(HealthDay News) — For patients with acute myocardial infarction, enrollment in Part D by hospital discharge is not associated with improved outcomes, according to a study published in Circulation: Cardiovascular Quality and Outcomes.

Abhinav Goyal, MD, from the Emory University School of Medicine in Atlanta, and colleagues describe trends in Medicare Part D enrollment in 59 149 Medicare beneficiaries discharged after acute myocardial infarction (MI). After adjustment for patient and hospital factors, the researchers compared 30-day and 1-year outcomes (all-cause death, all-cause readmissions, and major adverse cardiac events) among Part D enrollees (49.5%) and non-enrollees.

The researchers found that enrollees more often had all-cause 30-day death (4.0% vs 3.3%), but after multivariable adjustment this association was not statistically significant (adjusted hazard ratio [HR]=1.06; 95% CI, 0.97-1.17). 

The unadjusted risks for 30-day all-cause readmission or major cardiac events, and for 1-year mortality, all-cause readmission, or major adverse cardiac events, were also increased for enrollees, but after multivariable adjustment these correlations were attenuated. 

Among Part D enrollees, secondary prevention medication adherence remained low at 1 year post-discharge.

“Only half of Medicare-insured patients with acute MI were enrolled in Part D by hospital discharge, and their 30-day and 1-year adjusted outcomes did not differ substantially from non-enrollees,” the researchers wrote. “There remain opportunities for improvement in medication adherence among patients with prescription drug coverage.”


  1. Goyal A, de Lemos JA, Peng SA, et al. Association of Patient Enrollment in Medicare Part D With Outcomes After Acute Myocardial Infarction. Circ Cardiovasc Qual Outcomes. 2015;doi:10.1161/CIRCOUTCOMES.115.001650.