Aim: This study aimed to evaluate the bidirectional association between coronary artery disease (CAD) and epilepsy and to examine the modifying effect of genetic susceptibility.

Methods: Using data from the UK Biobank, we conducted cross-sectional and longitudinal analyses. In the cross-sectional analysis (n = 502,359), logistic regression estimated odds ratios for the association between CAD and epilepsy. In Cohort 1 (n = 496,921 without baseline epilepsy), stratified Cox models assessed the risk of incident epilepsy by CAD status. In Cohort 2 (n = 475,130 without baseline CAD), the risk of incident CAD by epilepsy status was similarly evaluated. Polygenic risk scores for CAD and epilepsy were incorporated to assess genetic modification.

Results: The median baseline age was 58.0 years, and 45.6% were male. Over a median follow-up of 13.8 years, 3,590 participants developed epilepsy and 39,223 developed CAD. CAD was significantly associated with epilepsy both cross-sectionally and longitudinally (hazard ratio (HR) 1.32; 95% confidence interval (CI): 1.15-1.51; P < 0.001). Conversely, epilepsy increased CAD risk (HR 1.31; 95%CI: 1.12-1.54; P < 0.001). These associations were consistent across age, sex, and body mass index (BMI) strata. CAD predicted epilepsy only in participants with low genetic risk, while epilepsy predicted CAD mainly in those with high genetic risk.

Conclusions: Our findings indicate a bidirectional association between CAD and epilepsy. Additionally, this association exhibits heterogeneity across subgroups and may be influenced by genetic susceptibility. These results underscore the need for further studies to elucidate the underlying mechanisms and clinical implications.

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.