Full Text Available

Access Repository
Note: Clicking the button above will open the full text document at the original institutional repository in a new window.
Cover Image

Prevalence of Occlusive Myocardial Infarction (OMI) in patients diagnosed with Non-ST-Elevation Myocardial Infarction (NSTEMI) at a single private facility in Cape Town, South Africa, during 2019

Show other versions (1)

Background: ST-Elevation Myocardial Infarction (STEMI) is strongly associated with acute coronary occlusion, leading to less urgent management of Non-ST-Elevation Myocardial Infarction (NSTEMI), often perceived as partial occlusion. However, 25.5% of NSTEMIs involve total coronary occlusion, signifi...

Full description

Saved in:
Main Author: Schoeman, Elmari
Other Authors: Stassen, Willem
Format: Thesis
Language:English
English
Published: Division of Emergency Medicine 2026
Subjects:
occlusive myocardial infarction
myocardial infarction
non-ST-segment myocardial infarction
acute coronary syndrome
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1867614309466505216
access_status_str Open Access
author Schoeman, Elmari
author2 Stassen, Willem
author_browse Schoeman, Elmari
Stassen, Willem
author_facet Stassen, Willem
Schoeman, Elmari
author_sort Schoeman, Elmari
collection Thesis
description Background: ST-Elevation Myocardial Infarction (STEMI) is strongly associated with acute coronary occlusion, leading to less urgent management of Non-ST-Elevation Myocardial Infarction (NSTEMI), often perceived as partial occlusion. However, 25.5% of NSTEMIs involve total coronary occlusion, significantly impacting mortality and Major Adverse Cardiovascular Events (MACE).1 The Occlusive Myocardial Infarction (OMI) vs Non-occlusive Myocardial Infarction (NOMI) paradigm has been proposed for better identification of acute myocardial infarction (AMI).2–5 Objectives: This study investigates the prevalence of OMI among NSTEMI patients in a private Cape Town emergency centre in 2019, analysing descriptive data, serial cardiac troponin I (cTnI) results, the proportion undergoing angiography, Thrombolysis in Myocardial Infarction (TIMI) flow grades, and door-to-angiogram times. Methods: A cross-sectional, observational study was conducted using a retrospective chart review of NSTEMI patients who underwent angiography. Data were analysed using descriptive statistics, Chi-square, and Mann-Whitney U-tests. Results: Among 31 NSTEMI patients, 83.9% (n=26) had OMI (median age 65 years, IQR 25), and 88.5% were male (p<0.001). Significant second cTnI levels (median 1450 ng/L, p=0.001) and a median door-to-angiogram time of 34 hours (IQR 48) were noted. The left anterior descending artery (34.6%) was the most common culprit lesion. Conclusion: The high prevalence of OMI among NSTEMIs highlights the limitations of the current STEMI/NSTEMI classification. Improved diagnostics and timely interventions, including emergent angiography and alternative treatments like thrombolysis, could enhance patient outcomes with reduced healthcare costs in resource-limited settings. The observed disparities and challenges in meeting international guidelines for timely interventions underscore the urgency of addressing accessibility issues. Heightened mortality and MACE risk among NSTEMIs with missed coronary occlusions1,7 highlight the need for expanded research to understand OMI prevalence and implications in South Africa.
format Thesis
id oai:open.uct.ac.za:11427/42642
institution University of Cape Town (South Africa)
language English
eng
last_indexed 2026-06-10T12:49:59.891Z
license_str Not specified — see source repository
provenance_str_mv Harvested via OAI-PMH from UCTD — University of Cape Town Open Access Repository
publishDate 2026
publishDateRange 2026
publishDateSort 2026
publisher Division of Emergency Medicine
publisherStr Division of Emergency Medicine
record_format dspace
source_str UCTD — University of Cape Town Open Access Repository
