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\begin{document}

\title{COMORBIDITIES AND THEIR IMPLICATIONS IN PATIENTS WITH AND WITHOUT TYPE 2
DIABETES MELLITUS AND HEART FAILURE WITH PRESERVED EJECTION FRACTION.
FINDINGS FROM THE RICA REGISTRY}



\author[1]{José Carlos Arévalo-Lorido}%
\author[1]{Juana Carretero-Gómez}%
\author[2]{Ricardo Gomez-Huelgas}%
\author[3]{Pau Llacer}%
\author[4]{Luis Manzano}%
\author[5]{Maria Angustias Quesada Simon}%
\author[6]{Bernardino Roca}%
\author[7]{Alvaro Gonzalez Franco}%
\author[8]{Jose Maria Cepeda}%
\author[9]{Manuel Montero}%
\affil[1]{Zafra Hospital County}%
\affil[2]{Carlos Haya Hospital}%
\affil[3]{Hospital de Manises}%
\affil[4]{Hospital Universitario Ramón y Cajal}%
\affil[5]{La Paz University Hospital Cardiology Service}%
\affil[6]{Affiliation not available}%
\affil[7]{HUCA}%
\affil[8]{Hospital Vega Baja}%
\affil[9]{IMIBIC/Hospital Reina Sofia de Córdoba}%


\vspace{-1em}



  
  \date{March 14, 2025}


\begingroup
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\selectlanguage{english}
\begin{abstract}
AIM: to determine if patients with heart failure and preserved ejection
fraction (HFpEF) and type 2 diabetes mellitus (T2DM) have a higher
comorbidity burden than those without T2DM, if other comorbidities are
preferentially associated with T2DM, and if these conditions confer a
worse patient prognosis. METHODS AND RESULTS: Cohort study based on the
RICA Spanish Heart Failure Registry, a multicenter, prospective registry
that enrolls patients admitted for decompensated HF and follows them for
1 year. We selected only patients with HFpEF, classified as having or
not having T2DM, and performed an agglomerative hierarchical clustering
based on variables such as the presence of arrhythmia, chronic
obstructive pulmonary disease, dyslipidemia, liver disease, stroke,
dementia, body mass index (BMI), hemoglobin levels, estimated glomerular
filtration rate, and systolic blood pressure. 1,934 patients were
analyzed: 907 had T2DM (mean age 78.4+/-7.6 years) and 1,027 did not
(mean age 81.4+/- 7.6 years). The analysis resulted in 4 clusters in
patients with T2DM, and 3 in the reminder. All clusters of patients with
T2DM showed higher BMI, and more kidney disease and anemia than those
without T2DM. Clusters of patients without T2DM had neither
significantly better nor worse outcomes. However, among the T2DM
patients, clusters 2, 3 and 4 all had significantly poorer outcomes, the
worst being cluster 3 (HR 2.0, 95\% CI 1.36-2.93, p=0.001). CONCLUSIONS:
Grouping our patients with HFpEF and T2DM into clusters based on
comorbidities revealed a greater disease burden and prognostic
implications associated with the T2DM phenotype, compared to those
without T2DM.%
\end{abstract}%



\sloppy


\textbf{COMORBIDITIES AND THEIR IMPLICATIONS IN PATIENTS WITH AND
WITHOUT TYPE 2 DIABETES MELLITUS AND HEART FAILURE WITH PRESERVED
EJECTION FRACTION. FINDINGS FROM THE RICA REGISTRY}

ABSTRACT

AIM: to determine if patients with heart failure and preserved ejection
fraction (HFpEF) and type 2 diabetes mellitus (T2DM) have a higher
comorbidity burden than those without T2DM, if other comorbidities are
preferentially associated with T2DM, and if these conditions confer a
worse patient prognosis.

METHODS AND RESULTS: Cohort study based on the RICA Spanish Heart
Failure Registry, a multicenter, prospective registry that enrolls
patients admitted for decompensated HF and follows them for 1 year. We
selected only patients with HFpEF, classified as having or not having
T2DM, and performed an agglomerative hierarchical clustering based on
variables such as the presence of arrhythmia, chronic obstructive
pulmonary disease, dyslipidemia, liver disease, stroke, dementia, body
mass index (BMI), hemoglobin levels, estimated glomerular filtration
rate, and systolic blood pressure. 1,934 patients were analyzed: 907 had
T2DM (mean age 78.4+/-7.6 years) and 1,027 did not (mean age 81.4+/- 7.6
years). The analysis resulted in 4 clusters in patients with T2DM, and 3
in the reminder. All clusters of patients with T2DM showed higher BMI,
and more kidney disease and anemia than those without T2DM. Clusters of
patients without T2DM had neither significantly better nor worse
outcomes. However, among the T2DM patients, clusters 2, 3 and 4 all had
significantly poorer outcomes, the worst being cluster 3 (HR 2.0, 95\%
CI 1.36-2.93, p=0.001).

CONCLUSIONS: Grouping our patients with HFpEF and T2DM into clusters
based on comorbidities revealed a greater disease burden and prognostic
implications associated with the T2DM phenotype, compared to those
without T2DM.

KEY WORDS: Heart failure with preserved ejection fraction; type 2
diabetes mellitus; comorbidity; kidney disease.

