Table 4.
Baseline Patient Characteristics by MRA Dosing Through 12-month Follow-up
| Stable Sub-target or Not Treated (n=1741) | Stable Target (n=570) | Medication Initiation/Dose Increase (n=163) | Medication Discontinuation/Dose Decrease (n=114) | P Value | |
|---|---|---|---|---|---|
| Age (years) | 69 (61-77) | 63 (54-71) | 65 (56-73) | 64 (55-72) | <0.001 |
| Female | 491 (28.2) | 187 (32.8) | 47 (28.8) | 30 (26.3) | 0.180 |
| Race | <0.001 | ||||
| White | 1370 (78.7) | 383 (67.2) | 116 (71.2) | 84 (73.7) | |
| Black/ African American | 224 (12.9) | 130 (22.8) | 31 (19.0) | 25 (21.9) | |
| Other | 147 (8.4) | 57 (10.0) | 16 (9.8) | 5 (4.4) | |
| Hispanic ethnicity | 378 (21.7) | 68 (11.9) | 21 (12.9) | 7 (6.1) | <0.001 |
| Ejection fraction (%) | 33 (25-37) | 28 (20-33) | 28 (20-33) | 28 (20-33) | <0.001 |
| NYHA class | <0.001 | ||||
| I | 179 (10.5) | 57 (10.2) | 18 (11.4) | 14 (12.6) | |
| II | 1061 (62.2) | 303 (54.1) | 79 (50.0) | 43 (38.7) | |
| III | 434 (25.4) | 187 (33.4) | 58 (36.7) | 49 (44.1) | |
| IV | 32 (1.9) | 13 (2.3) | 3 (1.9) | 5 (4.5) | |
| KCCQ-os Score | 69 (49-85) | 67 (48-87) | 62 (40-84) | 64 (44-82) | 0.008 |
| Vital sign and laboratory findings | |||||
| Systolic blood pressure (mmHg) | 122 (110-132) | 118 (106-129) | 119 (106-128) | 118 (104-130) | <0.001 |
| Diastolic blood pressure (mmHg) | 72 (67-80) | 71 (64-80) | 71 (62-80) | 72 (64-80) | 0.037 |
| Heart rate (bpm) | 72 (65-80) | 73 (66-83) | 76 (68-84) | 75 (64-83) | 0.001 |
| Body mass index (kg/m2) | 29.1 (25.6-33.5) | 30.7 (26.2-35.5) | 30.6 (24.5-34.7) | 29.1 (26.4-33.8) | 0.001 |
| Hemoglobin (g/dL) * | 13.3 (12.0-14.5) | 13.3 (12.2-14.5) | 13.2 (11.7-14.1) | 13.5 (11.7-14.7) | 0.573 |
| Serum sodium (mmol/L) † | 140 (138-142) | 139 (137-141) | 139 (136-141) | 139 (137-141) | <0.001 |
| BUN (mg/dL) ‡ | 20 (15-27) | 20 (15-26) | 20 (16-28) | 23 (17-28) | 0.084 |
| eGFR (mL/min/1.73m2) § | 0.272 | ||||
| <30 | 58 (5.4) | 13 (3.4) | 4 (3.4) | 6 (6.7) | |
| 30-44 | 150 (14.0) | 37 (9.8) | 13 (10.9) | 15 (16.7) | |
| 45-59 | 250 (23.3) | 92 (24.3) | 30 (25.2) | 23 (25.6) | |
| ≥60 | 615 (57.3) | 236 (62.4) | 72 (60.5) | 46 (51.1) | |
| NT-proBNP (pg/mL) ‖ | 1880 (818-4299) | 1234 (627-3125) | 2421 (919-5680) | 1664 (635-5580) | 0.205 |
| Hemoglobin A1c (%) # | 6.4 (5.9-7.6) | 6.5 (5.8-7.9) | 6.7 (6.2-7.9) | 6.7 (5.6-7.0) | 0.651 |
| Medical history | |||||
| HF hospitalization within 12 months prior to enrollment | 532 (30.6) | 247 (43.3) | 88 (54.0) | 68 (59.6) | <0.001 |
| Coronary artery disease | 1126 (64.7) | 330 (57.9) | 96 (58.9) | 73 (64.0) | 0.022 |
| Hypertension | 1467 (84.3) | 454 (79.6) | 132 (81.0) | 89 (78.1) | 0.033 |
| Hyperlipidemia | 1399 (80.4) | 415 (72.8) | 110 (67.5) | 84 (73.7) | <0.001 |
| Diabetes mellitus | 710 (40.8) | 233 (40.9) | 65 (39.9) | 46 (40.4) | 0.996 |
| Atrial fibrillation | 613 (35.2) | 195 (34.2) | 58 (35.6) | 48 (42.1) | 0.454 |
| Chronic renal insufficiency | 316 (18.2) | 102 (17.9) | 37 (22.7) | 23 (20.2) | 0.494 |
| Asthma/ COPD | 548 (31.5) | 178 (31.2) | 43 (26.4) | 32 (28.1) | 0.516 |
| History of ventricular tachycardia/ fibrillation | 297 (17.1) | 126 (22.1) | 24 (14.7) | 35 (30.7) | <0.001 |
| Depression | 437 (25.1) | 145 (25.4) | 47 (28.8) | 26 (22.8) | 0.684 |
| Active cigarette smoking | 325 (18.7) | 122 (21.4) | 42 (25.8) | 23 (20.2) | 0.112 |
| Heart failure device therapy | |||||
| Implantable cardioverter-defibrillator | 680 (39.1) | 297 (52.1) | 64 (39.3) | 51 (44.7) | <0.001 |
| Cardiac resynchronization therapy | 94 (5.4) | 44 (7.7) | 15 (9.2) | 17 (14.9) | <0.001 |
