Nonstandard Abbreviations and Acronyms ACCI age‐adjusted Charlson comorbidity index LASSO least absolute shrinkage and selection operator Clinical Perspective • This study introduces a novel nomogram incorporating the age‐adjusted Charlson comorbidity index to predict in‐hospital death in older patients with acute myocardial infarction. It identifies key risk factors including renal function, arrhythmias, and multimorbidity, enhancing the predictive accuracy of patient outcomes.