{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T22:16:04Z","timestamp":1788992164796,"version":"build-2803163510"},"reference-count":30,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,1,5]],"date-time":"2026-01-05T00:00:00Z","timestamp":1767571200000},"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>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>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\u2013Meier survival analysis and Cox regression models. Additionally, subgroup and sensitivity analyses were conducted to validate the robustness of the results.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 533 AMI-CS patients were included. The 4-group trajectory model showed good fit (AIC\u2009=\u200919,937.75; minimum AvePP\u2009=\u20090.81). 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\u2013Meier 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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fcvm.2025.1674197","type":"journal-article","created":{"date-parts":[[2026,1,5]],"date-time":"2026-01-05T05:30:26Z","timestamp":1767591026000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":2,"title":["Fluid balance trajectories and prognosis in patients with acute myocardial infarction complicated by cardiogenic shock: a group-based trajectory model approach"],"prefix":"10.3389","volume":"12","author":[{"given":"Chunmei","family":"Zhang","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhiyi","family":"Xie","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guangyu","family":"Lin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qitian","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,1,5]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"1840","DOI":"10.1001\/jama.2021.18323","article-title":"Cardiogenic shock after acute myocardial infarction: a review","volume":"326","author":"Samsky","year":"2021","journal-title":"JAMA"},{"key":"B2","doi-asserted-by":"publisher","first-page":"1892","DOI":"10.1001\/jama.297.17.1892","article-title":"Decline in rates of death and heart failure in acute coronary syndromes, 1999\u20132006","volume":"297","author":"Fox","year":"2007","journal-title":"JAMA"},{"key":"B3","doi-asserted-by":"publisher","first-page":"93","DOI":"10.1016\/j.ahj.2020.09.015","article-title":"Cardiac safety research consortium \u201cshock II\u201d think tank report: advancing practical approaches to generating evidence for the treatment of cardiogenic shock","volume":"230","author":"Samsky","year":"2020","journal-title":"Am Heart J"},{"key":"B4","doi-asserted-by":"publisher","first-page":"401","DOI":"10.1097\/MCC.0000000000000845","article-title":"Epidemiology and causes of cardiogenic shock","volume":"27","author":"Berg","year":"2021","journal-title":"Curr Opin Crit Care"},{"key":"B5","doi-asserted-by":"publisher","first-page":"2671","DOI":"10.1093\/eurheartj\/ehz363","article-title":"Management of cardiogenic shock complicating myocardial infarction: an update 2019","volume":"40","author":"Thiele","year":"2019","journal-title":"Eur Heart J"},{"key":"B6","doi-asserted-by":"publisher","first-page":"S22","DOI":"10.1016\/j.ahj.2010.10.012","article-title":"Evaluation and management of special subgroups after primary percutaneous coronary intervention","volume":"160","author":"De Luca","year":"2010","journal-title":"Am Heart J"},{"key":"B7","doi-asserted-by":"publisher","first-page":"102123","DOI":"10.1016\/j.cpcardiol.2023.102123","article-title":"Appropriateness of fluid therapy in cardiogenic shock management: a systematic review of current evidence","volume":"49","author":"Widiarti","year":"2024","journal-title":"Curr Probl Cardiol"},{"key":"B8","doi-asserted-by":"publisher","first-page":"821","DOI":"10.1002\/ejhf.872","article-title":"Organ dysfunction, injury and failure in acute heart failure: from pathophysiology to diagnosis and management. 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