Older age is known as a negative prognostic parameter in acute myocardial infarction (AMI) patients. In this study, we aimed to explore age-associated differences in treatment protocols, in-hospital and 1-year mortality. This cohort observational study included 277 consecutive AMI patients, separated into 2 groups according to whether their age was \ge80 years or not. We found that group I patients (aged \ge80 years) had a notably lower rate of percutaneous coronary intervention (PCI) performed (P 0.0001) and a notably higher in-hospital death rate (P 0.003). The multivariate logistic regression analysis found that three variables were independent predictors of in-hospital mortality: age \ge80 years (P 0.0001), LVEF 40% (P 0.0001), and Killip class \ge3 (P 0.0001). The 1-year death rate was again significantly higher in group I patients (P 0.001) and was independently predicted by the triple-vessel coronary artery disease (P = 0.004) and an LVEF 40% at admission (P = 0.001). The 1-year readmission rate was superior in group I (P 0.01) and independently predicted by an age \ge80 years (P 0.001), and an history of congestive heart failure (P 0.0001) or permanent atrial fibrillation (P 0.001). We concluded that patients aged \ge80 benefit less often from a PCI and have higher rates of in-hospital mortality, as well as of 1-year readmission and mortality rates.