WHAT IS ALREADY KNOWN ABOUT THIS TOPIC?

\begin{itemize}
\tightlist
\item
  Heart Failure with preserved ejection fraction is influenced for
  comorbidities.
\item
  Diabetes mellitus (DM) is one of the most important comorbidities
  associated.
\item
  The value of the remainder comorbidities in this setting is not fully
  understood.
\end{itemize}

WHAT DOES THIS ARTICLE ADD?

\begin{itemize}
\tightlist
\item
  Patients grouped comorbidities revealed a bigger disease burden in the
  case of DM.
\item
  Comorbidity groups with DM had prognostic effects compared to those
  without DM.
\end{itemize}

INTRODUCTION

Type 2 diabetes mellitus (T2DM) and heart failure (HF) are closely
related. Patients with T2DM have an increased risk of developing HF and
vice versa. Some studies report that more than one-third of patients who
are hospitalized for heart failure without a diagnosis of diabetes
mellitus (DM) exhibit impaired fasting glucose or glucose intolerance
{[}1{]}, and that the prevalence of diabetes in patients with heart
failure ranges from approximately 25\% to 40\%, depending on the
population studied {[}1{]}. However, few of these studies differentiated
between HF with reduced ejection fraction (HFrEF) and HF with preserved
ejection fraction (HFpEF). In a subanalysis of the CHARM program
(Candesartan in Heart failure Assessment of Reduction in Mortality and
morbidity), the prevalence of diagnosed diabetes was higher in patients
with HFpEF (40\%) than in those with HFrEF (35\%) {[}2{]}. Furthermore,
a number of trials in patients with HF have shown an increased risk of
cardiovascular death or hospitalization in men and women with diabetes
{[}3-6{]}. In the case of HFpEF, patients commonly present other
associated comorbidities such T2DM, which may contribute to the
pathophysiology of HF and its outcome, since their comorbidities are
associated with higher rates of non-cardiovascular hospitalization and
death. However, the potential impact of HFpEF on the prognosis of T2DM
in these patients is not fully characterized. Although diabetes was
associated with a steeper increase in left ventricle mass and wall
thickness compared to age and sex-adjusted controls in the Framingham
study {[}7{]}, the overall comorbidity burden in patients with T2DM and
HF is usually higher than in patients with HF alone {[}8{]}. Our aim in
this study was to determine if patients with HFpEF and T2DM have a
higher comorbidity burden than those without T2DM, if other
comorbidities are preferentially associated with T2DM, and if these
conditions confer a worse prognosis.

METHODS

Patients were recruited via the RICA Spanish National Heart Failure
Registry, supported by the HF and Atrial Fibrillation Working Group of
the Spanish Society of Internal Medicine (SEMI-IC-FA). The RICA registry
is an ongoing multicenter, prospective, cohort study that has been
described elsewhere {[}9,10{]}. This registry includes consecutive and
unique patients aged 50 years or older with HF according to the criteria
of the European Society of Cardiology {[}11{]}. Patients were included
at discharge after an acute event of decompensated HF between March 2008
and May2017,and followed up for 1 year.

The study protocol was approved by the Ethics Committee of the
University Hospital Reina Sofia, Cordoba, Spain, and all patients gave
their informed consent before inclusion in the cohort. Data were
collected in the database via a website (https://www.registrorica.org)
that was accessed with a personal password. Complete registry data are
published elsewhere {[}9{]}.

In this analysis, we included only patients with HFpEF {[}left
ventricular ejection fraction (LVEF) higher than 50\% and elevated
natriuretic peptides{]}, and we excluded patients with either reduced or
mid-range ejection fraction and HF caused by valvular heart disease
(figure 1). Data analyzed comprise past medical history related to HF,
Charlson comorbidity index (CCI), Barthel index (BI), Pfeiffer index
(PfI), acute HF episode admission clinical data {[}blood pressure, heart
rate (HR), body mass index (BMI){]} and blood chemistry values,
including kidney function defined by estimated glomerular filtration
rate (eGFR) based on the MDRD equation (Modification of Diet in Renal
Disease {[}12{]}), blood sugar profile, hemoglobin, serum sodium and
potassium levels, and natriuretic peptides.

HF was characterized using the New York Heart Association (NYHA) scale
and the evaluation of left ventricular ejection fraction (LVEF) by 2-D
echocardiography. We also recorded the etiology of HF (ischemic,
hypertensive, alcoholic, toxic, hypertrophic, and others) and the
potential cause of decompensation when the patients were included. We
excluded patients whose clinical or laboratory data were not fully
completed, patients without an echocardiographic examination, and
patients who either died during hospitalization or did not complete
follow-up.

To analyze differences between patients with and without diabetes, we
first divided the sample into two groups according to the diagnosis of
T2DM (based on patient history and prescription of hypoglycemic agents).
In a second step, we sub-divided the patients according to clusters
based on the following variables: arrhythmia, chronic obstructive
pulmonary disease (COPD), dyslipidemia, liver disease, stroke, dementia
(all defined according to investigators' criteria), BMI, hemoglobin,
eGFR, LVEF, and systolic blood pressure (SBP). The primary endpoint was
to analyze comorbidities in patients with both HFpEF and T2DM and in
patients with HFpEF but without T2DM. Secondary endpoints were to
analyze the outcomes of the clusters, firstly in terms of HF mortality
and readmissions, and secondly in terms of all-cause mortality and
readmissions.

\emph{Statistical analysis}

We performed an agglomerative hierarchical clustering with the Ward
minimum-variance method to group comorbidity variables and identify
aggregated conditions. We used the hclust function in R with the
dissimilarity matrix defined by the Kendall distance, assuming variables
were not parametric (Figure 2) {[}13{]}. The previously pre-specified
dichotomous variables (COPD, dyslipidemia, liver disease, dementia, and
stroke) were assigned a value of one when a given comorbidity was
present and zero when it was absent. Categorical variables, such as
stroke and arrhythmia, took their values depending on their respective
categories. In the case of stroke, the following values were assigned:
absent = 0, transitory ischemic accident = 1, hemorrhagic stroke = 2,
cardioembolic stroke = 3 and atherothrombotic stroke = 4. In the case of
arrhythmia, they were: sinus rhythm = 0, atrial fibrillation or flutter
(AF/flutter) = 1, atrioventricular block = 2, and other = 3. Finally,
the quantitative pre-specified variables (BMI, eGFR, LVEF, hemoglobin
and SBP) retained their numerical value.

