Association of Sociodemographic, Lifestyle, and Metabolic Risk Factors With Angiographic Severity of Coronary Artery Disease in Western Maharashtra.

Background Coronary artery disease (CAD) is an expanding public health problem in India, with an increasing burden in rural and peri-urban populations where patients frequently present with advanced disease. Evidence on the contribution of social and psychosocial factors to angiographic severity in these settings remains limited. Methods This hospital-based cross-sectional study included 100 consecutive adult patients with angiographically confirmed CAD at a tertiary care center in Western Maharashtra. Sociodemographic, lifestyle, psychosocial, and clinical data were collected using a structured proforma. Disease severity was categorized as single-vessel disease (SVD) or multi-vessel disease (MVD). Associations were assessed using Chi-square or Fisher's exact test, followed by multivariable binary logistic regression to identify independent predictors of MVD. Results Multi-vessel disease was present in 61% of patients, indicating a predominance of advanced coronary involvement. The study population was largely older, with 57% aged above 60 years, and showed male predominance (61%). Most participants were from rural areas (62%) and lived with family (72%). Hypertension (59%) and diabetes (37%) were common, and a high burden of biochemical abnormalities was observed, including deranged lipid profile (80%), positive troponin-I (80%), and elevated creatine phosphokinase-MB (CPK-MB) (76%). Although trends suggested higher MVD in older age groups and across certain psychosocial categories, none of the sociodemographic, lifestyle, clinical, or biochemical variables showed a statistically significant association with disease extent. In multivariable analysis, living arrangement emerged as the only independent predictor, with individuals living alone or outside family settings having significantly lower odds of MVD (adjusted OR = 0.13; 95% CI: 0.02-0.76; p = 0.024). Conclusion A high burden of multi-vessel CAD at presentation reflects the substantial underlying disease load in this population. While conventional risk factors did not independently predict angiographic severity, this highlights the complexity of CAD and the potential contribution of broader determinants beyond traditional clinical profiles. The significant association observed with living arrangement emphasizes the relevance of social context in shaping disease presentation and supports the incorporation of social determinants into cardiovascular risk assessment. These findings provide a valuable foundation for future research and may help guide more comprehensive and context-sensitive approaches to risk stratification in similar populations.