Cardiology and Angiology: An International Journal

The Pattern of Platelet Indices Amongst Hypertensive Patients in North-Central Nigeria: A Comparative Study

Ezinma Grace Obue — 2026-03-14

Background: Hypertension is a common and important major global health problem affecting more than 927 million people worldwide. Elevated levels of platelet indices correlates with platelet activation. Platelet activation plays a key role in the complications of hypertension.

Aim: To determine the levels of Platelet indices in hypertensive patients and to compare the platelet indices in control subjects in North central Nigeria.

Method: This was a cross-sectional comparative study conducted among 151 Hypertensives and 150 Normotensive controls in Federal Medical Centre Keffi Nasarawa State (North Central Nigeria).Three millilitres (3mls) of venous blood were aseptically collected by venepuncture from each participant into ETDA bottle and analysed using an automated full blood count machine. Data obtained were analysed using SPSS version 27, and results considered to be significant at p<0.05.

Results: This study assessed and compared the platelet indices between 151 hypertensive and 150 normotensive controls. Amongst the hypertensive patients, 57 (37.7%) were males while 94(62.2%) were females. Amongst the control group, 78(52.0) were males while 72(48.0) were females. The median of the mean platelet volume was 10.40fl and 10.20fl amongst hypertensive patients vs control subjects respectively. The median of the platelet distribution width was 12.80% and 12.60% amongst hypertensive patients vs. control subjects respectively. The platelet large cell ratio was 27.40% and 26.90% amongst patients vs. control subjects respectively

Conclusion: Our study demonstrated significant alteration in platelet indices in hypertensive patients compared to normotensive patients. The MPV, PDW and the PLCR in patients with hypertension was higher than in controlled subjects. These changes likely reflect increased platelet activation and may contribute to the elevated thrombotic risk observed in hypertensive patients.

Iron Deficiency in Older Adults Hospitalized for Acute Heart Failure: Prevalence, Clinical Correlates and One-Year Outcomes in a Moroccan Prospective Study

D. Bennani — 2026-04-02

Background: Iron deficiency is a common comorbidity in patients with heart failure. This association is often underrecognized in clinical practice, despite its important implications for symptoms and prognosis. Iron deficiency has been associated with worse symptoms, impaired functional status, and poorer clinical outcomes. Data from North Africa remain scarce, particularly in older adults hospitalized for acute or decompensated heart failure

Methods: A single-center (Ibn Rochd University Hospital in Casablanca) prospective observational study was conducted in the Cardiology Division. The study included consecutive patients aged ≥65 years admitted for acute heart failure, including both de novo presentations and acute decompensation of previously known chronic heart failure during a 12-month period. Iron deficiency was defined as a ferritin concentration <100 ng/mL, or 100-299 ng/mL with transferrin saturation <20%. Clinical, laboratory, and echocardiographic data were collected at admission. Patients were followed for one year for a composite outcome of heart failure rehospitalization or all-cause death.

Results: Fifty patients were included; the median age was 84 years (range, 65-104). Men and women were equally represented. Hypertension was present in 82%, diabetes in 32%, and active smoking in 18%. Functional limitation was substantial, with 50% of patients in NYHA class II, 40% in class III, and 10% in class IV. Anemia occurred in 52% of this cohort, and among those with Anemia, 82% of those were iron deficient. Among patients with iron deficiency, 63% were anemic and 37% were not. Echocardiographic findings displayed LVEF <45% for 38%; LV end-diastolic diameter >55 mm 24%; TAPSE <16 mm 24%; elevated pulmonary artery systolic pressure 40%; and a PASP/TAPSE ratio >3 mmHg/mm of 30%. At one year, event-free survival for the composite endpoint of heart failure rehospitalization or all-cause death was 94%. Given the very low number of events observed during follow-up, subgroup comparisons were descriptive and should be interpreted cautiously.

Conclusions: In this cohort of Moroccan patients hospitalized for acute heart failure, iron deficiency was highly prevalent and was frequently present in the absence of overt anemia. The data has highlighted the need for routine iron testing during the inpatient stay; as this will allow for the identification of patients who may later qualify for intravenous iron therapies after they have undergone a period of medical stabilization.