Bootstrap resampling techniques (n = 1000) were used to assess
reproducibility for each hierarchical cluster, applying the pvclust
function in R {[}14{]}. We computed the bootstrap probability (BP) value
which corresponds to the frequency with which the cluster is identified
in bootstrap copies, and the approximately unbiased (AU) probability
values by multiscale bootstrap resampling (Figure 2). Clusters with AU [?]
95\% are considered to be strongly supported by data.

Once the clusters were built, we performed univariate comparisons
between them. Quantitative variables were expressed as mean +/- standard
deviation if normal, and median +/- interquartile range if not normal.
The clusters were compared for various numeric parameters by one-way
analysis of variance and by the post hoc Tukey's test for multiple
comparisons. If the variables were not normal, we used the
Kruskal-Wallis test. Qualitative variables were expressed as absolute
number and percentage. Study groups were compared using the Chi-squared
test.

Finally, a Cox proportional-hazard model was used to examine the
association between the clusters and time to hospitalization and death.
The model covariates were selected a priori based on previous prognostic
reports and clinical experience, and variables which were significant in
the initial univariate comparisons were also included. Cumulative curves
were estimated by the Kaplan-Meier method and compared by log-rank
testing. A p value of \textless{} 0.05 was considered significant.
Analyses were performed using the SPSS and R programs.

RESULTS

A total of 1,934 patients were analyzed: 907 had T2DM (39.1\% men, mean
age 78.4+/-7.6 years) and 1,027 did not (39.9\% men, mean age 81.4+/-
7.6 years). The most prevalent comorbidities were dyslipidemia (52.4\%),
AF/flutter (67.4\%), and COPD (24.9\%). The similarity matrix and
significance by variable in the clusters are shown in figure 2.

Clusters

The analysis resulted in 7 significant clusters, 4 in the case of
patients with T2DM, and 3 in the non-diabetic patients. Dendrograms
portraying patients with and without T2DM are shown in supplementary
figure 1.

The resulting clusters are shown in table 1 and figure 3 (above).
Clusters 1, 2, 3 and 4 pertain to patients with T2DM. Cluster number 1
(n: 201) included predominantly female patients with high cardiovascular
risk without arrhythmia (only 1\% had AF/flutter). They had high
systolic blood pressure (SBP) and high prevalence of both dyslipidemia
and atherothrombotic stroke. Cluster number 2 (n: 303) included older
patients, also predominantly women, with no dyslipidemia, lower SBP, and
a prevalence of AF/flutter greater than 50\%. Cluster number 3 (n: 140)
included mostly male patients with COPD, dyslipidemia, and liver
disease. Although the presence of AF/flutter was 58.6\%, this cluster
showed the lowest rate of cerebrovascular disease (92.1\% patients
without any stroke). Cluster number 4 (n: 263) was similar to number 1.
However, the prevalence of AF/flutter (93.9\%), TIA (7.2\%), and
cardioembolic stroke (3.4\%) was much higher. Clusters 5, 6 and 7
pertain to patients without T2DM. On average, these clusters portrayed
older patients, with lower SBP and BMI and better eGFR than those with
T2DM. Overall, the associations among the variables included are less
significant (figure 2). However, variables such as hemoglobin and eGFR
are more significant in defining the clusters, whereas the presence of
arrhythmia is not. Cluster 5 contains predominantly men (66.5\%) with
COPD and a high prevalence of AF/flutter (64.8\%). They also have the
highest levels of eGFR (62.3 +/- 32.7ml/min, p=0.0001) and hemoglobin
(12.8 +/- 2.9 gr/dl, p=0.01). Cluster 6 again contains mainly women
(69.6\%) with excess weight and a high prevalence of dyslipidemia
(97.1\%) and stroke, both hemorrhagic and cardioembolic or
atherothrombotic (p=0.003). Approximately half have AF/flutter (55.1\%)
and of the three clusters without T2DM, patients in cluster 6 have the
lowest levels of eGFR (p=0.0001) and hemoglobin (p=0.01). Finally,
cluster 7, with a 67\% predominance of women, is quite undifferentiated,
with a slightly higher SBP than the other clusters without T2DM, and a
notable prevalence of AF/flutter (63.2\%) and TIA (4\%).

Some additional findings by clusters are shown in Table 2. Patients with
T2DM had more history of hypertension, mainly clusters 3 and 4. Charlson
comorbidity index is similarly higher in these patients, the highest
levels being found in cluster 3. Regarding etiology of HF, ischemic
cardiomyopathy was significantly prevalent in patients with T2DM
(p=0.001), particularly in cluster 3 (40\%). Finally, significant
differences in treatment were detected among the clusters. Overall,
patients with T2DM were more often treated with angiotensin-converting
enzyme inhibitors (ACEi)/angiotensin receptor blockers (ARB) (p=0.004),
beta-blockers (p=0.003), loop diuretics (p=0.007), and thiazides
(p=0.009).

