2005, (%) | 41% | 60% | |
| 2006, (%) | 36% | 64% | |
| 2007, (%) | 38% | 62% | |
| 2008, (%) | 34% | 67% | |
| 2009, (%) | 31% | 69% | |
| Age at index date, mean (SD) | 67 (12) | 71 (12) | <0.001 |
| Female, (%) | 1.1% | 0.9% | 0.38 |
| Race | <0.001 | ||
| White | 68% | 71% | |
| African American | 29% | 25% | |
| Other | 4% | 4% | |
| Medications at discharge/within 90 days | |||
| Loop diuretics, % | 97% | 96% | <0.001 |
| Thiazide diuretics, % | 19% | 14% | <0.001 |
| β‐Blocker (all), % | 95% | 93% | <0.001 |
| ACEI or ARB, % | 95% | 94% | <0.001 |
| Warfarin | 36% | 32% | <0.001 |
| Digoxin | 52% | 37% | <0.001 |
| Admission vitals | |||
| Systolic BP, mm Hg | 128 (25) | 132 (25) | <0.001 |
| Pulse, beats/min | 84 (20) | 83 (19) | 0.009 |
| BMI (kg/m2) | 30 (7) | 29 (7) | <0.001 |
| Discharge lab values | |||
| Sodium, mEq/L, mean (SD) | 137 (4) | 138 (4) | <0.001 |
| Potassium, mEq/L, mean (SD) | 4.1 (0.4) | 4.0 (0.4) | 0.23 |
| Serum creatinine, mg/dL, mean (SD) | 1.3 (0.4) | 1.4 (0.4) | <0.001 |
| Blood urea nitrogen, mg/dL, mean (SD) | 27 (14) | 28 (14) | 0.001 |
| Hemoglobin, g/dL, mean (SD) | 12.7 (1.8) | 12.5 (1.9) | <0.001 |
| Comorbid conditions | |||
| Total comorbidities (Elixhauser11), mean (SD) | 4.4 (2.4) | 4.3 (2.3) | 0.31 |
| Peripheral vascular disease | 15% | 17% | 0.02 |
| Hypertension, n (%) | 85% | 84% | 0.41 |
| Chronic pulmonary disease | 44% | 45% | 0.27 |
| Diabetes (uncomplicated) | 51% | 46% | <0.001 |
| Diabetes (complicated) | 15% | 14% | 0.047 |
| Hypothyroidism | 11% | 11% | 0.63 |
| Liver disease | 7% | 4% | <0.001 |
| Fluid and electrolyte disorders | 30% | 27% | 0.005 |
| Deficiency anemias | 29% | 30% | 0.47 |
| Depression | 15% | 12% | <0.001 |
| Additional comorbid conditions | |||
| Cardiac arrhythmias (from Quan14) | 63% | 63% | 0.42 |
| Ischemic heart disease | 76% | 77% | 0.97 |
| Pulmonary circulation disorders | 15% | 13% | 0.02 |
| Valvular disease | 27% | 28% | 0.41 |
| Noncompliancea | 18% | 16% | 0.03 |
ACEI indicates angiotensin‐converting enzyme inhibitor; ARB, angiotensin‐receptor blocker; BMI, body mass index; BP, blood pressure; ICD, implantable cardioverter defibrillator; MRA, mineralocorticoid receptor antagonist.
a
History of past noncompliance (ICD‐9, International Statistical Classification of Diseases, 9th Revision, v15.81).