Objectives: The aim of the study was to comprehensively characterize the population of hypertrophic cardiomyopathy (HCM) patients in Poland in 2016–2021, including the analysis of annual incidence, prevalence, comorbidities, and therapeutic paths. Methods: A population-based cross-sectional study was conducted using data from the Polish National Health Fund database. The analysis included a registered annual incidence and prevalence rates, mortality, prognosis, and data on patients pathways in the healthcare system. Results: In 2016, the registered annual incidence of HCM diagnosis in Poland was 1,494 cases (3.89/100,000), decreasing to 808 cases (2.11/100,000) in 2021. Despite the decline in new diagnoses, the registered prevalence of HCM increased from 13,271 cases (34.53/100,000) in 2016 to 13,880 cases (36.23/100,000) in 2021, indicating improved patient survival. Annual mortality rose from 824 deaths (2.14/100,000) in 2016 to 1,022 deaths (2.67/100,000) in 2021, with the highest mortality observed in older adults (60+ years). Conclusion: The study highlights significant underdiagnosis of HCM in Poland. Mortality in HCM population remains high, underscoring the need for improvement in earlier detection and comprehensive care strategies in Polish healthcare system.

Background Delirium is a form of acute brain dysfunction and geriatric patients are particularly vulnerable to this health problem. The aim of the study was to assess the incidence of delirium and determine the risk factors for delirium in patients ≥ 60 years of age hospitalized due to acute myocardial infarction (AMI). Methods The study included 405 consecutive patients (mean age: 73.1 ± 8.5, males: 61%) hospitalized due to AMI divided and characterized according to the in-hospital delirium presence. ResultsOf 405 patients, 57 (14%, mean age: 80.9 ± 7.3, males: 58%) experienced delirium. Patients with delirium were older (80.9 ± 7.3 vs. 71.82 ± 8.1 years), all of them presented multimorbidity, they more frequently used polypharmacy (96.5 vs. 30.2%) and their hospitalization was longer (8.0 ± 1.4 vs. 4.6 ± 1.0 days) as compared to the patients without delirium. Patients with delirium more frequently experience periprocedural complications as well as the in-hospital reversible problems: fever (40.4 vs. 0.9%), infections (78.9 vs. 3.7%), pulmonary oedema (73.7 vs. 0.6%), hypoxemia (91.1 vs. 98.3%), urinary catheter (96.5 vs. 17.2%), dehydration (89.5 vs. 6.6%), and insomnia (71.9 vs. 0.3%) compared to patients without delirium (P < 0.001 for all). Valvular heart disease (OR = 4.78; 95%CI: 1.10-2.70; P < 0.001, pulmonary oedema (OR = 66.79; 95%CI: 12.04-370.34, P < 0.001), and dehydration (OR = 37.26; 95%CI: 10.50-132.27, P < 0.001) were risk factors for delirium occurrence. Conclusions The in-hospital course of AMI is complicated by delirium occurrence in 14% of patients ≥ 60 years old. Recognizing and modification of potential, reversible risk factors associated with AMI can reduce the risk of delirium.

Background/Objectives: Angiotensin receptor–neprilysin inhibitor (ARNI) has a well-established advantage over angiotensin-converting enzyme inhibitor or angiotensin receptor blocker (ACEI/ARB) therapy in patients (pts) with heart failure with reduced ejection fraction (HFrEF), but in pts after acute myocardial infarction (AMI) with left ventricular (LV) systolic dysfunction, the advantage of ARNI has not been clearly proven. The efficacy of ARNI is compared with that of ACEI/ARB therapy in patients with their first AMI in terms of improvement of post-infarction LV systolic function. Methods: The study was conducted as a retrospective one-center cross-sectional analysis. Overall, 1473 pts (990 M, median age 71 [64; 77]) with AMI (their first AMI, complete coronary revascularization, no prior coronary revascularization or history of HF) hospitalized in 2022–2024 were enrolled in a retrospective cross-sectional analysis. The study population was categorized into pts receiving ARNI and ACEI/ARB. Then, based on the ARNI subgroup, matching that included age, sex, and LV ejection fraction (LVEF) was performed by using the 1:1 nearest neighbor method without returning. Finally, two groups (ARNI vs. ACEI/ARB) of 30 pts were obtained and analyzed at baseline and at a 6-week follow-up. The improvement of post-infarction LV systolic function was obtained in terms of LVEF, ΔLVEF, and relative ΔLVEF values (ΔLVEF/baseline LVEF). Results: The comparison of baseline characteristics revealed borderline lower initial LVEF (30 vs. 36%, p = 0.076) and a higher frequency of SGLT-2 inhibitor use (70% vs. 36.7%, p = 0.01) in the ARNI subgroup. At the 6-week follow-up, in both subgroups, a significant improvement in the median LVEF values was achieved—from a median LVEF value of 30% (27.3; 38) to 37% (30; 43; p = 0.0008) in the ARNI subgroup and from a median LVEF value of 36% (33; 39) to 45% (42; 52; p < 0.0001) in the ACEI/ARB subgroup. The median ΔLVEF in the ACEI/ARB subgroup was higher [10% (6; 12)] than in the ARNI subgroup [6% (2; 10.25), p = 0.018]. Similarly, the median relative ΔLVEF was higher in the ACEI/ARB subgroup [30% (15.4; 40)] than in the ARNI group [17.5% (7; 31.9), p = 0.047]. The vast majority of patients, particularly in the ARNI group (99.7%), were treated with the lowest available dose of the drug. Conclusions: Our current experience in ARNI therapy after AMI is promising; however, it is limited to a small group of patients with severe impairment of LV systolic function. Regardless of the significant improvement in the baseline LVEF observed in patients receiving both ACEI/ARB and ARNI at the 6-week follow-up, the absolute and relative increases in the LVEF were higher in subjects treated with ACEI/ARB. However, the clinical benefits of ARNI therapy may emerge more gradually, and its advantages could become more apparent over a longer follow-up period. The clinical efficacy of early use of ARNI in the setting of AMI needs further evaluation.

