Table 1.
Selected baseline characteristics of the study population stratified by adherence to the three classes of preventive therapies
| Adherent to | |||||||||
|---|---|---|---|---|---|---|---|---|---|
|
|
|||||||||
| Cohort | All three therapies |
ACEI/ARB + beta- blocker only |
ACEI/ARB + statin only |
Beta- blocker + statin only |
ACEI/ARB only |
Beta- blocker only |
Statin only |
None | |
|
| |||||||||
| N (%) | 90869 (100%) |
44051 (48.5%) |
8269 (9.1%) |
7242 (8.0%) |
12401 (13.6%) |
3396 (3.7%) |
4559 (5.0%) |
4304 (4.7%) |
6647(7.3%) |
| Sociodemographics, % | |||||||||
| Age, years | |||||||||
| 65–74 | 43.6 | 44.6 | 43.3 | 43.1 | 41.2 | 43.1 | 41.8 | 43.5 | 43.7 |
| 75–84 | 39.7 | 39.2 | 40.1 | 43.7 | 41.3 | 39.7 | 40.3 | 40.4 | 38.4 |
| 85+ | 16.7 | 16.1 | 17.6 | 17.2 | 17.6 | 17.2 | 17.9 | 16.2 | 17.9 |
| Gender (Male) | 45.2 | 45.4 | 40.9 | 45.5 | 45.9 | 41.4 | 43.0 | 51.5 | 47.3 |
| Race | |||||||||
| White | 85.0 | 86.1 | 84.5 | 84.8 | 87.1 | 80.0 | 85.1 | 86.2 | 76.6 |
| Black | 8.0 | 7.1 | 8.7 | 7.9 | 6.6 | 11.4 | 8.7 | 7.0 | 14.0 |
| Hispanic | 2.9 | 2.7 | 3.2 | 3.2 | 2.4 | 4.3 | 2.9 | 2.5 | 4.4 |
| Asian | 2.2 | 2.2 | 1.7 | 2.1 | 2.3 | 2.4 | 1.5 | 2.4 | 2.4 |
| Other | 1.9 | 1.9 | 1.9 | 2.0 | 1.6 | 1.9 | 1.8 | 1.9 | 2.7 |
| Income proxy* | |||||||||
| ≤$30000 | 47.2 | 46.9 | 47.7 | 46.4 | 45.6 | 51.4 | 46.0 | 44.5 | 52.1 |
| $30001–$60000 | 41.4 | 41.7 | 41.2 | 42.3 | 42.4 | 37.9 | 42. | 42.5 | 37.5 |
| $60001–$100000 | 9.2 | 9.18 | 9.1 | 9.1 | 9.7 | 8.3 | 9.9 | 10.4 | 8.3 |
| $100001–$150000 | 1.7 | 1.7 | 1.6 | 1.7 | 1.6 | 1.9 | 1.5 | 2.0 | 1.7 |
| ≥$150001 | 0.5 | 0.5 | 0.4 | 0.6 | 0.6 | 0.5 | 0.4 | 0.7 | 0.4 |
| Having Part D prescription drug benefit gap (“doughnut hole”) | 12.7 | 13.5 | 12.0 | 13.1 | 13.4 | 11.6 | 11.3 | 12.0 | 9.3 |
| Medicare & Medicaid dual eligibility | 23.5 | 24.4 | 21.5 | 22.6 | 21.2 | 25.7 | 19.8 | 19.3 | 29.6 |
|
| |||||||||
| Clinical characteristics (within 12 months prior to index admission), % | |||||||||
| AMI | 2.8 | 2.7 | 3.0 | 2.6 | 2.8 | 2.5 | 3.6 | 3.0 | 3.1 |
| CABG | 0.7 | 0.7 | 0.6 | 0.8 | 0.9 | 0.6 | 0.8 | 0.9 | 0.6 |
