Table 1.
Selected baseline characteristics in full cohort, by patient sex prematching, and by patient sex postmatching
| Patient, prescriber and contextual characteristics | Prematch | Postmatch | |||||
| Full cohort | Male | Female | ASD* | Male | Female | ASD* | |
| N=30 613 | n=14 943 | n=15 670 | n=10 486 | n=10 486 | |||
| n (%)† | %† | %† | % | %† | %† | % | |
| Predisposing patient characteristics | |||||||
| Age | |||||||
| 66–75 | 15 297 (50.0) | 58.6 | 41.7 | 34.3 | 56.3 | 46.1 | 20.6 |
| 76–85 | 11 154 (36.4) | 32.4 | 40.3 | 16.5 | 34.6 | 40.5 | 12.1 |
| 86+ | 4162 (13.6) | 9.0 | 18.0 | 26.4 | 9.1 | 13.5 | 14.0 |
| Race/ethnicity | |||||||
| White, non-Hispanic | 27 033 (88.3) | 89.8 | 86.9 | 9.3 | 90.4 | 88.0 | 7.7 |
| Black, non-Hispanic | 1837 (6.0) | 4.6 | 7.3 | 11.6 | 4.6 | 6.7 | 9.2 |
| Hispanic | 730 (2.4) | 2.1 | 2.7 | 4.0 | 2.0 | 2.5 | 3.0 |
| Asian, non-Hispanic | 644 (2.1) | 2.2 | 2.0 | 1.2 | 1.8 | 1.9 | 0.9 |
| Other | 369 (1.2) | 1.3 | 1.1 | 1.9 | 1.2 | 1.0 | 2.7 |
| Enabling patient characteristics | |||||||
| Dual Medicare/Medicaid eligibility‡ | 5578 (18.2) | 14.2 | 22.1 | 20.7 | 14.4 | 19.1 | 12.5 |
| Out-of-pocket index P2Y12 inhibitor cost§ | |||||||
| US$0 | 1259 (4.1) | 3.1 | 5.0 | 9.6 | 3.0 | 3.7 | 3.7 |
| US$0.01–US$5.00 | 5926 (19.4) | 15.8 | 22.8 | 17.8 | 16.4 | 21.0 | 11.9 |
| US$5.01–US$10.00 | 5239 (17.1) | 16.1 | 18.1 | 5.2 | 16.1 | 17.3 | 3.3 |
| US$10.01–US$30.00 | 2407 (7.9) | 8.3 | 7.5 | 3.0 | 8.5 | 7.4 | 4.0 |
| US$30.01–US$90.00 | 12 412 (40.5) | 44.3 | 36.9 | 15.2 | 44.7 | 39.8 | 9.9 |
| >US$90.00 | 3370 (11.0) | 12.3 | 9.8 | 8.2 | 11.3 | 10.8 | 1.8 |
| Patient-perceived need | |||||||
| Pre-AMI conditions¶ | |||||||
| Charlson Comorbidity Index | |||||||
| 0 | 11 365 (37.1) | 39.1 | 35.3 | 7.8 | 37.8 | 41.0 | 6.6 |
| 1–2 | 12 358 (40.4) | 38.4 | 42.2 | 7.7 | 40.6 | 42.2 | 3.1 |
| 3–4 | 4721 (15.4) | 15.3 | 15.5 | 0.7 | 15.3 | 12.3 | 8.7 |
| 5–7 | 1678 (5.5) | 5.5 | 5.4 | 0.3 | 4.9 | 3.7 | 6.4 |
| 8+ | 491 (1.6) | 1.7 | 1.5 | 1.3 | 1.3 | 0.9 | 4.2 |
| Depression | 3417 (11.2) | 7.6 | 14.5 | 22.0 | 7.6 | 12.9 | 17.4 |
| Dementia/Alzheimer’s** | 1750 (5.7) | 4.4 | 7.0 | 11.5 | 4.0 | 4.4 | 2.0 |
| Pre-AMI medications†† | |||||||
| Chronic medications‡‡ | |||||||
| 0 | 3493 (11.4) | 14.8 | 8.2 | 20.6 | 13.5 | 9.9 | 11.4 |
| 1–3 | 10 112 (33.0) | 36.5 | 29.7 | 14.5 | 35.9 | 34.1 | 3.9 |
| 4–6 | 9479 (31.0) | 28.9 | 32.9 | 8.5 | 30.9 | 33.4 | 5.4 |
| 7–9 | 4889 (16.0) | 13.4 | 18.4 | 13.7 | 13.8 | 15.6 | 5.3 |
| 10+ | 2640 (8.6) | 6.4 | 10.8 | 15.8 | 5.9 | 7.1 | 4.7 |
