Association of invasive treatment and lower mortality of octogenarians with acute myocardial infarction: a propensity-matched analysis

Objective: To investigate whether invasive strategy was associated with lower mortality in Chinese patients ≥ 80 years with acute myocardial infarction (AMI). Methods: We used retrospective data from our center between 2013 and 2017. During a median of 17.4 (interquartile range: 7.3-32.3) months follow-up, 120 deaths were recorded among 514 consecutive patients ≥ 80 years with AMI. The patients were divided into two groups: invasive treatment group (IT group, n = 269) and conservative treatment group (CT group, n = 245), which were also then compared with propensity score matching. Results: High mortality was found in CT group compared with that in the IT one. Cox proportional hazard regression analysis showed that invasive treatment was associated with lower mortality of patients ≥ 80 years. Moreover, the results revealed that the patients in IT group had lower in-hospital mortality (3.35% vs. 9.39%, P = 0.005). Besides, the Kaplan-Meier analysis revealed that the mortality was significantly lower in IT group compared with that in CT group using entire and propensity-matched cohort analysis (P < 0.001, respectively). Conclusions: Our data suggested that IT appeared to be associated with lower mortality in Chinese patients ≥ 80 years with AMI, which consists with previous studies in spite of either ST elevated myocardial infarction (STEMI) or non-STEMI (NSTEMI) patients.