Association of invasive treatment and lower mortality of patients ≥ 80 years 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.