| Post-AMI secondary prevention medications§§ | |||||||
| Statin | |||||||
| None | 4416 (14.4) | 14.0 | 14.8 | 2.1 | 12.9 | 13.0 | 0.4 |
| Filled prescription | 22 967 (75.0) | 74.6 | 75.4 | 1.7 | 76.2 | 77.8 | 3.9 |
| Remaining pre-AMI supply | 3230 (10.6) | 11.3 | 9.8 | 4.9 | 10.9 | 9.2 | 5.9 |
| ACE inhibitor or ARB | |||||||
| None | 8002 (26.1) | 27.6 | 24.8 | 6.3 | 26.0 | 24.5 | 3.5 |
| Filled prescription | 18 315 (59.8) | 58.3 | 61.3 | 6.2 | 59.4 | 62.0 | 5.2 |
| Remaining pre-AMI supply | 4296 (14.0) | 14.2 | 13.9 | 0.7 | 14.5 | 13.5 | 2.9 |
| Beta-blocker | |||||||
| None | 3042 (9.9) | 10.9 | 9.0 | 6.2 | 10.0 | 8.6 | 4.8 |
| Filled prescription | 24 992 (81.6) | 80.5 | 82.7 | 5.7 | 81.3 | 83.3 | 5.1 |
| Remaining pre-AMI supply | 2579 (8.4) | 8.6 | 8.3 | 1.3 | 8.6 | 8.1 | 2.0 |
| Early post-AMI follow-up with providers§§ | |||||||
| None | 2783 (9.1) | 9.8 | 8.4 | 4.7 | 9.3 | 8.4 | 3.3 |
| Primary care provider¶¶ only | 7539 (24.6) | 22.7 | 26.5 | 8.9 | 23.4 | 24.9 | 3.4 |
| Cardiologist only | 6937 (22.7) | 25.5 | 20.0 | 13.1 | 23.8 | 22.0 | 4.3 |
| Both | 13 354 (43.6) | 42.1 | 45.1 | 6.0 | 43.5 | 44.8 | 2.7 |
| Prescriber-perceived need | |||||||
| Pre-AMI conditions¶ | |||||||
| Diabetes | 9942 (32.5) | 31.6 | 33.3 | 3.6 | 31.8 | 30.0 | 3.8 |
| Heart failure | 3798 (12.4) | 11.0 | 13.8 | 8.4 | 10.5 | 8.9 | 5.3 |
| Coronary artery disease | 9609 (31.4) | 34.7 | 28.2 | 13.9 | 33.3 | 24.4 | 19.6 |
| Cerebrovascular disease | 1160 (3.8) | 3.6 | 3.9 | 1.5 | 3.4 | 3.0 | 2.5 |
| Peripheral vascular disease | 3746 (12.2) | 11.2 | 13.2 | 5.9 | 10.8 | 10.9 | 0.3 |
| Cancer | 3563 (11.6) | 15.1 | 8.3 | 21.3 | 14.8 | 7.4 | 23.8 |
| Previous venous thromboembolism | 1982 (6.5) | 6.3 | 6.7 | 1.8 | 5.9 | 5.7 | 1.0 |
| Atrial fibrillation | 2288 (7.5) | 7.3 | 7.6 | 1.0 | 6.2 | 5.1 | 4.7 |
| History of bleeding event | 4649 (15.2) | 16.0 | 14.4 | 4.5 | 15.3 | 12.4 | 8.6 |
| Pre-AMI medications†† | |||||||
| Statin | 13 021 (42.5) | 43.3 | 41.8 | 2.9 | 43.7 | 39.9 | 7.6 |
| ACE inhibitor or ARB | 14 967 (48.9) | 45.3 | 52.3 | 14.2 | 46.2 | 50.0 | 7.8 |
| Beta-blocker | 12 805 (41.8) | 39.1 | 44.4 | 10.8 | 39.3 | 41.2 | 3.9 |
| Anticoagulant | 2267 (7.4) | 7.6 | 7.2 | 1.8 | 6.4 | 5.1 | 5.7 |
| Index AMI hospitalisation characteristics | |||||||
| AMI intervention strategy*** | |||||||
| PCI with drug-eluting stent | 14 554 (47.5) | 50.0 | 45.2 | 9.5 | 53.7 | 47.9 | 11.5 |
| PCI with bare-metal stent | 6630 (21.7) | 22.9 | 20.5 | 5.9 | 22.2 | 22.0 | 0.4 |
| Other PCI | 1862 (6.1) | 7.0 | 5.3 | 7.1 | 7.0 | 5.7 | 5.1 |