Outcomes

Table 3 shows the results according to the multivariate Cox regression
analysis, and figure 3 (below) shows the Kaplan-Meier curves. Regarding
HF mortality and readmissions, age, comorbidity (CCI), Barthel index,
eGFR and serum sodium were significantly related to the endpoint. In the
analysis of the clusters, the clusters of patients without T2DM had
neither significantly better nor worse outcomes than those of cluster 1
(patients with T2DM). However, significantly worse outcomes were
detected among the patients with T2DM in clusters 2, 3 and 4, the worst
being in number 3 (HR 2.0, 95\% CI 1.36-2.93, p=0.001). As for total
mortality and readmissions, again age, comorbidity (CCI), Barthel index,
eGFR, and serum sodium were significantly related to this endpoint.
Furthermore, in terms of clusters, clusters of patients without T2DM
were again not significantly associated with an increase in total
mortality and readmissions. Nevertheless, cluster 3 and 4, showed this
association, and once more cluster 3 was the worst (HR 1.6, 95\% CI
1.22-2-16, p=0.001).

DISCUSSION

Our cluster analysis of patients with and without T2DM revealed a
greater number of defined groups among patients with T2DM and, moreover,
a worse prognosis in the majority of these patients compared with the
clusters of patients without T2DM.

Composite connections between comorbidities themselves and between
comorbidities and the cardiovascular system lead to the establishment of
HF, whether HFpEF or HFrEF. Conversely, HF may cause comorbidities,
which, in turn, adversely influence outcomes {[}15{]}. It is known that
HFpEF is associated with more comorbidities than HFrEF {[}16{]} and
thus, HFpEF emerges as a model with proinflammatory cardiovascular and
non-cardiovascular coexisting comorbidities, resulting in systemic
inflammation and later fibrosis and different clinical HFpEF phenotypes.
DM is a prevalent comorbidity in HF and has a significantly adverse
impact on prognosis. About 45\% of patients with HFpEF have DM, and the
prevalence of comorbid DM is growing most markedly in those with
new-onset HFpEF {[}17{]}. Although the characteristics and outcomes of
this population are poorly understood, some previous reports suggest
that DM is associated with increased morbidity and long-term mortality
in HFpEF {[}18,19{]}. Furthermore, patients with DM and HFpEF have
already been described as a unique phenotype within HFpEF {[}19{]}. In
this study, we show how other additional pathologies can form new
sub-clusters resulting in different outcomes within the group of
patients with T2DM, while this influence is not observed in patients
without T2DM.

Compared to the set of patients without T2DM, our patients with T2DM
shared similar characteristics to those previously described in this
phenotype {[}19{]}. Patients had higher BMI, more prevalence of both
dyslipidemia and ischemic etiology, and all subgroups were similar in
terms of impaired renal function and hemoglobin below 12 g/dl. We might
hypothesize about the presence of a cardiorenal anemia syndrome in this
population, derived from an interaction between diabetic microvascular
disease affecting the kidneys and myocardium {[}20{]}, and other factors
such as elevated central venous and intra-abdominal pressure, left
ventricular hypertrophy, left ventricular strain, RAAS activation,
oxidative injury, pulmonary hypertension, and right ventricular
dysfunction {[}21{]}. Additionally, it should be noted that AF/flutter
can form a separate cluster (cluster 4), very similar to cluster 1
except for the presence of these arrhythmias and older age. It is known
that AF/flutter interacts with both DM and HFpEF {[}22,23{]}. In our
case, the presence of AF/flutter in patients with HFpEF and DM
determines a different profile which adds up to a significantly worse
outcome. However, the worst profile in terms of outcomes corresponds to
cluster 3, the only group of T2DM patients with predominantly men, and
the one that is particularly characterized by the presence of COPD (also
more than half of the patients had AF/flutter). It is known that COPD is
an independent predictor of mortality in patients with HFpEF and in
patients with HFrEF {[}24{]}. DM is likewise independently correlated
with reduced lung function, while obesity may further worsen ventilatory
mechanics {[}25{]}. Apart from smoking, which is more prevalent in this
group, the comorbidity burden (CCI) is also the highest. All these
factors may incorporate a pro-inflammatory state that determines greater
cardiovascular disease, and this, along with a worse functional class
(the prevalence of NYHA III was the highest in this cluster), could
contribute to higher mortality.

In contrast to patients with T2DM, the clusters of patients without T2DM
had significant differences in hemoglobin and renal function (eGFR).
Renal impairment is not as prevalent as in diabetic patients and
determines one group (cluster 6) in which dyslipidemia and
cerebrovascular disease is also prevalent. This cluster is comparable
with clusters 1 and 4 in patients with T2DM. However, the differences in
hemoglobin and eGFR may lead to a lower prevalence of cardiorenal anemia
syndrome, and along with the absence of T2DM may contribute to the
differences in prognosis among these clusters. Again cluster 5 may have
some similarities with cluster 3. The presence of COPD and smoking are
decisive in both groups, though, here too, disparities in eGFR, BMI and
hemoglobin may play a role in the significant differences in outcomes.
Finally clusters 2 and 7, which were the most numerous, encompass the
oldest female patients with a high prevalence of AF/flutter and
hypertensive myocardiopathy, but with no another differential
characteristics. It could be that patients with genuine HFpEF and no
other relevant pathologies (their CCI was the lowest among the clusters
in their class, with/without T2DM) modify the phenotype, irrespective of
the presence or absence of T2DM, which would contribute to the
difference in the prognosis between both of them in terms of HF. These
clusters should be better defined using other variables that we were
unable to analyze, such as exercise capacity or vascular stiffness.

Our study has several limitations. Firstly, mortality during admission
was not recorded, and this may have led to a significant selection bias
and misleading results. Secondly, the data come from a registry which
started to include patients in 2008, so they may not all conform to the
current definition of HFpEF. Finally, we have not included in the
analysis some discordant comorbidities of T2DM (e.g., depression) that
may have a significant clinical impact {[}26{]}.

