title: Frequency and distribution of angiographically occluded coronary artery and in-hospital outcome of patients with Non ST elevation myocardial infarction.
abstract: OBJECTIVE
  To calculate the frequency and distribution of occluded coronary artery in patients with recent non-ST elevation myocardial infarction undergoing coronary angiography, and to compare major adverse cardiovascular events during hospitalisation with patients suffering from non-occluded coronary artery.
  
  
  METHODS
  The cross-sectional analytical study was conducted at Tabba Heart Institute, Karachi, from July2013 to March 2014. Patients of both gender and all ages undergoing angiography with non-ST elevation myocardial infarction were included. Data on patient demographics, angiographic findings and in-hospital complications was collected. Frequency of occluded vessels and their distribution was reported. Multivariate logistic regression modelling was used to examine variables associated with an occluded coronary artery in non-ST elevation myocardial infarction. Major adverse cardiovascular events were compared between patients of occluded and non-occluded coronary aetery. A two sided p-value of < 0.05 was taken as significant.
  
  
  RESULTS
  In 703 patients studied, occluded coronary artery was present in 277(39%). Predictors of having an occluded coronary artery were increasing age (57.6±11.2 vs. 60.0±10.0; p: 0.03) and low left ventricular ejection fraction (43.9±12.2 vs. 50.1±10.1; p: 0.000). There was no significant difference in terms of major adverse cardiovascular events in patients with occluded and non-occluded coronary arteries (Hazard Ratio: 0.53, 95% confidence interval: 0.14-1.98; p=0.33).
  
  
  CONCLUSIONS
  Totally occluded coronary vessel is a frequent finding in non-ST elevation myocardial infarction, highlighting the need for angiography and re-vascularisation to salvage at-risk myocardium in selected patients.
authors.affiliation: Department of Cardiology, Tabba Heart Institute, Karachi, Pakistan.
authors.forename: Saba
authors.initials: S
authors.lastname: Aijaz
authors.affiliation: Department of Cardiology, Tabba Heart Institute, Karachi, Pakistan.
authors.forename: Bashir
authors.initials: B
authors.lastname: Hanif
mesh_terms: D000368:Aged; D017023:Coronary Angiography; D054059:Coronary Occlusion / Q000150:complications* / Q000000981:diagnostic imaging* / Q000601:surgery; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009204:Myocardial Revascularization; D000072658:Non-ST Elevated Myocardial Infarction / Q000150:complications* / Q000209:etiology / Q000601:surgery; D016896:Treatment Outcome
keywords: Non-ST elevation myocardial infarction, NSTEMI, Occluded coronary artery, Major adverse cardiovascular events, MACE