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1. Abstract 1.1. Objective: Recent data has suggested an increased risk for patients with raised troponin,but prognosis of older patients with non-obstructive Coronary Artery Disease (CAD) is still unknown. 1.2. Methods : A retrospective cohort analysis was performed for all in-patients with raised troponin T (January 2010 to December 2011, n=1351), 858 above the age of 65 were studied. Of these, 513 had angiography and they were stratified according to their coronary arteries anatomy into older obstructive CAD (≥ 50% stenosis) (OO- CAD, 448, 87.3%) and older non-obstructive (1.3. Results: The mean age was similar between both older groups (77.9 ± 6.95 Vs.76.9 ± 7.02, P=0.236). The one-year MACCE rate was similar in both the ONO-CAD and OO-CAD group (one-year MACCE: RR [95% CI]=1.01[0.61-1.66], P=0.95). This was driven by the acute coronary syndrome patients who had unplanned revascularization and stroke. The one-year mortality was equal in ONO-CAD and OO-CAD group with a RR [95% CI]=1.48[0.81-2.7], P=0.19. This was similar to the total patient groups mortality at one- year with a RR [95% CI]= 0.93 [0.53-1.64], P=0.8. 1.4. Conclusion: Older patients with a raised troponin and non-obstructive CAD are at equivalent MACCE & mortality risk at one year to those with obstructive CAD.