In conclusion, the grouping of our patients with HFpEF and T2DM into
clusters based on their comorbidities revealed prognostic implications
according to the phenotype obtained. All clusters with T2DM presented
similar levels of kidney disease and anemia. In contrast, the clusters
of patients with HFpEF but without T2DM showed significant differences
in renal dysfunction and anemia. However, they did not have a
significantly worse outcome compared to the clusters with T2DM.
Therefore, comorbidities may play a more important role in determining
prognosis in patients with HFpEF and T2DM.

FUNDING

This study received neither grants nor funding.

CONFLICT OF INTEREST

The authors declare no conflict of interest.

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  Levey AS, Bosch JP, Lewis JB. Modification of diet in renal disease
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  rate from serum creatinine: a new prediction equation. Ann Intern Med.
  1999;\textbf{130} :461--470.
\item
  Müllner D. Fastcluster: Fast hierarchical agglomerative clustering
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  Suzuki R, Shimodaira H. Pvclust: an R package for assessing the
  uncertainty in hierarchical clustering. Bioinformatics
  2006;\textbf{22} :1540-2.
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  Triposkiadis F, Giamouzis G, Parissis J, Starling RC, Boudoulas H,
  Skoularigis J, Butler J, Filippatos G. Reframing the association and
  significance of co-morbidities in heart failure. Eur J Heart Fail.
  2016;\textbf{18} :744-58.
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  Chamberlain AM, St Sauver JL, Gerber Y, Manemann SM, Boyd CM, Dunlay
  SM, Rocca WA, Finney Rutten LJ, Jiang R, Weston SA, Roger VL.
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  Echouffo-Tcheugui JB, Xu H, DeVore AD, Schulte PJ, Butler J, Yancy CW,
  Bhatt DL, Hernandez AF, Heidenreich PA, Fonarow GC. Temporal trends
  and factors associated with diabetes mellitus among patients
  hospitalized with heart failure: findings from Get With The
  Guidelines-Heart Failure registry. Am Heart J 2016;\textbf{182}
  :9--20.
\item
  Kristensen SL, Mogensen UM, Jhund PS, Petrie MC, Preiss D, Win S,
  Køber L, McKelvie RS, Zile MR, Anand IS, Komajda M, Gottdiener JS,
  Carson PE, McMurray JJ. Clinical and echocardiographic characteristics
  and cardiovascular outcomes according to diabetes status in patients
  with heart failure and preserved ejection fraction: a report from the
  IPreserve trial (Irbesartan in Heart Failure With Preserved Ejection
  Fraction). Circulation 2017; \textbf{135} :724--35.
\item
  Lindman BR, Davila-Roman VG, Mann DL, McNulty S, Semigran MJ, Lewis
  GD, de las Fuentes L, Joseph SM, Vader J, Hernandez AF, Redfield MM.
  Cardiovascular phenotype in HFpEF patients with or without diabetes: a
  RELAX trial ancillary study. J Am Coll Cardiol 2014;\textbf{64}
  :541--9.
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  Tromp J, Lim SL, Tay WT, Teng TK, Chandramouli C, Ouwerkerk W, Wander
  GS, Sawhney JPS, Yap J, MacDonald MR, Ling LH, Sattar N, McMurray JJV,
  Richards AM, Anand I, Lam CSP; ASIAN-HF Investigators. Microvascular
  Disease in Patients With Diabetes With Heart Failure and Reduced
  Ejection Versus Preserved Ejection Fraction. Diabetes Care.
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  Agrawal A, Naranjo M, Kanjanahattakij N, Rangaswami J, Gupta S.
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  Movahed MR, Hashemzadeh M, Jamal MM. Diabetes mellitus is a strong,
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  Comorbidity in patients with diabetes mellitus: impact on medical
  health care utilization. BMC Health Serv Res. 2006;\textbf{6} :84.
\end{enumerate}

