Aim and objective: To review the correlation between the clinical profile and the coronary angiographic vessel burden in patients with acute coronary syndrome that has been documented in the literature. Background: The clinical profile and the atherosclerotic vessel burden need to be reviewed, regarding the risk factor and the severity of the coronary artery pathology it carries. The recent trends in the occurrence of metabolic comorbidities, the age of presentation of the primary cardiac event with its correlation with complications have to be taken into consideration from literature published so far to step up the nodal coronary care. Results: Studies are done across revealing a male predominance with respect to coronary care events. Diabetes mellitus and systemic hypertension are the most common risk factors. Conclusion: Diabetes is the single most common risk factor in most studies, involved with a multi-vessel pathology. With diabetes occurrence creeping into the third decade, the incidence of acute coronary syndromes has also begun in the younger age groups. Clinical significance: The recent trends are very important to predict and prevent cardiac event-related morbidity and mortality. This can also provide small-time hospitals information to aid the local community, as the cardiovascular cause is the leading cause of death in the world.