| Social and economic characteristics | |||||
| Insurance status | <0.001 | ||||
| Private Insurance/ Managed care (HMO, PPO) | 418 (24.0) | 178 (31.2) | 50 (30.7) | 34 (29.8) | |
| Medicare | 1100 (63.2) | 279 (48.9) | 77 (47.2) | 59 (51.8) | |
| Medicaid | 133 (7.6) | 75 (13.2) | 19 (11.7) | 10 (8.8) | |
| Other | 65 (3.7) | 31 (5.4) | 12 (7.4) | 5 (4.4) | |
| Uninsured | 25 (1.4) | 7 (1.2) | 5 (3.1) | 6 (5.3) | |
| Highest level of education | 0.095 | ||||
| Less than high school | 238 (13.7) | 69 (12.1) | 13 (8.0) | 6 (5.3) | |
| High school/ GED | 567 (32.6) | 206 (36.1) | 64 (39.3) | 32 (28.1) | |
| Some college | 552 (31.7) | 168 (29.5) | 52 (31.9) | 43 (37.7) | |
| Four-year college (Bachelor’s Degree) | 213 (12.2) | 75 (13.2) | 19 (11.7) | 18 (15.8) | |
| Graduate or other professional degree | 171 (9.8) | 52 (9.1) | 15 (9.2) | 15 (13.2) | |
| Total household income | 0.522 | ||||
| <$25,000 | 552 (31.7) | 178 (31.2) | 41 (25.2) | 30 (26.3) | |
| $25,000-$49,999 | 328 (18.8) | 119 (20.9) | 32 (19.6) | 24 (21.1) | |
| $50,000-$74,999 | 198 (11.4) | 65 (11.4) | 17 (10.4) | 16 (14.0) | |
| $75,000-$99,999 | 106 (6.1) | 36 (6.3) | 13 (8.0) | 5 (4.4) | |
| $100,000-$149,999 | 100 (5.7) | 28 (4.9) | 4 (2.5) | 6 (5.3) | |
| ≥$150,000 | 38 (2.2) | 12 (2.1) | 7 (4.3) | 5 (4.4) | |
| Prefer not to answer | 419 (24.1) | 132 (23.2) | 49 (30.1) | 28 (24.6) | |
| Employment status | <0.001 | ||||
| Full-time employee (≥35 hours/week) | 222 (12.8) | 99 (17.4) | 31 (19.0) | 12 (10.5) | |
| Part-time employee (<35 hours/week) | 126 (7.2) | 31 (5.4) | 15 (9.2) | 10 (8.8) | |
| Disability for medical reasons | 366 (21.0) | 198 (34.7) | 47 (28.8) | 39 (34.2) | |
| Not employed for other reasons (e.g., retired, student, unemployed) | 1027 (59.0) | 242 (42.5) | 70 (42.9) | 53 (46.5) | |
Data represent median (quartile 1 – quartile 3) or n (%).
There were 932, 314, 110, and 74 patients with available data for stable sub-target, stable target, medication initiation/dose increase, and medication discontinuation/dose decrease, respectively.
There were 1193, 429, 129, and 96 patients with available data for stable sub-target, stable target, medication initiation/dose increase, and medication discontinuation/dose decrease, respectively.
There were 1163, 413, 124, and 92 patients with available data for stable sub-target, stable target, medication initiation/dose increase, and medication discontinuation/dose decrease, respectively.
There were 1073, 378, 119, and 90 patients with available data for stable sub-target, stable target, medication initiation/dose increase, and medication discontinuation/dose decrease, respectively.
There were 159, 72, 26, and 20 patients with available data for stable sub-target, stable target, medication initiation/dose increase, and medication discontinuation/dose decrease, respectively.
There were 371, 118, 36, and 18 patients with available data for stable sub-target, stable target, medication initiation/dose increase, and medication discontinuation/dose decrease, respectively.
BMI, body mass index; bpm, beats per minute; BUN, blood urea nitrogen; COPD, chronic obstructive pulmonary disease; eGFR, estimated glomerular filtration rate; GED, general equivalency diploma; HF, heart failure; HMO, health maintenance organization; KCCQ-os, Kansas City Cardiomyopathy Questionnaire overall summary score; NT-proBNP, N-terminal pro-B-type natriuretic peptide; NYHA, New York Heart Association; PPO, preferred provider organization; PRO, patient-reported outcome.