Table 1: Characteristics by clusters based on selected comorbidities\selectlanguage{english}
\begin{longtable}[]{@{}llllllllll@{}}
\toprule
\begin{minipage}[b]{0.07\columnwidth}\raggedright\strut
Variable\strut
\end{minipage} & \begin{minipage}[b]{0.07\columnwidth}\raggedright\strut
Cluster 1\strut
\end{minipage} & \begin{minipage}[b]{0.07\columnwidth}\raggedright\strut
Cluster 2\strut
\end{minipage} & \begin{minipage}[b]{0.07\columnwidth}\raggedright\strut
Cluster 3\strut
\end{minipage} & \begin{minipage}[b]{0.07\columnwidth}\raggedright\strut
Cluster 4\strut
\end{minipage} & \begin{minipage}[b]{0.07\columnwidth}\raggedright\strut
P\strut
\end{minipage} & \begin{minipage}[b]{0.07\columnwidth}\raggedright\strut
Cluster 5\strut
\end{minipage} & \begin{minipage}[b]{0.07\columnwidth}\raggedright\strut
Cluster 6\strut
\end{minipage} & \begin{minipage}[b]{0.07\columnwidth}\raggedright\strut
Cluster 7\strut
\end{minipage} & \begin{minipage}[b]{0.07\columnwidth}\raggedright\strut
P\strut
\end{minipage}\tabularnewline
\midrule
\endhead
\begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
N\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
201\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
303\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
140\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
263\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
236\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
316\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
475\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
Age\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
78 (12)\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
81 (8)\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
78 (9)\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
80 (9)\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
0.0000\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
82 (9.5)\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
82.5 (8)\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
84 (8)\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
0.0006\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
Sex (male)\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
55 (27.4\%)\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
124 (40.9\%)\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
91 (65\%)\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
85 (32.3\%)\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
0.00001\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
157 (66.5\%)\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
96 (30.4\%)\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
157 (33\%)\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
0.0001\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
SBP (mmHg)\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
148 (38)\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
140 (36)\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
141 (35)\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
140 (37)\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
0.0005\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
137 (35)\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
135 (35)\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
137 (33)\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
0.0001\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
eGFR (MDRD)\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
49.2 (35.6)\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
51.9 (32.9)\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
54 (32)\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
51.7 (35.9)\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
0.39\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
62.3 (33.7)\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
58.2 (38.9)\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
60 (35)\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
0.0001\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
Hemoglobin (g/dl)\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
11.4 (2.5)\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
11.7 (2.8)\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
11.1 (2.9)\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
11.5 (2.7)\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
0.62\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
12.8 (2.9)\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
12.1 (2.7)\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
12.3 (2.6)\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
0.01\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
BMI (kg/m2)\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
30.5 (8.8)\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
29.7 (7.2)\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
31.2 (6.8)\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
30.9 (7.3)\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
0.28\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
28.5 (7.2)\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
28.9 (7.0)\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
28.3 (6.6)\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
0.25\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
Dyslipidemia\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
201 (100\%)\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
2 (0.66\%)\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
135 (96.4\%)\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
263 (100\%)\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
0.0001\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
102 (43.2\%)\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
307 (97.1\%)\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
3 (0.63\%)\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
0.0001\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
COPD\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
0 (0\%)\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
77 (25.4\%)\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
140 (100\%)\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
0 (0\%)\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
0.0001\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
236 (100\%)\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
5 (1.6\%)\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
24 (5\%)\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
0.0001\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
Arrhythmia\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
Arrhythmia\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
Arrhythmia\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
Arrhythmia\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
Arrhythmia\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
Arrhythmia\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
No\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
199 (99\%)\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
104 (34.3\%)\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
54 (38.6\%)\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
2 (0.76\%)\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
0.0001\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
76 (32.2\%)\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
130 (41.1\%)\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
167 (35.2\%)\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
0.08\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
AF/flutter\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
2 (1\%)\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
191 (63\%)\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
82 (58.6\%)\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
247 (93.9\%)\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
153 (64.8\%)\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
174 (55.1\%)\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
300 (63.2\%)\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
AV block\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
0 (0\%)\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
5 (1.65\%)\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
1 (0.7\%)\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
9 (3.4\%)\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
5 (2.1\%)\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
6 (1.9\%)\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
6 (1.3\%)\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
Other\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
0 (0\%)\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
3 (0.9\%)\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
3 (2.1\%)\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
5 (1.9\%)\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
2 (0.8\%)\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
6 (1.9\%)\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
2 (0.4\%)\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
Stroke\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
Stroke\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
Stroke\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
Stroke\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
Stroke\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
Stroke\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
No\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
179 (89\%)\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
262 (86.5\%)\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
129 (92.1\%)\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
214 (81.4\%)\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
0.002\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
220 (93.2\%)\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
260 (82.3\%)\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
420 (88.4\%)\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
0.003\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
TIA\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
9 (4.5\%)\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
13 (4.3\%)\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
3 (2.1\%)\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
19 (7.2\%)\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
9 (3.8\%)\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
12 (3.8\%)\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
19 (4\%)\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
Hemorrhagic\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
0 (0\%)\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
2 (0.6\%)\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
3 (2.1\%)\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
5 (1.9\%)\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
2 (0.8\%)\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
8 (2.5\%)\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
4 (0.8\%)\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
Cardioembolic\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
0 (0\%)\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
8 (2.6\%)\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
3 (2.1\%)\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
9 (3.4\%)\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
2 (0.85\%)\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
16 (5.1\%)\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
15 (3.2\%)\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
Atherothrombotic\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
13 (6.5\%)\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
18 (5.9\%)\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
2 (1.4\%)\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
16 (6.1\%)\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
3 (1.3\%)\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
20 (6.3\%)\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
17 (3.6\%)\strut
\end{minipage} & \begin{minipage}[t]{0.10\columnwidth}\raggedright\strut
\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
Liver disease\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
12 (5.9\%)\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
20 (6.6\%)\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
18 (12.9\%)\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
13 (4.9\%)\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
0.02\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
16 (6.8\%)\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
11 (3.5\%)\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
23 (4.8\%)\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
0.2\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
Dementia\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
8 (3.9\%)\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
19 (6.3\%)\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
6 (4.3\%)\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
9 (3.4\%)\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
0.4\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
10 (4.2\%)\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
16 (5.1\%)\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
28 (5.9\%)\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
0.6\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
HbA1c (\%)\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
7.2 (2.2)\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
6.8 (1.3)\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
7 (1.6)\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
6.9 (2)\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
0.29\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.07\columnwidth}\raggedright\strut
\strut
\end{minipage}\tabularnewline
\bottomrule
\end{longtable}

Quantitative variables are shown as mean (standard deviation).
Qualitative variables are shown as absolute number (percentage).

AF/flutter: atrial fibrillation/flutter; AV block: atrioventricular
block; BMI: body mass index; COPD: chronic obstructive pulmonary
disease; eGFR: estimated glomerular filtration ratio by MDRD formula;
HbA1c: glycosylated hemoglobin; SBP: systolic blood pressure; TIA:
transitory ischemic attack.

