Factors Associated With Multivessel Coronary Artery Involvement in Patients With Coronary Artery Disease: A Retrospective Observational Study

Objectives: Coronary artery disease can affect a single vessel, two vessels, or multiple vessels. Percutaneous coronary intervention (PCI) has shown significant results in improving myocardial perfusion and reducing reinfarction; however, a large proportion of PCI patients are at risk of increased complications due to multivessel coronary artery involvement and other clinical characteristics, such as obesity and age. This study aimed to identify demographic and clinical factors associated with multivessel coronary artery disease, double- or triple-vessel involvement, among patients undergoing PCI, and to compare these characteristics between patients undergoing PCI for double-vessel and triple-vessel disease. Materials and methods: This retrospective observational study was conducted at Doctor Soliman Fakeeh Hospital (DSFH), Jeddah, Saudi Arabia, between January 2019 and December 2024. This study included adult patients diagnosed with coronary artery disease who underwent PCI at DSFH. Patients were categorized into single-vessel PCI, double-vessel PCI, or triple-vessel PCI groups. Results: A total of 1,329 patients were included in the study, with 978 undergoing single-vessel PCI, 324 undergoing double-vessel PCI, and 27 undergoing triple-vessel PCI. Patients aged ≥65 years had nearly twice the odds of undergoing multivessel PCI compared with those <45 years (adjusted odds ratio (aOR) 1.90, 95% CI 1.17-3.09, p = 0.009). The distribution of body mass index categories differed significantly (p < 0.001). Obese patients were more than two-and-a-half times more susceptible to having multivessel involvement compared to patients with normal weight (aOR 2.62, 95% CI 1.77-3.88, p < 0.001). Advanced age and obesity were significant factors associated with PCI after limited adjustment for multivessel coronary artery disease, whereas the overweight status was not associated with increased odds. Conclusions: Although several factors can cause coronary artery disease, obesity and advanced age were found to be significant factors associated with multivessel coronary artery disease requiring PCI. This study provides additional evidence supporting the association between advanced age, obesity, and multivessel coronary artery disease among patients undergoing PCI.