Statin use following hospitalization among Medicare beneficiaries with a secondary discharge diagnosis of acute myocardial infarction

Background: patients with coronary heart disease are recommended to use statins following hospital discharge. acute myocardial infarction (ami) is a common complication of hospitalization,but the use of statins following discharge among patients who were not initially hospitalized for ami has not been assessed adequately.methods and results: using the medicare 5% national random sample,we determined statin use among beneficiaries who were hospitalized and who had a secondary discharge diagnosis of ami and among beneficiaries who had a primary discharge diagnosis of ami,coronary artery bypass grafting,or percutaneous coronary intervention in 2007-2009. statin use was defined by a pharmacy (medicare part d) claim within 90 days following discharge. of 8175 medicare beneficiaries who did not take statins prior to hospitalization,31.2% with ami as a secondary discharge diagnosis,60.5% with ami as the primary discharge diagnosis,67.6% with coronary artery bypass grafting,and 63.9% with a percutaneous coronary intervention initiated statins. after multivariable adjustment,the risk ratio for statin initiation comparing beneficiaries with a secondary versus primary discharge diagnosis of ami was 0.59 (95% ci 0.54 to 0.65). among 5468 medicare beneficiaries taking statins prior to hospitalization,statin use following discharge was lower for those with ami as a secondary discharge diagnosis (71.8%) compared with their counterparts with ami,coronary artery bypass grafting,and percutaneous coronary intervention (84.1%,83.8%,and 87.3%,respectively) as the primary discharge diagnosis.conclusion: medicare beneficiaries with a secondary hospital discharge diagnosis of ami were less likely to fill statins compared with those with other coronary heart disease events. © 2015 the authors. published on behalf of the american heart association,inc.,by wiley blackwell.