Table 2: Clinical, laboratory and echocardiographic findings by cluster\selectlanguage{english}
\begin{longtable}[]{@{}lllllllll@{}}
\toprule
\begin{minipage}[b]{0.08\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[b]{0.08\columnwidth}\raggedright\strut
Patients with T2DM\strut
\end{minipage} & \begin{minipage}[b]{0.08\columnwidth}\raggedright\strut
Patients with T2DM\strut
\end{minipage} & \begin{minipage}[b]{0.08\columnwidth}\raggedright\strut
Patients with T2DM\strut
\end{minipage} & \begin{minipage}[b]{0.08\columnwidth}\raggedright\strut
Patients with T2DM\strut
\end{minipage} & \begin{minipage}[b]{0.08\columnwidth}\raggedright\strut
Patients without T2DM\strut
\end{minipage} & \begin{minipage}[b]{0.08\columnwidth}\raggedright\strut
Patients without T2DM\strut
\end{minipage} & \begin{minipage}[b]{0.08\columnwidth}\raggedright\strut
Patients without T2DM\strut
\end{minipage} & \begin{minipage}[b]{0.08\columnwidth}\raggedright\strut
\strut
\end{minipage}\tabularnewline
\midrule
\endhead
\begin{minipage}[t]{0.08\columnwidth}\raggedright\strut
VARIABLE\strut
\end{minipage} & \begin{minipage}[t]{0.08\columnwidth}\raggedright\strut
CLUSTER 1\strut
\end{minipage} & \begin{minipage}[t]{0.08\columnwidth}\raggedright\strut
CLUSTER 2\strut
\end{minipage} & \begin{minipage}[t]{0.08\columnwidth}\raggedright\strut
CLUSTER 3\strut
\end{minipage} & \begin{minipage}[t]{0.08\columnwidth}\raggedright\strut
CLUSTER 4\strut
\end{minipage} & \begin{minipage}[t]{0.08\columnwidth}\raggedright\strut
CLUSTER 5\strut
\end{minipage} & \begin{minipage}[t]{0.08\columnwidth}\raggedright\strut
CLUSTER 6\strut
\end{minipage} & \begin{minipage}[t]{0.08\columnwidth}\raggedright\strut
CLUSTER 7\strut
\end{minipage} & \begin{minipage}[t]{0.08\columnwidth}\raggedright\strut
P\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.08\columnwidth}\raggedright\strut
N\strut
\end{minipage} & \begin{minipage}[t]{0.08\columnwidth}\raggedright\strut
201\strut
\end{minipage} & \begin{minipage}[t]{0.08\columnwidth}\raggedright\strut
303\strut
\end{minipage} & \begin{minipage}[t]{0.08\columnwidth}\raggedright\strut
140\strut
\end{minipage} & \begin{minipage}[t]{0.08\columnwidth}\raggedright\strut
263\strut
\end{minipage} & \begin{minipage}[t]{0.08\columnwidth}\raggedright\strut
236\strut
\end{minipage} & \begin{minipage}[t]{0.08\columnwidth}\raggedright\strut
316\strut
\end{minipage} & \begin{minipage}[t]{0.08\columnwidth}\raggedright\strut
475\strut
\end{minipage} & \begin{minipage}[t]{0.08\columnwidth}\raggedright\strut
\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.08\columnwidth}\raggedright\strut
History of hypertension\strut
\end{minipage} & \begin{minipage}[t]{0.08\columnwidth}\raggedright\strut
191 (95\%)\strut
\end{minipage} & \begin{minipage}[t]{0.08\columnwidth}\raggedright\strut
288 (95\%)\strut
\end{minipage} & \begin{minipage}[t]{0.08\columnwidth}\raggedright\strut
137 (98\%)\strut
\end{minipage} & \begin{minipage}[t]{0.08\columnwidth}\raggedright\strut
253 (96\%)\strut
\end{minipage} & \begin{minipage}[t]{0.08\columnwidth}\raggedright\strut
201 (85\%)\strut
\end{minipage} & \begin{minipage}[t]{0.08\columnwidth}\raggedright\strut
286 (91\%)\strut
\end{minipage} & \begin{minipage}[t]{0.08\columnwidth}\raggedright\strut
408 (86\%)\strut
\end{minipage} & \begin{minipage}[t]{0.08\columnwidth}\raggedright\strut
\textless{}0.001\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.08\columnwidth}\raggedright\strut
History of smoking\strut
\end{minipage} & \begin{minipage}[t]{0.08\columnwidth}\raggedright\strut
44 (22\%)\strut
\end{minipage} & \begin{minipage}[t]{0.08\columnwidth}\raggedright\strut
99 (33\%)\strut
\end{minipage} & \begin{minipage}[t]{0.08\columnwidth}\raggedright\strut
86 (61\%)\strut
\end{minipage} & \begin{minipage}[t]{0.08\columnwidth}\raggedright\strut
75 (29\%)\strut
\end{minipage} & \begin{minipage}[t]{0.08\columnwidth}\raggedright\strut
127 (54\%)\strut
\end{minipage} & \begin{minipage}[t]{0.08\columnwidth}\raggedright\strut
71 (22\%)\strut
\end{minipage} & \begin{minipage}[t]{0.08\columnwidth}\raggedright\strut
117 (25\%)\strut
\end{minipage} & \begin{minipage}[t]{0.08\columnwidth}\raggedright\strut
0.187\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.08\columnwidth}\raggedright\strut
History of alcoholism\strut
\end{minipage} & \begin{minipage}[t]{0.08\columnwidth}\raggedright\strut
19 (9.5\%)\strut
\end{minipage} & \begin{minipage}[t]{0.08\columnwidth}\raggedright\strut
48 (16\%)\strut
