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

Figures

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  Figure 1. Countries with institutions participating in the cluster analysis and their recruitment rate. Values are presented as approximated percentages. This figure was created with MapChart.net.

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  Figure 2. Heatmap of clusters from latent class analysis of comorbidities. AF indicates atrial fibrillation; CAD, coronary artery disease; CKD, chronic kidney disease; COPD, chronic obstructive pulmonary disease; PAD, peripheral artery disease; and TIA, transient ischemic attack.

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  Figure 3. Suspected causes of HF by cluster. *Idiopathic accounts for 3.3% of cases in Cluster 2 and 1% in Cluster 3. “Other” includes causes such as hypertrophic, familial, peripartum, toxic, chemotherapy induced, alcoholic, metabolic, infectious, Chagas, restrictive, and traumatic cardiomyopathies, among others. HF indicates heart failure.

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  Figure 4. Co‐occurrence network of comorbidities. This figure presents a co‐occurrence network based on co‐occurrence counts. Thicker and darker lines between nodes (comorbidities) indicate higher rates of co‐occurrence. AF indicates atrial fibrillation; CAD, coronary artery disease; CKD, chronic kidney disease; COPD, chronic obstructive pulmonary disease; DLP, dyslipidemia; PAD, peripheral artery disease; and TIA, transient ischemic attack.

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  Figure 5. In‐hospital outcomes by cluster. No. for analysis by outcome: A, dialysis (N=1620); B, ICU admission (N=1593); C, IMV (N=1618); D, in‐hospital mortality (N=1598). Missing data: ICU admission: total, 45 (2.7%); Cluster 1, 28 (3.4%); Cluster 2, 15 (2.9%); Cluster 3, 2 (0.7%). In‐hospital mortality: total, 40 (2.4%); Cluster 1, 26 (3.1%); Cluster 2, 12 (2.3%); Cluster 3, 2 (0.7%). IMV: total, 20 (1.2%); Cluster 1, 15 (1.8%); Cluster 2, 5 (1.0%); Cluster 3, 0 (0.0%). Dialysis: total, 18 (1.1%); Cluster 1, 15 (1.8%); Cluster 2, 3 (0.6%); Cluster 3, 0 (0.0%). ICU indicates intensive care unit; and IMV, invasive mechanical ventilation.

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  Figure 6. Univariate and multivariable analysis of factors associated with ICU admission. A, Displays the univariate analysis of factors associated with ICU admission. B, Displays the multivariable analysis of factors associated with this outcome obtained through a backward elimination method. aRR indicates adjusted risk ratios; HF, heart failure; ICU, intensive care unit; RR, risk ratios; and y, years.