{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T16:11:51Z","timestamp":1792080711266,"version":"4.4.0"},"reference-count":26,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,3,13]],"date-time":"2025-03-13T00:00:00Z","timestamp":1741824000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Cardiovasc. Med."],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Myocardial infarction (MI) complicated by heart failure (HF) is a common and severe clinical condition associated with poor outcomes. Estimated plasma volume status (ePVS), a marker of congestion derived from hemoglobin and hematocrit, has shown promise in predicting outcomes in various cardiovascular diseases. This study aimed to investigate the relationship between ePVS and both short-term and long-term prognosis in patients with MI complicated by HF.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A retrospective cohort study was conducted using data from the Medical Information Mart for Intensive Care IV (MIMIC-IV) database, including 3,238 patients with MI complicated by HF. Patients were stratified into quartiles based on ePVS values. The primary outcomes were in-hospital mortality, 180-day mortality, and 1-year mortality. Kaplan\u2013Meier curves, multivariate Cox regression analysis, and subgroup analyses were performed to assess the relationship between ePVS and outcomes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Kaplan\u2013Meier analysis showed significant differences in survival rates across ePVS quartiles for all outcomes (<jats:italic>P<\/jats:italic>\u2009&amp;lt;\u20090.001). Multivariate logistic regression analysis revealed that patients in the highest quartile of ePVS (Q4 vs. Q1) had an independently increased risk of in-hospital mortality (OR 1.58, 95% CI 1.16\u20132.13, <jats:italic>P<\/jats:italic>\u2009=\u20090.003). Cox regression analysis further demonstrated that higher ePVS (Q4 vs. Q1) was associated with an increased risk of 180-day mortality (HR 1.45, 95% CI 1.19\u20131.75, <jats:italic>P<\/jats:italic>\u2009&amp;lt;\u20090.001) and 1-year mortality (HR 1.51, 95% CI 1.27\u20131.80, <jats:italic>P<\/jats:italic>\u2009&amp;lt;\u20090.001). Both Kaplan\u2013Meier survival curves and restricted cubic spline models confirmed a positive association between ePVS and long-term mortality risks.The association between ePVS and long-term outcomes was stronger than for in-hospital mortality. Subgroup analyses revealed that the relationship between ePVS and long-term mortality was more pronounced in patients with systolic blood pressure below 140 mmHg, lower LODS and OASIS scores, and those without hemorrhagic disorders or anemia (<jats:italic>P<\/jats:italic> for interaction &amp;lt;0.05).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>ePVS was an independent predictor of both short-term and long-term mortality in patients with MI complicated by HF. Its prognostic value was particularly significant for long-term outcomes, suggesting its potential utility in risk stratification and guiding treatment strategies for this high-risk population.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fcvm.2025.1499378","type":"journal-article","created":{"date-parts":[[2025,3,13]],"date-time":"2025-03-13T10:11:26Z","timestamp":1741860686000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":5,"title":["Estimated plasma volume status as a prognostic indicator in myocardial infarction and heart failure: insights from the MIMIC-IV database"],"prefix":"10.3389","volume":"12","author":[{"given":"Bin","family":"Luo","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zheng","family":"Ma","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guoyong","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xue","family":"Jiang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Caixia","family":"Guo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2025,3,13]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"174","DOI":"10.1007\/BF02696647","article-title":"Therapies to prevent heart failure post-myocardial infarction","volume":"2","author":"Thomas","year":"2005","journal-title":"Curr Heart Fail Rep"},{"key":"B2","doi-asserted-by":"publisher","first-page":"294","DOI":"10.1177\/1403494819829333","article-title":"Ischemic heart failure as a complication of incident acute myocardial infarction: timing and time trends: a national analysis including 78,814 Danish patients during 2000\u20132009","volume":"48","author":"Sulo","year":"2020","journal-title":"Scand J Public Health"},{"key":"B3","doi-asserted-by":"publisher","first-page":"e891","DOI":"10.1161\/CIR.0000000000000670","article-title":"Contemporary diagnosis and management of patients with myocardial infarction in the absence of obstructive coronary artery disease: a scientific statement from the American Heart Association","volume":"139","author":"Tamis-Holland","year":"2019","journal-title":"Circulation"},{"key":"B4","doi-asserted-by":"publisher","first-page":"164","DOI":"10.1159\/000450526","article-title":"Assessment and management of volume overload and congestion in chronic heart failure: can measuring blood volume provide new insights?","volume":"2","author":"Miller","year":"2017","journal-title":"Kidney Dis (Basel)"},{"key":"B5","doi-asserted-by":"publisher","first-page":"163","DOI":"10.1097\/00041552-200403000-00004","article-title":"The association between congestive heart failure and chronic renal disease","volume":"13","author":"Silverberg","year":"2004","journal-title":"Curr Opin Nephrol Hypertens"},{"key":"B6","doi-asserted-by":"publisher","first-page":"886","DOI":"10.1016\/j.jchf.2015.06.014","article-title":"Prognostic value of estimated plasma volume in heart failure","volume":"3","author":"Duarte","year":"2015","journal-title":"JACC Heart Fail"},{"key":"B7","doi-asserted-by":"publisher","first-page":"1392","DOI":"10.1007\/s00392-020-01639-4","article-title":"Prognostic impact of plasma volume estimated from hemoglobin and hematocrit in heart failure with preserved ejection fraction","volume":"109","author":"Kobayashi","year":"2020","journal-title":"Clin Res Cardiol"},{"key":"B8","doi-asserted-by":"publisher","first-page":"530","DOI":"10.1186\/s12872-021-02338-2","article-title":"Estimated plasma volume status (ePVS) is a predictor for acute myocardial infarction in-hospital mortality: analysis based on MIMIC-III database","volume":"21","author":"Chen","year":"2021","journal-title":"BMC Cardiovasc Disord"},{"key":"B9","doi-asserted-by":"publisher","first-page":"100748","DOI":"10.1016\/j.ijcha.2021.100748","article-title":"Clinical impact of estimated plasma volume status and its additive effect with the GRACE risk score on in-hospital and long-term mortality for acute myocardial infarction","volume":"33","author":"Kawai","year":"2021","journal-title":"Int J Cardiol Heart Vasc"},{"key":"B10","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1038\/s41597-022-01899-x","article-title":"MIMIC-IV, a freely accessible electronic health record dataset","volume":"10","author":"Johnson","year":"2023","journal-title":"Sci Data"},{"key":"B11","doi-asserted-by":"publisher","first-page":"106","DOI":"10.1016\/j.jcrc.2020.05.001","article-title":"Estimated plasma volume status (ePVS) could be an easy-to-use clinical tool to determine the risk of sepsis or death in patients with fever","volume":"58","author":"Turcato","year":"2020","journal-title":"J Crit Care"},{"key":"B12","volume-title":"Plasmapheresis. 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