ArticleFrontiers in cardiovascular medicine2025
Fluid balance trajectories and prognosis in patients with acute myocardial infarction complicated by cardiogenic shock: a group-based trajectory model approach.
Article in Frontiers in cardiovascular medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
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3 citing papers in PubMed.
- Association of fluid balance trajectories and cumulative fluid balance with in-hospital mortality in patients with acute pancreatitis.Frontiers in medicine · 2026Article
- First-day lactate trajectories and subsequent in-hospital mortality in cardiogenic shock: a landmark multicohort study.Frontiers in cardiovascular medicine · 2026Article
- The first 24-h negative fluid balance is related to lower short-term mortality but higher AKI progression in critically ill heart failure: a retrospective cohort study.Therapeutic advances in cardiovascular diseaseArticle
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4 authors.
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Abstract
Background: Fluid management is crucial in the treatment of patients with acute myocardial infarction complicated by cardiogenic shock (AMI-CS), yet the optimal strategy remains unclear. This study aims to evaluate the association between fluid balance (FB) trajectories and prognosis in AMI-CS patients. Methods: This study utilized data from the MIMIC-IV database, including patients diagnosed with AMI-CS. A Group-Based Trajectory Model (GBTM) was applied to identify patient groups with similar FB trends. The association between different FB trajectories and patient survival was assessed using Kaplan-Meier survival analysis and Cox regression models. Additionally, subgroup and sensitivity analyses were conducted to validate the robustness of the results. Results: A total of 533 AMI-CS patients were included. The 4-group trajectory model showed good fit (AIC = 19,937.75; minimum AvePP = 0.81). Four FB trajectory patterns were identified: trajectory 1 (stable negative balance), trajectory 2 (rapid decline to negative balance), trajectory 3 (persistent positive balance), and trajectory 4 (high-level decreasing). Kaplan-Meier survival analysis revealed that patients in trajectories 1 and 2 had higher survival rates, while those in the fluid overload group had a significantly higher risk of death compared to the non-overload group. Cox regression analysis further demonstrated that, compared to trajectory 2, trajectory 3 was associated with a significantly increased mortality risk, while trajectory 1 showed no statistically significant difference. Subgroup and sensitivity analyses were consistent, confirming the robustness of the study findings. Conclusion: Among the dynamic FB patterns in AMI-CS patients, stable negative balance or rapid transition to negative balance is associated with the best prognosis. The GBTM approach helps identify different risk strata within the AMI-CS patient population.
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