Table 1.
Baseline characteristics of heart failure patients initiating mineralocorticoid receptor antagonist therapy, overall and by the pattern of laboratory monitoring
| Parameter | All patients | Lacking pre-initiation monitoring | Undergoing pre-initiation monitoring | Appropriate monitoring (all three pre-/ post-occasions)a |
|---|---|---|---|---|
| N | 4036 (100%) | 448 (11%) | 3588 (89%) | 934 (23%) |
| Age (years) | 78 (67–85) | 78 (69–85) | 78 (67–85) | 75 (65–83) |
| Age (categories) | ||||
| <45 years | 70 (2%) | 5 (1.1%) | 65 (1.8%) | 23 (2%) |
| 45–64 years | 727 (18%) | 73 (16%) | 654 (18%) | 212 (23%) |
| 65–75 years | 903 (22%) | 97 (22%) | 806 (23%) | 232 (25%) |
| >75 years | 2336 (58%) | 273 (61%) | 2063 (58%) | 467 (50%) |
| Women | 1824 (45%) | 225 (50%) | 1599 (45%) | 361 (39%) |
| eGFR (mL/min/1.73 m2) | ||||
| Median (IQR) | 67 (51–82) | 69 (55–82) | 67 (51–82) | 66 (51–81) |
| Missing | 383 (9%) | 383 (85%) | 0 (0%) | 0 (0%) |
| eGFR (categories) | ||||
| >60 mL/min/1.73 m2 | 2245 (56%) | — | 133 (3.7%) | 570 (61%) |
| 45–60 mL/min/1.73 m2 | 803 (20%) | — | 464 (13%) | 186 (20%) |
| 30–45 mL/min/1.73 m2 | 471 (12%) | — | 790 (22%) | 125 (13%) |
| <30 mL/min/1.73 m2 | 134 (3%) | — | 2201 (61%) | 53 (6%) |
| Potassium (mmol/L) | ||||
| Median (IQR) | 4.1 (3.6–4.2) | 3.8 (3.4–3.9) | 4.1 (3.7–4.2) | 4.0 (3.9–4.1) |
| Missing | 427 (11%) | 427 (95%) | 0 (0%) | 0 (0%) |
| Potassium (categories) | ||||
| <4 mmol/L | 1800 (45%) | — | 1783 (50%) | 523 (56%) |
| 4–5 mmol/L | 1789 (44%) | — | 1785 (50%) | 406 (43%) |
| >5 mmol/L | 20 (0%) | — | 20 (0.6%) | 5 (1%) |
| Site of first prescription | ||||
| Hospital centres | 1816 (45%) | 55 (12%) | 1761 (49%) | 580 (62%) |
| Primary health care centres | 976 (24%) | 251 (56%) | 725 (20%) | 126 (13%) |
| Other centres | 1194 (30%) | 109 (24%) | 1085 (30%) | 226 (24%) |
| Missing | 50 (1%) | 33 (7%) | 17 (0.5%) | 2 (<0%) |
| Diabetes mellitus | 1278 (32%) | 130 (29%) | 1148 (32%) | 298 (32%) |
| Myocardial infarction | 1197 (30%) | 111 (25%) | 1086 (30%) | 285 (31%) |
| Peripheral vascular disease | 551 (14%) | 58 (13%) | 493 (14%) | 132 (14%) |
| Cerebrovascular disease | 733 (18%) | 75 (17%) | 658 (18%) | 157 (17%) |
| Chronic kidney disease (diagnosis) | 215 (5%) | 14 (3%) | 201 (5.6%) | 71 (8%) |
| ACEi | 2820 (70%) | 282 (63%) | 2538 (71%) | 706 (76%) |
| ARB | 1543 (38%) | 178 (40%) | 1365 (38%) | 384 (41%) |
| Beta-blocker | 3609 (89%) | 378 (84%) | 3231 (90%) | 878 (94%) |
| Diuretics | 3882 (96%) | 417 (93%) | 3465 (97%) | 907 (97%) |
| Other antihypertensive drugs | 1553 (38%) | 165 (37%) | 1388 (39%) | 366 (39%) |
ACEi, angiotensin-converting enzyme inhibitor; ARB, angiotensin receptor blocker; MRA, mineralocorticoid receptor antagonist.
aThis group is a subset of those undergoing pre-initiation laboratory monitoring.