Table 1

Characteristics of the study population at baseline

VariablesWhole cohort (N = 146)High OPP (N = 72)Low OPP (N = 74)P-value
Age—years61.3 ± 13.559.2 ± 12.963.3 ± 13.80.065
Female sex—no. (%)32 (22%)17 (24%)15 (20%)0.626
Weight—kg74.2 ± 19.275.1 ± 21.573.4 ± 16,80.589
Height—m1.70 ± 0.111.69 ± 0.121.70 ± 0.900.643
BMI—kg/m226.2 ± 11.727.2 ± 16.125.1 ± 4.70.291
NYHA class I–II—no. (%)9 (6%)7 (12%)2 (3%)0.019
Advanced decompensated heart failure—no. (%)128 (88%)58 (81%)70 (95%)0.012
Smoking habit—no. (%)79 (54%)35 (49%)44 (61%)0.180
Arterial hypertension—no. (%)60 (41%)27 (38%)33 (45%)0.346
Diabetes mellitus—no. (%)47 (32%)26 (36%)21 (28%)0.317
Dyslipidaemia—no. (%)56 (38%)24 (33%)32 (44%)0.194
COPD—no. (%)25 (17%)13 (18%)12 (16%)0.797
Chronic kidney disease—no. (%)52 (36%)23 (32%)29 (39%)0.361
Prior PCI—no. %45 (31%)19 (26%)26 (35%)0.253
Prior CABG—no. (%)23 (16%)15 (21%)8 (11%)0.104
Atrial fibrillation—no. (%)71 (49%)27 (38%)44 (59%)0.010
SOFA score4.23 ± 2.393.3 ± 2.25.2 ± 2.2<0.001
Device therapy—no. (%)
ICDa78 (53%)31 (43%)47 (65%)0.013
CRT-D36 (25%)18 (25%)18 (24%)0.925
Haemodynamics
Systolic blood pressure—mmHg107.9 ± 17.9119.4 ± 16.296.7 ± 11.1<0.001
MAP—mmHg80.2 ± 13.289.4 ± 11.471.2 ± 7.4<0.001
Diastolic blood pressure—mmHg66.3 ± 12.474.4 ± 10.958.4 ± 8.0<0.001
Heart rate—b.p.m.86.2 ± 18.290.0 ± 19.582.6 ± 16.20.014
CVP—mmHg14.0 ± 6.111.8 ± 6.116.2 ± 5.3<0.001
Central venous oxygen saturation—%55.9 ± 12.757.6 ± 12.254.4 ± 13.10.352
OPP—mmHg66.3 ± 14.777.7 ± 11.255.1 ± 7.1<0.001
Shock index—b.p.m./mmHg0.82 ± 0.200.77 ± 0.170.87 ± 0.210.001
Proportional differential pressure—%38.2 ± 8.137.3 ± 7.739.1 ± 8.40.171
Laboratory tests
Haemoglobin—g/dL12.2 ± 2.012.5 ± 2.011.9 ± 2.00.068
Creatinine—mg/dL1.58 ± 0.861.47 ± 0.911.69 ± 0.810.121
Blood urea nitrogen—mg/dL85 ± 5772 ± 4896 ± 610.025
Serum sodium—mmol/L136 ± 6138 ± 5134 ± 6<0.001
Total bilirubin—mg/dL1.5 ± 1.21.3 ± 0.91.6 ± 1.40.071
Total bilirubin ≥ 1.2 mg/dL—no. (%)58 (40%)23 (35%)35 (48%)0.136
Alanine transaminase—IU/L128 ± 41798 ± 239157 ± 5350.430
Aspartate transaminase—IU/L85 ± 25163 ± 141106 ± 3200.348
High-sensitivity troponin T—ng/mL344 ± 1459258 ± 1346417 ± 15590.595
NT-proBNP—pg/mL6437 (IQR 8910)4981 (IQR 6193)8512 (IQR 12 200)0.002
Lactate—mmol/L1.7 ± 1.41.5 ± 0.61.9 ± 1.90.203
Hs-CRP– mg/L13.1 ± 26.16.8 ± 9.219.2 ± 34.50.010
Heart failure home medications
Furosemide—no. (%)121 (83%)56 (78%)65 (90%)0.041
Beta-blocker—no. (%)110 (75%)52 (72%)58 (81%)0.239
ACEi or ARB—no. (%)65 (44%)30 (42%)35 (48%)0.447
Sacubitril-valsartan—no. (%)16 (11%)11 (15%)5 (7%)0.105
MRA—no. (%)90 (62%)36 (50%)54 (74%)0.003
Ivabradine—no. (%)12 (8%)7 (10%)5 (7%)0.581
Baseline in-hospital medications
Furosemide dose—daily mg173 ± 145143 ± 134203 ± 1510.013
Dobutamine dose—mcg/kg/min4.2 ± 1.73.7 ± 1.24.4 ± 1.80.528
Dobutamine—no. (%)15 (10%)3 (4%)12 (16%)0.027
Non-invasive ventilation—no. (%)32 (22%)16 (22%)16 (22%)0.930
Echocardiographic data
LVEDD—mm64.3 ± 13.463.3 ± 13.065.0 ± 13.70.512
LV ejection fraction—%23.8 ± 11.424.6 ± 11.523.1 ± 11.30.436
At least moderate-to-severe mitral regurgitation—no. (%)90 (62%)41 (59%)47 (65%)0.560
TAPSE—mm14.9 ± 3.815.4 ± 3.314.4 ± 4.20.177
Right ventricular fractional area change—%25.3 ± 6.725.2 ± 4.225.3 ± 8.00.953
At least moderate-to-severe tricuspid regurgitation—no. (%)75 (56%)30 (48%)45 (63%)0.101
