Association between fluid input and mortality in patients with acute right ventricular myocardial infarction

Abstract

Aim: To investigate the association between fluid input volume and long-term outcomes, including all-cause mortality, cardiac mortality, and in-hospital hypotension, in patients with right ventricular myocardial infarction (RVMI).

Methods: This retrospective multicenter study included 1,561 patients with RVMI from four hospitals between 1 January 2013 and 30 June 2021. Fluid input volume was assessed on the first day and as the average over 3 and 7 days. Cox proportional hazards models were used to evaluate associations with all-cause mortality, cardiac mortality, and in-hospital hypotension.

Results: The median follow-up was 4.8 years (interquartile range: 2.7-6.4). We found a significantly lower all-cause mortality risk with higher first-day fluid input (median tertile hazard ratio (HR): 0.64, 95% confidence interval (CI): 0.44-0.94; highest tertile HR: 0.66, 95%CI: 0.44-0.99) compared with the lowest input tertile. Similar reductions were observed for cardiac mortality (median tertile HR: 0.52, 95%CI: 0.31-0.85; highest tertile HR: 0.50, 95%CI: 0.30-0.85). However, average fluid input over three or seven days was not associated with long-term mortality risk. Higher first-day input was associated with reduced in-hospital hypotension risk (HR: 0.68, 95%CI: 0.46-1.00; P = 0.049) after confounder adjustment.

Conclusion: Sufficient early fluid input is associated with improved long-term outcomes (all-cause and cardiac mortality) and lower in-hospital hypotension risk in patients with RVMI.

Keywords

Right ventricular myocardial infarction / fluid input volume / acute myocardial infarction / mortality

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