Comorbidity Clusters in Acute Heart Failure: Insights From the AMERICCAASS Registry

BACKGROUND: Acute heart failure (HF) frequently coexists with multimorbidity. Comorbidity clusters have been associated with distinct clinical outcomes, but data from the Americas remain limited. We aimed to identify comorbidity clusters in patients with acute HF and assess their association with in-hospital outcomes. METHODS: This cohort study applied latent class analysis to patients from the AMERICCAASS Registry (Registro Americano de Insuficiencia Cardiaca Ambulatoria o Agudamente descompensada). Adjusted Poisson regression assessed in-hospital mortality and intensive care unit (ICU) admission, and multivariable analysis identified independent predictors of ICU admission. RESULTS: <0.001), compared with Cluster 1. Severe valvular insufficiency, peripheral artery disease, dyslipidemia, cancer, acute coronary syndrome, anemia, and cardiogenic shock were associated with higher ICU admission risk. CONCLUSIONS: Patients with acute HF in the Americas exhibit distinct comorbidity patterns associated with different clinical profiles and ICU admission rates, which may inform risk stratification and management strategies. REGISTRATION: URL: https://www.clinicaltrials.gov; Unique Identifier: NCT05295641.