Estimated PASP—mmHg52.5 ± 16.153.5 ± 16.851.7 ± 15.60.567
VariablesWhole cohort (N = 146)High OPP (N = 72)Low OPP (N = 74)P-value
Age—years61.3 ± 13.559.2 ± 12.963.3 ± 13.80.065
Female sex—no. (%)32 (22%)17 (24%)15 (20%)0.626
Weight—kg74.2 ± 19.275.1 ± 21.573.4 ± 16,80.589
Height—m1.70 ± 0.111.69 ± 0.121.70 ± 0.900.643
BMI—kg/m226.2 ± 11.727.2 ± 16.125.1 ± 4.70.291
NYHA class I–II—no. (%)9 (6%)7 (12%)2 (3%)0.019
Advanced decompensated heart failure—no. (%)128 (88%)58 (81%)70 (95%)0.012
Smoking habit—no. (%)79 (54%)35 (49%)44 (61%)0.180
Arterial hypertension—no. (%)60 (41%)27 (38%)33 (45%)0.346
Diabetes mellitus—no. (%)47 (32%)26 (36%)21 (28%)0.317
Dyslipidaemia—no. (%)56 (38%)24 (33%)32 (44%)0.194
COPD—no. (%)25 (17%)13 (18%)12 (16%)0.797
Chronic kidney disease—no. (%)52 (36%)23 (32%)29 (39%)0.361
Prior PCI—no. %45 (31%)19 (26%)26 (35%)0.253
Prior CABG—no. (%)23 (16%)15 (21%)8 (11%)0.104
Atrial fibrillation—no. (%)71 (49%)27 (38%)44 (59%)0.010
SOFA score4.23 ± 2.393.3 ± 2.25.2 ± 2.2<0.001
Device therapy—no. (%)
ICDa78 (53%)31 (43%)47 (65%)0.013
CRT-D36 (25%)18 (25%)18 (24%)0.925
Haemodynamics
Systolic blood pressure—mmHg107.9 ± 17.9119.4 ± 16.296.7 ± 11.1<0.001
MAP—mmHg80.2 ± 13.289.4 ± 11.471.2 ± 7.4<0.001
Diastolic blood pressure—mmHg66.3 ± 12.474.4 ± 10.958.4 ± 8.0<0.001
Heart rate—b.p.m.86.2 ± 18.290.0 ± 19.582.6 ± 16.20.014
CVP—mmHg14.0 ± 6.111.8 ± 6.116.2 ± 5.3<0.001
Central venous oxygen saturation—%55.9 ± 12.757.6 ± 12.254.4 ± 13.10.352
OPP—mmHg66.3 ± 14.777.7 ± 11.255.1 ± 7.1<0.001
Shock index—b.p.m./mmHg0.82 ± 0.200.77 ± 0.170.87 ± 0.210.001
Proportional differential pressure—%38.2 ± 8.137.3 ± 7.739.1 ± 8.40.171
Laboratory tests
Haemoglobin—g/dL12.2 ± 2.012.5 ± 2.011.9 ± 2.00.068
Creatinine—mg/dL1.58 ± 0.861.47 ± 0.911.69 ± 0.810.121
Blood urea nitrogen—mg/dL85 ± 5772 ± 4896 ± 610.025
Serum sodium—mmol/L136 ± 6138 ± 5134 ± 6<0.001
Total bilirubin—mg/dL1.5 ± 1.21.3 ± 0.91.6 ± 1.40.071
Total bilirubin ≥ 1.2 mg/dL—no. (%)58 (40%)23 (35%)35 (48%)0.136
Alanine transaminase—IU/L128 ± 41798 ± 239157 ± 5350.430
Aspartate transaminase—IU/L85 ± 25163 ± 141106 ± 3200.348
High-sensitivity troponin T—ng/mL344 ± 1459258 ± 1346417 ± 15590.595
NT-proBNP—pg/mL6437 (IQR 8910)4981 (IQR 6193)8512 (IQR 12 200)0.002
Lactate—mmol/L1.7 ± 1.41.5 ± 0.61.9 ± 1.90.203
Hs-CRP– mg/L13.1 ± 26.16.8 ± 9.219.2 ± 34.50.010
Heart failure home medications
Furosemide—no. (%)121 (83%)56 (78%)65 (90%)0.041
Beta-blocker—no. (%)110 (75%)52 (72%)58 (81%)0.239
ACEi or ARB—no. (%)65 (44%)30 (42%)35 (48%)0.447
Sacubitril-valsartan—no. (%)16 (11%)11 (15%)5 (7%)0.105
MRA—no. (%)90 (62%)36 (50%)54 (74%)0.003
Ivabradine—no. (%)12 (8%)7 (10%)5 (7%)0.581
Baseline in-hospital medications
Furosemide dose—daily mg173 ± 145143 ± 134203 ± 1510.013
Dobutamine dose—mcg/kg/min4.2 ± 1.73.7 ± 1.24.4 ± 1.80.528
Dobutamine—no. (%)15 (10%)3 (4%)12 (16%)0.027
Non-invasive ventilation—no. (%)32 (22%)16 (22%)16 (22%)0.930
Echocardiographic data
LVEDD—mm64.3 ± 13.463.3 ± 13.065.0 ± 13.70.512
LV ejection fraction—%23.8 ± 11.424.6 ± 11.523.1 ± 11.30.436
At least moderate-to-severe mitral regurgitation—no. (%)90 (62%)41 (59%)47 (65%)0.560
TAPSE—mm14.9 ± 3.815.4 ± 3.314.4 ± 4.20.177
Right ventricular fractional area change—%25.3 ± 6.725.2 ± 4.225.3 ± 8.00.953
At least moderate-to-severe tricuspid regurgitation—no. (%)75 (56%)30 (48%)45 (63%)0.101
Estimated PASP—mmHg52.5 ± 16.153.5 ± 16.851.7 ± 15.60.567