| PCI | 4.8 | 4.8 | 4.8 | 4.8 | 4.7 | 4.7 | 5.7 | 4.6 | 4.6 |
| Stroke/TIA | 6.0 | 5.6 | 5.9 | 6.4 | 6.1 | 6.2 | 7.3 | 6.5 | 7.2 |
| Unstable Angina | 3.8 | 3.7 | 3.8 | 3.9 | 4.2 | 4.5 | 4.2 | 3.5 | 3.5 |
| Angina Pectoris | 6.2 | 6.2 | 6.1 | 6.5 | 6.5 | 6.3 | 7.2 | 5.9 | 5.4 |
| IHD | 44.0 | 43.0 | 45.2 | 44.8 | 45.4 | 43.5 | 47.9 | 43.8 | 43.0 |
| CHF | 20.7 | 19.8 | 21.7 | 19.6 | 22.5 | 21.4 | 22.8 | 19.5 | 22.8 |
| Atrial Fibrillation | 9.7 | 9.3 | 10.4 | 9.9 | 10.9 | 9.3 | 10.9 | 9.94 | 8.1 |
| Hypertension | 75.6 | 75.2 | 78.2 | 76.7 | 76.6 | 77.9 | 78.7 | 71.4 | 71.1 |
| PVD | 17.3 | 16.6 | 17.6 | 17.3 | 18.6 | 16.8 | 19.5 | 17.3 | 17.8 |
| Hyperlipidemia | 59.3 | 59.5 | 60.0 | 60.2 | 61.5 | 56.4 | 60.7 | 60.5 | 51.2 |
| Diabetes | 40.0 | 40.0 | 40.7 | 39.8 | 40.3 | 41.0 | 42.0 | 38.0 | 38.3 |
| CKD | 11.4 | 10.2 | 10.5 | 10.4 | 15.1 | 10.6 | 14.8 | 12.5 | 11.9 |
| COPD | 21.3 | 19.8 | 21.7 | 21.8 | 22.5 | 23.5 | 21.2 | 23.9 | 24.7 |
| Asthma | 5.1 | 4.6 | 5.2 | 5.4 | 5.5 | 6.4 | 5.0 | 5.7 | 6.2 |
| Liver Disease | 1.5 | 1.5 | 1.8 | 1.1 | 1.4 | 1.9 | 1.6 | 1.5 | 1.8 |
| Cancer | 10.4 | 9.9 | 10.8 | 10.4 | 11.2 | 9.8 | 12.1 | 11.6 | 9.76 |
| Depression | 13.0 | 12.1 | 13.1 | 13.3 | 13.7 | 14.2 | 14.6 | 14.5 | 15.3 |
| Dementia/Alzheimer ’s Disease | 9.5 | 7.2 | 7.0 | 8.4 | 7.4 | 9.8 | 8.7 | 8.7 | 11.8 |
| Charlson Comorbidity | |||||||||
| Index | |||||||||
| 0 | 30.7 | 32.2 | 29.7 | 30.4 | 28.8 | 29.0 | 27.0 | 30.4 | 30.0 |
| 1–2 | 39.8 | 40.1 | 40.3 | 40.8 | 38.5 | 41.4 | 39.2 | 39.0 | 39.1 |
| 3–5 | 23.4 | 22.2 | 24.3 | 23.3 | 25.3 | 24.1 | 25.5 | 23.9 | 24.3 |
| 6–8 | 5.0 | 4.6 | 4.7 | 4.5 | 6.3 | 4.4 | 6.7 | 5.4 | 5.4 |
| 9+ | 1.1 | 0.9 | 1.0 | 1.0 | 1.2 | 1.2 | 1.6 | 1.4 | 1.2 |
|
| |||||||||
| Pre-admission medication use (within 180 days prior to index admission), % | |||||||||
| ACEI/ARB | 69.5 | 70.8 | 73.5 | 73.0 | 69.1 | 73.9 | 66.7 | 60.5 | 58.9 |
| Beta-blocker | 56.6 | 58.8 | 61.6 | 51.1 | 58.2 | 48.3 | 62.9 | 48.6 | 44.3 |
| Statin | 61.2 | 63.7 | 55.5 | 67.0 | 64.5 | 52.0 | 54.3 | 63.9 | 47.7 |
|
| |||||||||
| Characteristics of index admission, % | |||||||||