A Hierarchical Nonlinear Modelling Framework of Uncertainty Surveillance of Aggregated Global Cholesterol

Francis Ayiah-Mensah — 2026-04-02

Cholesterol is a key risk factor that can be altered and has become a primary factor in cardiovascular disease. Still, trend analyses at the global level often use aggregated estimates as error-free, which may exaggerate accuracy. The objective of the study was to measure long-term trends in the means of total cholesterol across countries and had the advantage of clearly modelling demographic structure, in addition to accounting for measurement error. The aims were to analyse changes over time by sex and age group, to examine nonlinear dynamics in age-period models, and to compare conventional and uncertainty-aware modelling. Multidecade-long country-year-sex-age group data on harmonised data used multilevel growth models, generalised additive mixed models and uncertainty-aware weighted multilevel models in which inverse-variance weights were based on reported 95% uncertainty intervals. Findings revealed that the average total cholesterol decreased significantly worldwide (weighted annual change: -0.0027 mmol/L, p = 0.046), with women having higher baseline levels than men (\(\beta\) = 0.09 mmol/L difference, p < 0.001). The temporal declines were steeper in older age, but the interaction between years and test age ranged from -0.0008 mmol/L/year to -0.0084 mmol/L/year (p < 0.001). Uncertainty-aware estimates were consistently smaller than those from unweighted models, indicating less overconfidence. The nonlinear age-period interaction was significant (p < 0.001). Its novelty lies in propagating reported uncertainty intervals directly into hierarchical models, which is the primary statistical constraint in previous studies. Among the actionable recommendations, it is possible to mention implementing models of uncertainty-aware global surveillance and focusing on age- and sex-specific approaches to lipid control to achieve faster progress toward cardiovascular disease reduction goals.

Epidemiology, Risk Factors and Diagnostic Features of Acute Pulmonary Embolism in a Moroccan Tertiary Cardiology Department: A Retrospective Descriptive Study

D. Bennani — 2026-04-03

Background: Acute pulmonary embolism (PE) constitutes a leading cause of illness and death from cardiovascular disease around the world. Even with better ways to diagnose and treat PE, it is still difficult to manage, especially in places where local data are limited. In Morocco, there is little recent hospital-based information about the clinical characteristics of patients admitted with acute PE.

Aim: This study aims to describe the epidemiology, risk factors, clinical presentation, and diagnostic features of patients with acute PE admitted to the cardiology department at Ibn Rochd University Hospital.

Methods: A retrospective descriptive study of consecutive patients admitted to the cardiology department of Ibn Rochd University Hospital, Casablanca, conducted for acute PE confirmed by CTPA between January 2024 and December 2025. Demographic characteristics, thromboembolic risk factors, clinical presentation, electrocardiographic findings, echocardiographic features, and CTPA findings were extracted from medical records and analysed descriptively.

Results: Fifty-four patients were included, with a mean age of 60 ± 18 years (range 22–88); 58% were women. At least one provoking or contributing factor was found in 98% of patients. Prolonged immobilisation was the most common risk factor, present in 81% of cases. Obesity, recent surgery, hormonal exposure or postpartum status among women, active cancer, chronic heart disease or chronic respiratory disease, history of miscarriage by females, prior history of venous thromboembolism, were all reported to be risk factors for pulmonary embolism. The most common presenting symptom was dyspnea, followed by chest pain (98%), and ECG changes were frequently observed (S1Q3 pattern [50%], anterior T-wave inversions [44%], and sinus tachycardia [37%]). A right ventricular dilation was observed in 65% of participants via an echocardiogram, systolic dysfunction was also seen in 48% of patients, and all cases were confirmed on a CTPA. Proximal emboli were noted in 72% of patients and 69% of patients demonstrated bilateral involvement.

Conclusion: In this single-centre Moroccan study, acute PE occurred mainly in middle-aged and older adults and was slightly more common in women. Identifiable thromboembolic risk factors were frequent, especially immobilisation, obesity, surgery, cancer, and hormonal exposure. CTPA was the basis of diagnosis, while echocardiography provided important information on right ventricular involvement. The results show the need for better prevention, earlier diagnosis, and larger multicenter studies on pulmonary embolism in Morocco.

Successful Cutting Balloon Angioplasty in Renal Fibromuscular Dysplasia: A Case Report

Pramod Tulsidas Gitte — 2026-03-14

Fibromuscular dysplasia (FMD) is a rare non-atherosclerotic, non-inflammatory arterial disease that most often affects renal and carotid arteries in young women. This case report describes a 33-year-old female with symptomatic resistant hypertension refractory to multiple medications. An abdominal computed tomographic (CT) angiogram revealed mid to distal right renal artery stenosis with the classic 'string of beads' appearance, diagnostic for fibromuscular dysplasia (FMD). Following a successful percutaneous transluminal right renal angioplasty (PTRA) with cutting balloon without stent placement, the patient's blood pressure significantly improved, allowing for a reduction in medication. This case emphasizes the need for a high index of suspicion for Reno-vascular hypertension in young patients with resistant hypertension, as an early intervention with PTRA can lead to excellent clinical outcomes.