DISCUSSION
OCA, NSTEMI, CAD, infarct, dyslipidemia
DIABETES MELLITUS, HYPERTENSION, INFARCT, CAD, DYSLIPIDEMIA
In this study out of 126 patients, 32.50% were NSTEMI with occluded coronary arteries while 67.5% were NSTEMI with non-occluded coronary arteries.In our study, 32.50% of NSTEMI patients had occluded coronary arteries which were similar to previously conducted studies.There was male predominance (59.5%) in our study presenting with NSTEMI. Also, the majority of the patients were male in NSTEMI with the occluded coronary artery (61% vs 39%). Men have a 2.4-fold overall risk for NSTEMI compared with women.Studies have shown that the south Asian population had a higher rate of MI at a younger age (mean age 53 years) compared to the western population explained by multiple risk factors at ages<60 years.Hypertension, diabetes mellitus, smoking and dyslipidemia are the major risk factors for NSTEMI. In our study, a family history of CAD was found to be statistically significant. Family history has been emphasized as a major nonmodifiable risk factor by the National Cholesterol Education Program Adult Treatment Panel (NCEP-ATP) III guidelines.In our study, NSTEMI patients with occluded coronary arteries presented earlier to the hospital in comparison to non-occluded coronary artery patients. However, there was still a delay in the presentation (>24 hours). This delay in a presentation can lead to delayed revascularization in an occluded artery which can lead to both early and long-term adverse outcomes. The Occluded Artery Trial (OAT), showed no benefit to revascularization for patients with an occluded infarct artery 24 hours after symptom onset.There were some limitations of our study. Our study population was small and hence it was difficult to achieve statistical significance for the differences in clinical outcomes between NSTEMI patients with OCA and NOCA. Our study was also single-centred and hence the results obtained may not be generalized to other populations. Follow up study was not done in our study as a result long-term effect of revascularization could not be ascertained so a study with long-term follow-up is required.