Objective: The advantages and disadvantages of percutaneous coronary intervention (PCI) versus conservative medical treatment (CMT) for the very elderly with acute myocardial infarction are still uncertain. To determine the major adverse cardiac events in hospital and at 6 months follow-up of PCI and CMT of acute myocardial infarction (AMI) on the very elderly patients is purpose of this study.

Patients and Methods: A descriptive study with cohort, prospective and multi centers. From June 2017 to June 2018, 275 patients (≥ 80 years old) with AMI were enrolled. All patients were divided into 2 groups included a CMT group (n=133) and a PCI group (n=142). 

Results: In-hospital mortality of the CMT group was significant higher than PCI group (18.05% vs 8.45%, p = 0.018). The cardiovascular mortality and recurrent myocardial infarction (MI) after 6months follow-up were still significant higher in CMT group than those PCI group (respectively, 15.75% vs 8.45%, p=0.002; 15.75% vs 3.45%, p=0.001). The two strategies did not differ in term of stroke and major bleeding.  

Conclusions: In treatment of AMI in the very elderly patients, PCI is superior to CMT in the reduction of in-hospital mortality and 6-month cardiovascular mortality as well as recurrent MI.