| NSTEMI | 71.9 | 70.7 | 72.7 | 73.8 | 72.4 | 74.3 | 73.8 | 71.4 | 73.7 |
| CHF | 35.3 | 34.7 | 35.1 | 31.8 | 38.4 | 34.5 | 37.6 | 35.0 | 37.0 |
| Cardiogenic Shock | 2.7 | 2.7 | 2.4 | 2.0 | 3.6 | 2.2 | 2.8 | 3.4 | 2.3 |
| Cardiac Arrest | 1.2 | 1.2 | 1.1 | 0.9 | 1.2 | 0.8 | 1.5 | 1.6 | 0.9 |
| Acute Renal Failure | 12.2 | 10.3 | 11.0 | 10.7 | 18.0 | 10.4 | 15.5 | 14.6 | 13.3 |
| Cardiac Dysrhythmias | 30.2 | 29.9 | 31.6 | 31.0 | 31.2 | 29.3 | 31.0 | 30.7 | 27.3 |
| Hypotension | 5.0 | 4.8 | 4.5 | 5.1 | 5.6 | 4.7 | 5.0 | 6.1 | 4.6 |
| Angiocardiography | 67.4 | 69.1 | 66.3 | 67.5 | 66.3 | 65.6 | 64.2 | 67.9 | 62.0 |
| CABG | 7.72 | 7.04 | 6.71 | 7.24 | 11.0 | 6.48 | 8.62 | 10.0 | 6.39 |
| PCI | 48.6 | 51.6 | 47.0 | 48.4 | 46.0 | 46.4 | 42.9 | 46.8 | 41.6 |
| Cardiac Catheterization | 67.7 | 69.3 | 66.7 | 67.9 | 66.7 | 66.3 | 65.2 | 67.7 | 62.5 |
| Thrombolytic use for AMI | 0.7 | 0.7 | 0.8 | 0.6 | 0.5 | 0.8 | 0.6 | 0.7 | 0.7 |
| Antiplatelet use for AMI | 5.4 | 5.6 | 5.3 | 5.6 | 5.4 | 4.8 | 4.9 | 5.3 | 4.9 |
|
| |||||||||
| Adherence (PDC), mean (during 180 days after the index discharge) | |||||||||
| ACEI/ARB | 0.81 | 0.97 | 0.96 | 0.96 | 0.45 | 0.94 | 0.46 | 0.46 | 0.45 |
| Beta-blocker | 0.86 | 0.97 | 0.96 | 0.53 | 0.97 | 0.53 | 0.95 | 0.52 | 0.48 |
| Statin | 0.85 | 0.97 | 0.52 | 0.95 | 0.96 | 0.51 | 0.51 | 0.94 | 0.46 |
|
| |||||||||
| Follow-up days, mean | 347 | 351 | 347 | 352 | 344 | 345 | 344 | 347 | 335 |
Values are percentages if not otherwise stated.
ACEI/ARB = angiotensin converting enzyme inhibitors/angiotensin II receptor blocker; AMI = acute myocardial infarction; CABG = coronary artery bypass surgery; CHF = congestive heart failure; CKD = chronic kidney disease; COPD = chronic obstructive pulmonary disease; IHD = ischemic heart disease; NSTEMI = non-ST-elevation myocardial infarction; PDC = proportion of days covered; PCI = percutaneous coronary interventions; PVD = peripheral vascular disease; TIA = transient ischemic attack; PDC = proportion of days covered.
*
Average household income at Census block groups of residence among residents who were 65 years and older