Percentages are calculated from the known data only. Significant P-values are written in bold.

ACEi, angiotensin converting enzyme inhibitor; ARB, angiotensin receptor blocker; BMI, body mass index; CABG, coronary artery bypass graft; COPD, chronic obstructive pulmonary disease; CRT-D, cardiac resynchronization therapy with defibrillator; CVP, central venous pressure; Hs-CRP, high-sensitivity C-reactive protein; ICD, implantable cardioverter-defibrillator; IQR, interquartile range; LV, left ventricular; LVEDD, left ventricular end-diastolic diameter; MAP, mean arterial pressure; MRA, mineralocorticoid receptor antagonist; NYHA, New York Heart Association; NT-proBNP, N-terminal pro-B-type natriuretic peptide; OPP, organ perfusion pressure; PASP, pulmonary artery systolic pressure; PCI, percutaneous coronary intervention; SOFA, Sequential Organ Failure Assessment; TAPSE, tricuspid annular plane systolic excursion.

aThis category includes either an implantable cardioverter–defibrillator or cardiac resynchronization therapy with a defibrillator.

Table 1

Characteristics of the study population at baseline

VariablesWhole cohort (N = 146)High OPP (N = 72)Low OPP (N = 74)P-value
Age—years61.3 ± 13.559.2 ± 12.963.3 ± 13.80.065
Female sex—no. (%)32 (22%)17 (24%)15 (20%)0.626
Weight—kg74.2 ± 19.275.1 ± 21.573.4 ± 16,80.589
Height—m1.70 ± 0.111.69 ± 0.121.70 ± 0.900.643
BMI—kg/m226.2 ± 11.727.2 ± 16.125.1 ± 4.70.291
NYHA class I–II—no. (%)9 (6%)7 (12%)2 (3%)0.019
Advanced decompensated heart failure—no. (%)128 (88%)58 (81%)70 (95%)0.012
Smoking habit—no. (%)79 (54%)35 (49%)44 (61%)0.180
Arterial hypertension—no. (%)60 (41%)27 (38%)33 (45%)0.346
Diabetes mellitus—no. (%)47 (32%)26 (36%)21 (28%)0.317
Dyslipidaemia—no. (%)56 (38%)24 (33%)32 (44%)0.194
COPD—no. (%)25 (17%)13 (18%)12 (16%)0.797
Chronic kidney disease—no. (%)52 (36%)23 (32%)29 (39%)0.361
Prior PCI—no. %45 (31%)19 (26%)26 (35%)0.253
Prior CABG—no. (%)23 (16%)15 (21%)8 (11%)0.104
Atrial fibrillation—no. (%)71 (49%)27 (38%)44 (59%)0.010
SOFA score4.23 ± 2.393.3 ± 2.25.2 ± 2.2<0.001
Device therapy—no. (%)
ICDa78 (53%)31 (43%)47 (65%)0.013
CRT-D36 (25%)18 (25%)18 (24%)0.925
Haemodynamics
Systolic blood pressure—mmHg107.9 ± 17.9119.4 ± 16.296.7 ± 11.1<0.001
MAP—mmHg80.2 ± 13.289.4 ± 11.471.2 ± 7.4<0.001
Diastolic blood pressure—mmHg66.3 ± 12.474.4 ± 10.958.4 ± 8.0<0.001
Heart rate—b.p.m.86.2 ± 18.290.0 ± 19.582.6 ± 16.20.014
CVP—mmHg14.0 ± 6.111.8 ± 6.116.2 ± 5.3<0.001
Central venous oxygen saturation—%55.9 ± 12.757.6 ± 12.254.4 ± 13.10.352
OPP—mmHg66.3 ± 14.777.7 ± 11.255.1 ± 7.1<0.001
