Gudnadottir GS, et al. - Among multimorbid older people with ST-elevation myocardial infarction (STEMI) and complex health requirements, who registered between 2006 and 2013 in the SWEDEHEART registry, researchers assessed one-year outcomes between those managed invasively (n=1,089; examined with coronary angiography ≤14 days) and those managed non-invasively (n=570); mean age was 79 years and 83 years in the two groups, respectively. A composite of all-cause death, admission due to new acute coronary syndrome, stroke or transient ischemic attack was the primary event. In the invasive group and in the non-invasive group, the occurrence of the primary event was noted in 31% of patients and in 55% patients, respectively, following multivariable adjustment for baseline differences between the groups, including propensity scores. The invasive group and the non-invasive group had 1-year mortality of 18% and 45%, respectively. High rates of new ischemic events and death were observed in multimorbid older people with complex health needs and STEMI. Lower event rates were observed with an invasive vs. non-invasive strategy in this cohort of older, high risk STEMI patients.