Table 1:
Baseline Characteristics of Patients based on Beta-Blocker and ACEi/ARB Exposure after HFrEF Hospitalization, 2008–2015
| Beta-Blocker Exposure N / Mean (%/SD) |
ACEi/ARB/ARNI Exposure N / Mean (%/SD) |
|||||
|---|---|---|---|---|---|---|
| No Exposure (0 PDC) | Some Exposure (1–80 PDC) | High Exposure (80+ PDC) | No Exposure (0 PDC) | Some Exposure (1–80 PDC) | High Exposure (80+ PDC) | |
| N | 82183 (27.8) | 104898 (35.5) | 108413 (36.7) | 113102 (38.3) | 101844 (34.5) | 80548 (27.3) |
| Demographic Characteristics | ||||||
| Mean Age | 82.0 (8.3) | 79.6 (8.0) | 79.5 (8.0) | 81.8 (8.2) | 79.3 (8.0) | 79.2 (8.0) |
| Age Category | ||||||
| 66–74 | 17718 (21.6) | 32042 (30.5) | 33627 (31.0) | 25133 (22.2) | 32372 (31.8) | 25882 (32.1) |
| 75–84 | 30031 (36.5) | 41546 (39.6) | 42976 (39.6) | 42175 (37.3) | 40499 (39.8) | 31879 (39.6) |
| 85+ | 34434 (41.9) | 31310 (29.8) | 31810 (29.3) | 45794 (40.5) | 28973 (28.4) | 22787 (28.3) |
| Sex | ||||||
| Male | 36256 (44.1) | 50269 (47.9) | 50556 (46.6) | 53678 (47.5) | 47661 (46.8) | 35742 (44.4) |
| Female | 45927 (55.9) | 54629 (52.1) | 57857 (53.4) | 59424 (52.5) | 54183 (53.2) | 44806 (55.6) |
| Race/Ethnicity | ||||||
| White | 70102 (85.3) | 84804 (80.8) | 90537 (83.5) | 97235 (86.0) | 82351 (80.9) | 65857 (81.8) |
| Black | 6384 (7.8) | 11383 (10.9) | 9230 (8.5) | 8730 (7.7) | 10707 (10.5) | 7560 (9.4) |
| Hispanic | 3650 (4.4) | 5833 (5.6) | 5532 (5.1) | 4457 (3.9) | 5817 (5.7) | 4741 (5.9) |
| Other | 2047 (2.5) | 2878 (2.7) | 3114 (2.9) | 2680 (2.4) | 2969 (2.9) | 2390 (3.0) |
| Socioeconomic Characteristics | ||||||
| Dual Eligibility | 29115 (35.4) | 35894 (34.2) | 36406 (33.6) | 37550 (33.2) | 35314 (34.7) | 28551 (35.4) |
| % Bachelor’s Degree* | 26.8 (15.7) | 26.7 (15.6) | 27.2 (15.7) | 27.3 (15.7) | 26.5 (15.5) | 27.0 (15.7) |
| % below Federal Poverty Line* | 15.7 (9.1) | 16.0 (9.5) | 15.5 (9.2) | 15.4 (9.1) | 16.1 (9.4) | 15.8 (9.4) |
| Geography | ||||||
| Midwest | 20776 (25.3) | 26668 (25.4) | 30007 (27.7) | 29499 (26.1) | 26157 (25.7) | 21795 (27.1) |
| Northeast | 17218 (21.0) | 21267 (20.3) | 24174 (22.3) | 25311 (22.4) | 19859 (19.5) | 17489 (21.7) |
| South | 33103 (40.3) | 43194 (41.2) | 40469 (37.3) | 44229 (39.1) | 41973 (41.2) | 30564 (37.9) |
| West | 11086 (13.5) | 13769 (13.1) | 13763 (12.7) | 14063 (12.4) | 13855 (13.6) | 10700 (13.3) |
| Medical Comorbidities † | ||||||
| ≤ 3 Elixhauser Comorbidities | 35647 (43.4) | 48978 (46.7) | 55781 (51.5) | 45526 (40.3) | 50124 (49.2) | 44756 (55.6) |
| ≥ 4 Elixhauser Comorbidities | 46536 (56.6) | 55920 (53.3) | 52632 (48.5) | 67576 (59.7) | 51720 (50.8) | 35792 (44.4) |
| Frailty Score | 0.22 (0.07) | 0.21 (0.06) | 0.20 (0.06) | 0.22 (0.07) | 0.21 (0.06) | 0.20 (0.06) |
| Implantable Cardiac Defibrillator | 8163 (9.9) | 15914 (15.2) | 15404 (14.2) | 14234 (12.6) | 14801 (14.5) | 10446 (13.0) |
| Index Admission Comorbidities ‡ | ||||||
| Hypotension | 6265 (7.6) | 7150 (6.8) | 7462 (6.9) | 9546 (8.4) | 6556 (6.4) | 4775 (5.9) |
| Bradycardia | 4394 (5.3) | 5265 (5.0) | 5848 (5.4) | 5727 (5.1) | 5362 (5.3) | 4418 (5.5) |
| Acute Kidney Injury | 16523 (20.1) | 20513 (19.6) | 20696 (19.1) | 29225 (25.8) | 17570 (17.3) | 10937 (13.6) |
| Medication Use Prior to Admission § | ||||||
| 0 PDC | 62825 (76.4) | 41765 (39.8) | 37210 (34.3) | 83582(73.9) | 41232 (40.5) | 24240 (30.1) |
| 1–79 PDC | 15077 (18.3) | 48813 (46.5) | 47527 (43.8) | 27084 (23.9) | 55881 (54.9) | 51246 (63.6) |
| 80+ PDC | 4281 (5.2) | 14320 (13.7) | 23676 (21.8) | 2436 (2.2) | 4731 (4.6) | 5062 (6.3) |
| Total number of Drugs at Discharge | 4.0 (3.6) | 5.5 (3.4) | 6.9 (2.9) | 4.5 (3.6) | 5.8 (3.3) | 6.9 (2.8) |
| All-Cause Hospitalizations in Year Prior | ||||||
| 0 Hospitalizations | 36145 (44.0) | 48573 (46.3) | 56402 (52.0) | 48079 (42.5) | 49432 (48.5) | 43609 (54.1) |
| 1–2 Hospitalizations | 21562 (26.2) | 26872 (25.6) | 26715 (24.6) | 29832 (26.4) | 25765 (25.3) | 19552 (24.3) |
| 3+ Hospitalizations | 24476 (29.8) | 29453 (28.1) | 25296 (23.3) | 35191 (31.1) | 26647 (26.2) | 17387 (21.6) |
ACEi is angiotensin-converting enzyme inhibitors; ARB is angiotensin II receptor blockers; ARNI is angiotensin receptor-neprilysin inhibitor; MRA is mineralocorticoid receptor antagonists; PDC is percentage of days covered
*
ZCTA-level characteristics derived from linking beneficiary zip codes with US Census Data
†
Individual Elixhauser comorbidities are included in inverse probability weighting
‡
Relevant comorbidities that might impact use of neurohormonal therapy
§
Beta-blocker use prior to admission for beta blocker exposure group, ACEi/ARB/ARNI use prior to admission for ACEi/ARB/ARNI exposure group.