Shock index—b.p.m./mmHg0.82 ± 0.200.77 ± 0.170.87 ± 0.210.001
Proportional differential pressure—%38.2 ± 8.137.3 ± 7.739.1 ± 8.40.171
Laboratory tests
Haemoglobin—g/dL12.2 ± 2.012.5 ± 2.011.9 ± 2.00.068
Creatinine—mg/dL1.58 ± 0.861.47 ± 0.911.69 ± 0.810.121
Blood urea nitrogen—mg/dL85 ± 5772 ± 4896 ± 610.025
Serum sodium—mmol/L136 ± 6138 ± 5134 ± 6<0.001
Total bilirubin—mg/dL1.5 ± 1.21.3 ± 0.91.6 ± 1.40.071
Total bilirubin ≥ 1.2 mg/dL—no. (%)58 (40%)23 (35%)35 (48%)0.136
Alanine transaminase—IU/L128 ± 41798 ± 239157 ± 5350.430
Aspartate transaminase—IU/L85 ± 25163 ± 141106 ± 3200.348
High-sensitivity troponin T—ng/mL344 ± 1459258 ± 1346417 ± 15590.595
NT-proBNP—pg/mL6437 (IQR 8910)4981 (IQR 6193)8512 (IQR 12 200)0.002
Lactate—mmol/L1.7 ± 1.41.5 ± 0.61.9 ± 1.90.203
Hs-CRP– mg/L13.1 ± 26.16.8 ± 9.219.2 ± 34.50.010
Heart failure home medications
Furosemide—no. (%)121 (83%)56 (78%)65 (90%)0.041
Beta-blocker—no. (%)110 (75%)52 (72%)58 (81%)0.239
ACEi or ARB—no. (%)65 (44%)30 (42%)35 (48%)0.447
Sacubitril-valsartan—no. (%)16 (11%)11 (15%)5 (7%)0.105
MRA—no. (%)90 (62%)36 (50%)54 (74%)0.003
Ivabradine—no. (%)12 (8%)7 (10%)5 (7%)0.581
Baseline in-hospital medications
Furosemide dose—daily mg173 ± 145143 ± 134203 ± 1510.013
Dobutamine dose—mcg/kg/min4.2 ± 1.73.7 ± 1.24.4 ± 1.80.528
Dobutamine—no. (%)15 (10%)3 (4%)12 (16%)0.027
Non-invasive ventilation—no. (%)32 (22%)16 (22%)16 (22%)0.930
Echocardiographic data
LVEDD—mm64.3 ± 13.463.3 ± 13.065.0 ± 13.70.512
LV ejection fraction—%23.8 ± 11.424.6 ± 11.523.1 ± 11.30.436
At least moderate-to-severe mitral regurgitation—no. (%)90 (62%)41 (59%)47 (65%)0.560
TAPSE—mm14.9 ± 3.815.4 ± 3.314.4 ± 4.20.177
Right ventricular fractional area change—%25.3 ± 6.725.2 ± 4.225.3 ± 8.00.953
At least moderate-to-severe tricuspid regurgitation—no. (%)75 (56%)30 (48%)45 (63%)0.101
Estimated PASP—mmHg52.5 ± 16.153.5 ± 16.851.7 ± 15.60.567
VariablesWhole cohort (N = 146)High OPP (N = 72)Low OPP (N = 74)P-value
Age—years61.3 ± 13.559.2 ± 12.963.3 ± 13.80.065
Female sex—no. (%)32 (22%)17 (24%)15 (20%)0.626
Weight—kg74.2 ± 19.275.1 ± 21.573.4 ± 16,80.589
Height—m1.70 ± 0.111.69 ± 0.121.70 ± 0.900.643
BMI—kg/m226.2 ± 11.727.2 ± 16.125.1 ± 4.70.291
NYHA class I–II—no. (%)9 (6%)7 (12%)2 (3%)0.019
Advanced decompensated heart failure—no. (%)128 (88%)58 (81%)70 (95%)0.012
Smoking habit—no. (%)79 (54%)35 (49%)44 (61%)0.180
Arterial hypertension—no. (%)60 (41%)27 (38%)33 (45%)0.346
Diabetes mellitus—no. (%)47 (32%)26 (36%)21 (28%)0.317
Dyslipidaemia—no. (%)56 (38%)24 (33%)32 (44%)0.194
COPD—no. (%)25 (17%)13 (18%)12 (16%)0.797
Chronic kidney disease—no. (%)52 (36%)23 (32%)29 (39%)0.361
