This study aimed to evaluate clinical outcomes in octogenarian patients with acute myocardial infarction (AMI) treated by primary angioplasty. We used our clinical database consisting of all patients treated using primary angioplasty (< or = 12 hours) for acute ST elevation myocardial infarction excluding patients with cardiogenic shock. The clinical and angiographic results of non-shock patients, distinguished according to age < 80 years and > or = 80 years, was characterized by higher 30-day mortality among the elderly compared to younger patients (12% versus 3.3%) and overall major cardiac events (17.5% versus 7.4%). Thus, primary angioplasty in the octogenarian patients, albeit feasible and relatively safe, is associated with 30-days death rates that are higher in octogenarian patients as compared to younger patients.