spelling oai:open.uct.ac.za:11427/42642 Prevalence of Occlusive Myocardial Infarction (OMI) in patients diagnosed with Non-ST-Elevation Myocardial Infarction (NSTEMI) at a single private facility in Cape Town, South Africa, during 2019 Schoeman, Elmari Stassen, Willem D'Andrea, Ibrahim occlusive myocardial infarction myocardial infarction non-ST-segment myocardial infarction acute coronary syndrome Background: ST-Elevation Myocardial Infarction (STEMI) is strongly associated with acute coronary occlusion, leading to less urgent management of Non-ST-Elevation Myocardial Infarction (NSTEMI), often perceived as partial occlusion. However, 25.5% of NSTEMIs involve total coronary occlusion, significantly impacting mortality and Major Adverse Cardiovascular Events (MACE).1 The Occlusive Myocardial Infarction (OMI) vs Non-occlusive Myocardial Infarction (NOMI) paradigm has been proposed for better identification of acute myocardial infarction (AMI).2–5 Objectives: This study investigates the prevalence of OMI among NSTEMI patients in a private Cape Town emergency centre in 2019, analysing descriptive data, serial cardiac troponin I (cTnI) results, the proportion undergoing angiography, Thrombolysis in Myocardial Infarction (TIMI) flow grades, and door-to-angiogram times. Methods: A cross-sectional, observational study was conducted using a retrospective chart review of NSTEMI patients who underwent angiography. Data were analysed using descriptive statistics, Chi-square, and Mann-Whitney U-tests. Results: Among 31 NSTEMI patients, 83.9% (n=26) had OMI (median age 65 years, IQR 25), and 88.5% were male (p<0.001). Significant second cTnI levels (median 1450 ng/L, p=0.001) and a median door-to-angiogram time of 34 hours (IQR 48) were noted. The left anterior descending artery (34.6%) was the most common culprit lesion. Conclusion: The high prevalence of OMI among NSTEMIs highlights the limitations of the current STEMI/NSTEMI classification. Improved diagnostics and timely interventions, including emergent angiography and alternative treatments like thrombolysis, could enhance patient outcomes with reduced healthcare costs in resource-limited settings. The observed disparities and challenges in meeting international guidelines for timely interventions underscore the urgency of addressing accessibility issues. Heightened mortality and MACE risk among NSTEMIs with missed coronary occlusions1,7 highlight the need for expanded research to understand OMI prevalence and implications in South Africa. 2026-01-21T11:55:16Z 2026-01-21T11:55:16Z 2025 2026-01-21T11:40:01Z Thesis / Dissertation Masters MMed http://hdl.handle.net/11427/42642 en eng application/pdf Division of Emergency Medicine Faculty of Health Sciences University of Cape Town
spellingShingle occlusive myocardial infarction
myocardial infarction
non-ST-segment myocardial infarction
acute coronary syndrome
Schoeman, Elmari
Prevalence of Occlusive Myocardial Infarction (OMI) in patients diagnosed with Non-ST-Elevation Myocardial Infarction (NSTEMI) at a single private facility in Cape Town, South Africa, during 2019
thesis_degree_str Master's
title Prevalence of Occlusive Myocardial Infarction (OMI) in patients diagnosed with Non-ST-Elevation Myocardial Infarction (NSTEMI) at a single private facility in Cape Town, South Africa, during 2019
title_full Prevalence of Occlusive Myocardial Infarction (OMI) in patients diagnosed with Non-ST-Elevation Myocardial Infarction (NSTEMI) at a single private facility in Cape Town, South Africa, during 2019
title_fullStr Prevalence of Occlusive Myocardial Infarction (OMI) in patients diagnosed with Non-ST-Elevation Myocardial Infarction (NSTEMI) at a single private facility in Cape Town, South Africa, during 2019
title_full_unstemmed Prevalence of Occlusive Myocardial Infarction (OMI) in patients diagnosed with Non-ST-Elevation Myocardial Infarction (NSTEMI) at a single private facility in Cape Town, South Africa, during 2019
title_short Prevalence of Occlusive Myocardial Infarction (OMI) in patients diagnosed with Non-ST-Elevation Myocardial Infarction (NSTEMI) at a single private facility in Cape Town, South Africa, during 2019
title_sort prevalence of occlusive myocardial infarction omi in patients diagnosed with non st elevation myocardial infarction nstemi at a single private facility in cape town south africa during 2019
topic occlusive myocardial infarction
myocardial infarction
non-ST-segment myocardial infarction
acute coronary syndrome
url http://hdl.handle.net/11427/42642
work_keys_str_mv AT schoemanelmari prevalenceofocclusivemyocardialinfarctionomiinpatientsdiagnosedwithnonstelevationmyocardialinfarctionnstemiatasingleprivatefacilityincapetownsouthafricaduring2019

Similar Items