Prior PCI—no. %45 (31%)19 (26%)26 (35%)0.253
Prior CABG—no. (%)23 (16%)15 (21%)8 (11%)0.104
Atrial fibrillation—no. (%)71 (49%)27 (38%)44 (59%)0.010
SOFA score4.23 ± 2.393.3 ± 2.25.2 ± 2.2<0.001
Device therapy—no. (%)
ICDa78 (53%)31 (43%)47 (65%)0.013
CRT-D36 (25%)18 (25%)18 (24%)0.925
Haemodynamics
Systolic blood pressure—mmHg107.9 ± 17.9119.4 ± 16.296.7 ± 11.1<0.001
MAP—mmHg80.2 ± 13.289.4 ± 11.471.2 ± 7.4<0.001
Diastolic blood pressure—mmHg66.3 ± 12.474.4 ± 10.958.4 ± 8.0<0.001
Heart rate—b.p.m.86.2 ± 18.290.0 ± 19.582.6 ± 16.20.014
CVP—mmHg14.0 ± 6.111.8 ± 6.116.2 ± 5.3<0.001
Central venous oxygen saturation—%55.9 ± 12.757.6 ± 12.254.4 ± 13.10.352
OPP—mmHg66.3 ± 14.777.7 ± 11.255.1 ± 7.1<0.001
Shock index—b.p.m./mmHg0.82 ± 0.200.77 ± 0.170.87 ± 0.210.001
Proportional differential pressure—%38.2 ± 8.137.3 ± 7.739.1 ± 8.40.171
Laboratory tests
Haemoglobin—g/dL12.2 ± 2.012.5 ± 2.011.9 ± 2.00.068
Creatinine—mg/dL1.58 ± 0.861.47 ± 0.911.69 ± 0.810.121
Blood urea nitrogen—mg/dL85 ± 5772 ± 4896 ± 610.025
Serum sodium—mmol/L136 ± 6138 ± 5134 ± 6<0.001
Total bilirubin—mg/dL1.5 ± 1.21.3 ± 0.91.6 ± 1.40.071
Total bilirubin ≥ 1.2 mg/dL—no. (%)58 (40%)23 (35%)35 (48%)0.136
Alanine transaminase—IU/L128 ± 41798 ± 239157 ± 5350.430
Aspartate transaminase—IU/L85 ± 25163 ± 141106 ± 3200.348
High-sensitivity troponin T—ng/mL344 ± 1459258 ± 1346417 ± 15590.595
NT-proBNP—pg/mL6437 (IQR 8910)4981 (IQR 6193)8512 (IQR 12 200)0.002
Lactate—mmol/L1.7 ± 1.41.5 ± 0.61.9 ± 1.90.203
Hs-CRP– mg/L13.1 ± 26.16.8 ± 9.219.2 ± 34.50.010
Heart failure home medications
Furosemide—no. (%)121 (83%)56 (78%)65 (90%)0.041
Beta-blocker—no. (%)110 (75%)52 (72%)58 (81%)0.239
ACEi or ARB—no. (%)65 (44%)30 (42%)35 (48%)0.447
Sacubitril-valsartan—no. (%)16 (11%)11 (15%)5 (7%)0.105
MRA—no. (%)90 (62%)36 (50%)54 (74%)0.003
Ivabradine—no. (%)12 (8%)7 (10%)5 (7%)0.581
Baseline in-hospital medications
Furosemide dose—daily mg173 ± 145143 ± 134203 ± 1510.013
Dobutamine dose—mcg/kg/min4.2 ± 1.73.7 ± 1.24.4 ± 1.80.528
Dobutamine—no. (%)15 (10%)3 (4%)12 (16%)0.027
Non-invasive ventilation—no. (%)32 (22%)16 (22%)16 (22%)0.930
Echocardiographic data
LVEDD—mm64.3 ± 13.463.3 ± 13.065.0 ± 13.70.512
LV ejection fraction—%23.8 ± 11.424.6 ± 11.523.1 ± 11.30.436
At least moderate-to-severe mitral regurgitation—no. (%)90 (62%)41 (59%)47 (65%)0.560
TAPSE—mm14.9 ± 3.815.4 ± 3.314.4 ± 4.20.177
Right ventricular fractional area change—%25.3 ± 6.725.2 ± 4.225.3 ± 8.00.953
At least moderate-to-severe tricuspid regurgitation—no. (%)75 (56%)30 (48%)45 (63%)0.101
Estimated PASP—mmHg52.5 ± 16.153.5 ± 16.851.7 ± 15.60.567

