Table 1.
Baseline Characteristics by New Discharge Prescription for Spironolactone in Patients with Heart Failure, Left Ventricular Ejection Fraction ≤35% and Serum Creatinine ≤2.5 mg/dL for Men and ≤2.0 mg/dL for Women, Before and After Propensity Score Matching
| Characteristic | Before Propensity Score Matching (n=6986) |
After Propensity Score Matching (n=1724) |
||||
|---|---|---|---|---|---|---|
| Spironolactone |
P value | Spironolactone |
P value | |||
| No (n=6121) | Yes (n=865) | No (n=862) | Yes (n=862) | |||
| Age (years) | 76(±10) | 75 (±11) | 0.001 | 75 (±11) | 75 (±11) | 0.517 |
| Women | 2435 (40) | 365 (42) | 0.175 | 365(42) | 364 (42) | 0.961 |
| African American | 802 (13) | 141 (16) | 0.010 | 149 (17) | 141 (16) | 0.606 |
| Admitted from nursing home | 83 (1) | 9 (1) | 0.446 | 11(1) | 9 (1) | 0.653 |
| Left ventricular ejection fraction (%) | 25 (±7) | 24 (±7) | <0.001 | 24 (±7) | 24 (±7) | 0.428 |
| Past medical history | ||||||
| Heart failure hospitalization in past 6 months | 2837 (46) | 412 (48) | 0.479 | 402 (47) | 411 (48) | 0.664 |
| Hypertension | 4009 (66) | 553 (64) | 0.365 | 566 (66) | 552 (64) | 0.480 |
| Coronary artery disease | 3622 (59) | 488 (56) | 0.123 | 507(59) | 487 (57) | 0.330 |
| Myocardial infarction | 1881 (31) | 250 (29) | 0.274 | 247 (29) | 249 (29) | 0.915 |
| Coronary revascularization | 2249 (37) | 315 (36) | 0.852 | 326 (38) | 314 (36) | 0.550 |
| Diabetes mellitus | 2334 (38) | 328 (38) | 0.904 | 338 (39) | 327 (38) | 0.586 |
| Cerebrovascular accidents | 934 (15) | 116 (13) | 0.154 | 121(14) | 116 (14) | 0.727 |
| Peripheral vascular disease | 888 (15) | 134 (16) | 0.443 | 147 (17) | 134 (16) | 0.397 |
| Atrial fibrillation | 2027 (33) | 249 (29) | 0.011 | 254 (30) | 249 (29) | 0.791 |
| Ventricular arrhythmia | 523 (9) | 80 (9) | 0.490 | 84 (10) | 80 (9) | 0.743 |
| Automated cardioverter defibrillator | 508 (8) | 88 (10) | 0.065 | 97 (11) | 88 (10) | 0.484 |
| Biventricular pacemaker | 321 (5) | 38 (4) | 0.289 | 40 (5) | 38 (4) | 0.817 |
| Chronic obstructive pulmonary disease | 1648 (27) | 223 (26) | 0.477 | 236 (27) | 222 (26) | 0.445 |
| Depression | 559 (9) | 77 (9) | 0.825 | 69 (8) | 77 (9) | 0.489 |
| Admission clinical and laboratory data | ||||||
| Dyspnea at rest | 2693 (44) | 359 (42) | 0.166 | 365(42) | 358 (42) | 0.733 |
| Dyspnea on exertion | 3851 (63) | 607 (70) | <0.001 | 623 (72) | 604 (70) | 0.312 |
| Orthopnea | 1650 (27) | 313 (36) | <0.001 | 314 (36) | 310 (36) | 0.841 |
| Paroxysmal nocturnal dyspnea | 1018 (17) | 182 (21) | 0.001 | 193 (22) | 180 (21) | 0.447 |
| Jugular venous pressure elevation | 1891(31) | 316 (37) | 0.001 | 322(37) | 314 (36) | 0.690 |
| Third heart sound | 728 (12) | 146 (17) | <0.001 | 120 (14) | 144 (17) | 0.108 |
| Pulmonary rales | 3830(63) | 579 (67) | 0.013 | 593 (69) | 577 (67) | 0.409 |
| Lower extremity edema | 3632 (59) | 580 (67) | <0.001 | 585 (68) | 577(67) | 0.681 |
| Serum brain natriuretic peptide (pg/mL)† | 1392 (999) | 1380(1045) | 0.730 | 1436 (1081) | 1380 (1047) | 0.312 |
| Serum troponin elevation* | 1156 (19) | 167 (19) | 0.768 | 161 (19) | 167 (19) | 0.713 |
| Discharge clinical and laboratory data | ||||||
| Systolic blood pressure (mmHg) | 120 (±20) | 117(±20) | <0.001 | 117(±18) | 117(±20) | 0.802 |
| Diastolic blood pressure (mmHg) | 66(±12) | 65 (±12) | 0.274 | 65(±12) | 65(±12) | 0.610 |
| Pulse (beats per minute) | 76(±13) | 76 (±13) | 0.518 | 75 (±13) | 75 (±13) | 0.960 |
| Serum creatinine (mg/dL) | 1.5 (±0.5) | 1.4 (±0.5) | <0.001 | 1.4 (±0.5) | 1.4 (±0.5) | 0.235 |
| Discharge medication | ||||||
| Angiotensin-converting enzyme inhibitors or angiotensin II receptor blockers | 4440 (73) | 715 (83) | <0.001 | 716 (83) | 712 (83) | 0.798 |
| Beta-blockers | 4314 (71) | 699 (81) | <0.001 | 692 (80) | 696 (81) | 0.808 |
| Digoxin | 2392 (39) | 420 (49) | <0.001 | 387 (45) | 417 (48) | 0.148 |
| Diuretics | 5191 (85) | 774 (90) | <0.001 | 758 (88) | 771 (89) | 0.323 |
| Hydralazine | 191 (3) | 17 (2) | 0.061 | 21 (2) | 17 (2) | 0.512 |
| Nitrates | 1556 (25) | 196 (23) | 0.079 | 189 (22) | 195 (23) | 0.728 |
| Anti-arrhythmic drugs | 1007 (17) | 130 (15) | 0.289 | 135 (16) | 129 (15) | 0.688 |
| Warfarin | 1718(28) | 272 (31) | 0.039 | 271 (31) | 271 (31) | 1.000 |
| Aspirin | 3224 (53) | 488 (56) | 0.039 | 514 (60) | 486 (56) | 0.172 |
| Statins | 2291 (37) | 363 (42) | 0.010 | 382 (44) | 361 (42) | 0.307 |
| Hospital beds (numbers)† | 375 (250) | 375 (300) | 0.572 | 375 (251) | 375 (300) | 0.736 |
| Hospital length of stay (days) | 5.7 (±5.6) | 6.2 (±4.2) | 0.009 | 6.4 (±7.2) | 6.2 (±4.2) | 0.562 |
Values are number (percentage) or mean (± standard deviation).
*
Values determined by local laboratories;
†
Values are for median (interquartile range) and p values are based on non-parametric tests comparing medians across the groups