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Background Little is known regarding primary percutaneous coronary intervention (pPCI) for ST-segment elevation myocardial infarction (STEMI) in the elderly. Methods Data on 319 octogenarians, 641 septuagenarians, and 2451 younger patients was collected from an ongoing prospective registry of patients treated with pPCI for STEMI at two Mediterranean-area medical centers in 2009-2017. Results More octogenarian patients were female (40.8 vs. 31.9 septuagenarians and 26.5% under 70 y, p less then 0.01), had hypertension (79.5 vs. 69.5 and