Percentages are calculated from the known data only. Significant P-values are written in bold.

ACEi, angiotensin converting enzyme inhibitor; ARB, angiotensin receptor blocker; BMI, body mass index; CABG, coronary artery bypass graft; COPD, chronic obstructive pulmonary disease; CRT-D, cardiac resynchronization therapy with defibrillator; CVP, central venous pressure; Hs-CRP, high-sensitivity C-reactive protein; ICD, implantable cardioverter-defibrillator; IQR, interquartile range; LV, left ventricular; LVEDD, left ventricular end-diastolic diameter; MAP, mean arterial pressure; MRA, mineralocorticoid receptor antagonist; NYHA, New York Heart Association; NT-proBNP, N-terminal pro-B-type natriuretic peptide; OPP, organ perfusion pressure; PASP, pulmonary artery systolic pressure; PCI, percutaneous coronary intervention; SOFA, Sequential Organ Failure Assessment; TAPSE, tricuspid annular plane systolic excursion.

aThis category includes either an implantable cardioverter–defibrillator or cardiac resynchronization therapy with a defibrillator.

Close
This Feature Is Available To Subscribers Only

Sign In or Create an Account

Close

This PDF is available to Subscribers Only

View Article Abstract & Purchase Options

For full access to this pdf, sign in to an existing account, or purchase an annual subscription.

Close