Table 1.
Patient Characteristics
| Characteristic | SAC/VAL Cohort (n=279) | ACEI/ARB Cohort (n=279) | P Value | Used for Matcha | Prematch SMD (%) | Postmatch SMD (%) |
|---|---|---|---|---|---|---|
| Age, y, mean (SD) | 68.2 (12.4) | 67.6 (12.9) | 0.400 | ✓b | −29.78 | 5.51 |
| Male, n (%) | 192 (68.8) | 188 (67.4) | 0.720 | ✓ | 14.94 | 3.02 |
| Medicare Advantage health plan, n (%) | 205 (73.5) | 205 (73.5) | ··· | ✓ | −25.68 | −0.00 |
| Geographical region, n (%) | 0.786 | ✓ | 5.20 | −5.31 | ||
| Northeast | 54 (19.4) | 45 (16.1) | 0.313 | ✓ | 6.92 | 8.36 |
| Midwest | 77 (27.6) | 82 (29.4) | 0.630 | ✓ | −23.93 | −3.85 |
| South | 129 (46.2) | 133 (47.7) | 0.726 | Ref. | 19.77 | −2.92 |
| West | 19 (6.8) | 19 (6.8) | 1.000 | ✓ | −4.46 | 0.00 |
| Duration of postindex period, days, mean (SD) | 186.9 (69.2) | 183.0 (71.2) | 0.352 | ✓b | −177.2 | 5.82 |
| Selected preindex comorbid conditions, n (%)c | ||||||
| Hypertension | 256 (91.8) | 251 (90.0) | 0.457 | 0.51 | 6.33 | |
| Dyslipidemia (including hypercholesterolemia) | 226 (81.0) | 221 (79.2) | 0.584 | ✓ | 1.29 | 4.56 |
| Ischemic heart disease (including MI) | 215 (77.1) | 200 (71.7) | 0.137 | 11.77 | 12.34 | |
| Diabetes mellitus (including complications) | 156 (55.9) | 157 (56.3) | 0.932 | ✓ | 12.54 | −0.72 |
| Atrial fibrillation | 125 (44.8) | 132 (47.3) | 0.545 | 4.56 | −5.05 | |
| Renal disease | 89 (31.9) | 93 (33.3) | 0.703 | 1.06 | −3.08 | |
| Chronic obstructive pulmonary disease | 76 (27.2) | 82 (29.4) | 0.581 | −4.08 | −4.76 | |
| Sleep apnea | 74 (26.5) | 70 (25.1) | 0.708 | ✓ | 16.22 | 3.39 |
| Anemia (including iron deficiency) | 37 (13.3) | 42 (15.1) | 0.530 | 1.44 | −5.27 | |
| Selected preindex signs and symptoms, n (%)c | ||||||
| Shortness of breath (not including sleep apnea) | 228 (81.7) | 230 (82.4) | 0.823 | ✓ | 31.47 | −1.67 |
| Altered consciousness | 103 (36.9) | 118 (42.3) | 0.188 | −0.68 | −11.10 | |
| Tachycardia | 88 (31.5) | 93 (33.3) | 0.653 | ✓ | 17.04 | −3.98 |
| Edema and fluid overload | 60 (21.5) | 72 (25.8) | 0.232 | ✓ | −5.20 | −10.32 |
| Pulmonary edema | 38 (13.6) | 36 (12.9) | 0.803 | ✓ | 11.29 | 2.23 |
| Number of preindex guideline‐recommended therapies,d n (%) | ||||||
| 0 | 7 (2.5) | 2 (0.7) | 0.097 | −8.83 | 10.16 | |
| 1 | 23 (8.2) | 28 (10.0) | 0.447 | −41.19 | −5.08 | |
| 2 | 92 (33.0) | 98 (35.1) | 0.591 | −28.14 | −4.44 | |
| 3 | 109 (39.1) | 105 (37.6) | 0.730 | 35.95 | 3.15 | |
| 4 | 45 (16.1) | 42 (15.1) | 0.722 | 39.81 | 3.54 | |
| 5 | 3 (1.1) | 4 (1.4) | 0.706 | 14.42 | −4.12 | |
| Preindex CRT/ICD, n (%) | 172 (61.6) | 157 (56.3) | 0.163 | ✓ | 55.33 | 11.15 |
| Preindex HF hospitalization, n (%) | 66 (23.7) | 64 (22.9) | 0.835 | ✓b | 27.10 | 1.85 |
| Preindex all‐cause hospitalization, n (%) | 124 (44.4) | 136 (48.7) | 0.312 | 0.24 | −8.65 | |
ACEI/ARB indicates angiotensin‐converting enzyme inhibitor or angiotensin‐receptor blocker; CRT/ICD, cardiac resynchronization therapy or implantable cardioverter‐defibrillator; HF, heart failure; ref., reference; MI, myocardial infarction; SAC/VAL, sacubitril/valsartan; SMD, standardized mean difference.
In addition to the patient characteristics indicated, SAC/VAL and ACEI/ARB cohorts were matched for preindex Quan–Charlson comorbidity score (category), selected preindex comorbid conditions (ischemic heart disease [other than MI], pulmonary vascular disease, peripheral artery disease, liver disease, anxiety [including adjustment disorders with anxiety], and substance abuse/dependence [including drugs and alcohol]), preindex HF‐related outpatient pharmacotherapy (ACEI/ARB, evidence‐based beta blocker, mineralocorticoid receptor agonist, loop diuretic, thiazide diuretic, and digoxin), selected preindex other outpatient pharmacotherapy (anticoagulant, antiplatelet agent, nondihydropyridine calcium‐channel blocker, dihydropyridine calcium‐channel blocker, lipid‐altering medication, vasodilator, insulin, and noninsulin hypoglycemic agent), preindex revascularization, preindex all‐cause medical and pharmacy costs (health plan–dependent quintiles), and encounter with cardiologist in the month preindex. Each preindex outpatient pharmacotherapy was calculated as total days’ supply.
Match performed using categorical version.
Identified using ICD‐9‐CM and ICD‐10‐CM diagnosis codes.
Guideline‐recommended medical therapies included ACEI/ARB, evidence‐based beta blocker, mineralocorticoid receptor agonist, isosorbide dinitrate+hydralazine, digoxin, and ivabradine.