Objectives To compare the in-hospital outcomes of elderly patients with acute myocardial infarction (AMI) treated by interventional or conservative protocols. Patients and Methods One handred and seventy-six consecutive patients hospitalized for AMI were involved, including 95 patients underwent emergent percutaneous coronary intervention (PCI) within 24 h after the onset of AMI and 81 patients received conservative non-invasive therapies. Clinical characteristics and in-hospital cardiac events of these two divisions were analyzed. Results In the PCI group, success rate of procedure and lesions was 98.9% and 98.5% , respectively. Procedure related complication were occurred in 6 cases(6.3% ) and no patient died during operative procedures. PCI group had a lower in-hospital mortality (11.6% vs24.7%, P<0.05) and overall cardiac events rate (24.2%vs56.8%, P<0.01) compared with conservative group. Patients complicated by pump failure at admission in PCI group had a lower mortality compared with their counterpart in conservative group(27.3% vs60.9%, P<0.05). The average hospital duration between the two groups was no significant differences. The coronary care unit (CCU) duration of the PCI group was less than that of conservative group (4±5d vs 8±5d, P < 0.05). Conclusions In elderly patients with AMI, interventional treatment can significantly decrease the in-hospital mortality and cardiac events rate compared with conservative treatment, thus gains a better short-term outcome. (J Geriatr Cardiol 2005;2(1) :24-27. ) Objectives To compare the in-hospital outcomes of elderly patients with acute myocardial infarction (AMI) treated by interventional or conservative protocols. Patients and Methods One handred and seventy-six consecutive patients hospitalized for AMI were involved, including 95 patients underwent emergent percutaneous coronary intervention (PCI) within 24 h after the onset of AMI and 81 patients received conservative non-invasive therapies. Clinical characteristics and in-hospital cardiac events of these two divisions were analyzed. Results In the PCI group, success rate of procedure and lesions was 98.9 % and 98.5%, respectively. Procedure related complication were occurred in 6 cases (6.3%) and no patient died during operative procedures. PCI group had a lower in-hospital mortality (11.6% vs 24.7%, P <0.05) and overall Patients complicated by pump failure at admission in PCI group had a lower mortality benefit (24.2% vs56.8%, P <0.01) compared with conservative group. with their counterpart in the conservative group (27.3% vs 60.9%, P <0.05). The average hospital duration between the two groups was no significant differences. The coronary care unit (CCU) duration of the PCI group was less than that of conservative group (4 ± 5d vs 8 ± 5d, P <0.05). Conclusions In elderly patients with AMI, interventional treatment can significantly decrease the in-hospital mortality and cardiac events rate compared with conservative treatment, thus gain a better short-term outcome. (J Geriatr Cardiol 2005; 2 (1): 24-27.)