| Coronary artery bypass surgery | 1001 (3.3) | 4.4 | 2.2 | 12.6 | 1.7 | 1.7 | 0.3 |
| Medical management or fibrinolytics | 6566 (21.4) | 15.8 | 26.9 | 27.4 | 15.4 | 22.6 | 18.3 |
| Heart failure | 8126 (26.5) | 23.9 | 29.1 | 11.8 | 24.0 | 22.7 | 2.9 |
| Bleeding event | 1963 (6.4) | 6.9 | 5.9 | 3.9 | 6.0 | 4.5 | 6.8 |
| Acute kidney injury | 3227 (10.5) | 10.9 | 10.2 | 2.1 | 10.5 | 7.4 | 10.8 |
| Post-AMI medications§§ | |||||||
| Index P2Y12 inhibitor product | |||||||
| Brand-name clopidogrel | 22 182 (72.5) | 70.7 | 74.1 | 7.6 | 72.8 | 74.3 | 3.3 |
| Generic clopidogrel | 6450 (21.1) | 21.0 | 21.1 | 0.1 | 20.8 | 20.7 | 0.1 |
| Brand-name prasugrel | 1470 (4.8) | 6.4 | 3.3 | 14.4 | 4.7 | 3.5 | 6.4 |
| Brand-name ticagrelor | 511 (1.7) | 1.8 | 1.5 | 2.7 | 1.6 | 1.5 | 1.0 |
| Proton pump inhibitor | |||||||
| None | 23 730 (77.5) | 80.7 | 74.5 | 14.8 | 80.7 | 77.3 | 8.4 |
| Omeprazole/esomeprazole | 3756 (12.3) | 10.2 | 14.2 | 12.3 | 10.2 | 12.7 | 7.8 |
| Lansoprazole/dexlansoprazole | 441 (1.4) | 1.3 | 1.6 | 2.2 | 1.1 | 1.0 | 1.7 |
| Pantoprazole/rabeprazole | 2686 (8.8) | 7.8 | 9.7 | 6.6 | 7.9 | 9.0 | 3.9 |
| Prescriber managing post-AMI medications††† | |||||||
| Male | 23 601 (77.1) | 78.5 | 75.7 | 6.6 | 78.6 | 75.6 | 7.2 |
| Younger (born in/after 1975) | 3651 (11.9) | 12.0 | 11.9 | 0.3 | 12.2 | 11.6 | 1.7 |
| Cardiologist | 13 803 (45.1) | 48.8 | 41.6 | 14.4 | 48.4 | 44.6 | 7.7 |
* ASD ≥10% considered significant difference between male and female patients.
†Column percentages.
‡Medicare beneficiaries dually enrolled with full Medicaid benefits at any point in 12 calendar months before through one calendar month after index AMI hospitalisation.
§Standardised to 30-day supply and adjusted for inflation to 2015 US$.
¶Measured 12 months pre-AMI admission date.
**Medicare Chronic Conditions Data Warehouse definition.
††Measured 6 months pre-AMI admission date.
‡‡≥2 prescription fills on separate dates for unique fourth-level ATC code.
§§Measured through 30 days post-AMI discharge date.
¶¶Primary care physician, physician assistant or nurse practitioner.
***Measured during index AMI hospitalisation; includes coronary revascularisation procedures through 30 days post-AMI discharge date.
†††Prescriber of most cardiovascular medications for patient during 30 days post-AMI.
AMI, acute myocardial infarction; ARB, angiotensin II receptor blocker; ASD, absolute standardised difference; ATC, Anatomical Therapeutic Chemical Classification System; PCI, percutaneous coronary intervention.;