Background: Regardless of genetic origin and recommended screening methods, hypertrophic cardiomyopathy (HCM) is commonly diagnosed late in the advanced stages of the disease. The aim of this study was to analyse the case history of patients with HCM in order to obtain an initiation of the diagnostic process. Methods: This study was a retrospective, tertiary, single-centre cohort analysis of 85 consecutive pts with HCM (mean age at the time of HCM diagnosis: 51 ± 15 years; F/M: 42/43) who were hospitalized during the period from 1 January 2013 to 31 December 2022. Type of referral to the hospital, the reason for hospitalization as well as accompanying symptoms, comorbidities, and family history were analysed to obtain an initiation of the diagnostic process. The analysis was limited to hospitalizations in which the diagnosis of HCM was stated for the first time. Results: An analysis of the type of referral to the hospital revealed the following data: 18% of patients were admitted as urgent hospitalizations (UHs) and 82% as elective hospitalizations (EHs). Among the UHs, the majority of patients were transferred from another hospital (13%), and among the EHs, 65% of patients were referred from a specialised outpatient medical care (SMC) facility. The majority of patients in both the UH and EH groups were symptomatic: 84% in the EH group (the most common symptom was exertional dyspnea in 56% of pts) and 93% in the UH group (the most common symptom was syncope in 60% of pts). Among the analysed population, the most frequent comorbidities were systemic hypertension (51%), lipid metabolism disorders (38%) and obesity (23%). Conclusions: A diagnosis of HCM is often made at an advanced age in symptomatic patients, mainly during an EH. Nearly one-fifth of the Polish HCM population is diagnosed during a UH after a sudden event, which suggests the need for improvements in medical care in Poland.

Background/Objectives: Angiotensin receptor-neprilysin inhibitor (AR-NI) has a well-established advantage over angiotensin converting enzyme inhibitor or angiotensin receptor blocker (ACEI/ARB) therapy in patients (pts) with heart failure with reduced ejection fraction (HFrEF), but in pts after acute myocardial infarction (AMI) with left ventricular (LV) systolic dysfunction the advantage of ARNI has not been clearly proven. To com-pare of the efficacy of ARNI versus ACEI/ARB therapy in patients with the first AMI in terms of improvement of post-infarction LV systolic function. Methods: Overall 1473 pts (990M, median age 71 [64;77]) with AMI (the first AMI, complete coronary revascularization, no prior: coronary revas-cularization, history of HF) hospitalized in 2022-2024 were enrolled into retrospective cross-sectional analysis. The study population was catego-rized into pts receiving ARNI and ACEI/ARB. Then based on ARNI subgroup included age, sex, and LV ejection fraction (LVEF) matching was performed by using the 1:1 nearest neighbour method without returning. Finally two groups (ARNI vs ACEI/ARB) of 30 pts were obtained and an-alysed at baseline and in 6-week follow-up. The improvement of post-infarction LV systolic function was obtained as LVEF value, ΔLVEF and relative ΔLVEF (ΔLVEF / baseline LVEF). Results: The comparison of baseline characteristics revealed borderline lower initial LVEF (30 vs 36%, p=0.076) and higher frequency of of SGLT-2 inhibitors use (70% vs 36.7%, p=0.01) in the ARNI subgroup. In 6-week follow-up in both subgroups a significant improvement in the median LVEF values was achieved: from median LVEF value 30% (27.3; 38) up to 37% (30; 43; p=0.0008) in ARNI and from median LVEF value 36% (33; 39) up to 45% (42; 52; p<0.0001) in ACEI/ARB subgroup. Median ΔLVEF in the ACEI/ARB subgroup was higher [10% (6; 12)] than in the ARNI subgroup [6% (2; 10.25), p=0.018]. Similarly median relative ΔLVEF was higher in the ACEI/ARB subgroup [30% (15.4; 40)] than in the ARNI group [17.5% (7; 31.9), p=0.047]. Conclusions: Our current experience in ARNI therapy after AMI is promising, however, it is limited to a small group of patients with severe impairment of LV systolic function. Regardless of significant improvement of baseline LVEF observed in patients receiving both ACEI/ARB and ARNI in 6 week follow-up the value of absolute and relative LVEF increase were higher in subjects treated with ACEI/ARB. The clinical efficacy of early use of ARNI in the setting of AMI needs further evaluation.