\end{minipage} & \begin{minipage}[t]{0.08\columnwidth}\raggedright\strut
35 (25\%)\strut
\end{minipage} & \begin{minipage}[t]{0.08\columnwidth}\raggedright\strut
29 (11\%)\strut
\end{minipage} & \begin{minipage}[t]{0.08\columnwidth}\raggedright\strut
61 (26\%)\strut
\end{minipage} & \begin{minipage}[t]{0.08\columnwidth}\raggedright\strut
37 (12\%)\strut
\end{minipage} & \begin{minipage}[t]{0.08\columnwidth}\raggedright\strut
49 (10\%)\strut
\end{minipage} & \begin{minipage}[t]{0.08\columnwidth}\raggedright\strut
0.948\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.08\columnwidth}\raggedright\strut
CCI\strut
\end{minipage} & \begin{minipage}[t]{0.08\columnwidth}\raggedright\strut
4.17\selectlanguage{ngerman}±2.28\strut
\end{minipage} & \begin{minipage}[t]{0.08\columnwidth}\raggedright\strut
3.64\selectlanguage{ngerman}±2.45\strut
\end{minipage} & \begin{minipage}[t]{0.08\columnwidth}\raggedright\strut
5.29\selectlanguage{ngerman}±2.49\strut
\end{minipage} & \begin{minipage}[t]{0.08\columnwidth}\raggedright\strut
4.06\selectlanguage{ngerman}±2.25\strut
\end{minipage} & \begin{minipage}[t]{0.08\columnwidth}\raggedright\strut
2.67\selectlanguage{ngerman}±1.87\strut
\end{minipage} & \begin{minipage}[t]{0.08\columnwidth}\raggedright\strut
1.83\selectlanguage{ngerman}±1.78\strut
\end{minipage} & \begin{minipage}[t]{0.08\columnwidth}\raggedright\strut
1.65\selectlanguage{ngerman}±1.75\strut
\end{minipage} & \begin{minipage}[t]{0.08\columnwidth}\raggedright\strut
\textless{}0.001\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.08\columnwidth}\raggedright\strut
Barthel index\strut
\end{minipage} & \begin{minipage}[t]{0.08\columnwidth}\raggedright\strut
81.59\selectlanguage{ngerman}±24.12\strut
\end{minipage} & \begin{minipage}[t]{0.08\columnwidth}\raggedright\strut
79.59\selectlanguage{ngerman}±23.11\strut
\end{minipage} & \begin{minipage}[t]{0.08\columnwidth}\raggedright\strut
84.61\selectlanguage{ngerman}±19.39\strut
\end{minipage} & \begin{minipage}[t]{0.08\columnwidth}\raggedright\strut
79.10\selectlanguage{ngerman}±22.90\strut
\end{minipage} & \begin{minipage}[t]{0.08\columnwidth}\raggedright\strut
84.51\selectlanguage{ngerman}±19.54\strut
\end{minipage} & \begin{minipage}[t]{0.08\columnwidth}\raggedright\strut
81.29\selectlanguage{ngerman}±22.75\strut
\end{minipage} & \begin{minipage}[t]{0.08\columnwidth}\raggedright\strut
81.84\selectlanguage{ngerman}±22.55\strut
\end{minipage} & \begin{minipage}[t]{0.08\columnwidth}\raggedright\strut
0.113\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.08\columnwidth}\raggedright\strut
Pfeiffer index\strut
\end{minipage} & \begin{minipage}[t]{0.08\columnwidth}\raggedright\strut
1.57\selectlanguage{ngerman}±2.04\strut
\end{minipage} & \begin{minipage}[t]{0.08\columnwidth}\raggedright\strut
1.69\selectlanguage{ngerman}±2.21\strut
\end{minipage} & \begin{minipage}[t]{0.08\columnwidth}\raggedright\strut
1.22\selectlanguage{ngerman}±1.54\strut
\end{minipage} & \begin{minipage}[t]{0.08\columnwidth}\raggedright\strut
1.62\selectlanguage{ngerman}±1.82\strut
\end{minipage} & \begin{minipage}[t]{0.08\columnwidth}\raggedright\strut
1.50\selectlanguage{ngerman}±1.88\strut
\end{minipage} & \begin{minipage}[t]{0.08\columnwidth}\raggedright\strut
1.63\selectlanguage{ngerman}±1.99\strut
\end{minipage} & \begin{minipage}[t]{0.08\columnwidth}\raggedright\strut
1.53\selectlanguage{ngerman}±1.91\strut
\end{minipage} & \begin{minipage}[t]{0.08\columnwidth}\raggedright\strut
0.914\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.08\columnwidth}\raggedright\strut
HR (bpm)\strut
\end{minipage} & \begin{minipage}[t]{0.08\columnwidth}\raggedright\strut
84.97\selectlanguage{ngerman}±22.51\strut
\end{minipage} & \begin{minipage}[t]{0.08\columnwidth}\raggedright\strut
85.51\selectlanguage{ngerman}±20.76\strut
\end{minipage} & \begin{minipage}[t]{0.08\columnwidth}\raggedright\strut
85.40\selectlanguage{ngerman}±19.90\strut
\end{minipage} & \begin{minipage}[t]{0.08\columnwidth}\raggedright\strut
83.88\selectlanguage{ngerman}±21.99\strut
\end{minipage} & \begin{minipage}[t]{0.08\columnwidth}\raggedright\strut
88.68\selectlanguage{ngerman}±22,19\strut
\end{minipage} & \begin{minipage}[t]{0.08\columnwidth}\raggedright\strut
86.62\selectlanguage{ngerman}±22,49\strut
\end{minipage} & \begin{minipage}[t]{0.08\columnwidth}\raggedright\strut
88.93\selectlanguage{ngerman}±24.33\strut
\end{minipage} & \begin{minipage}[t]{0.08\columnwidth}\raggedright\strut
0,001\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.08\columnwidth}\raggedright\strut
LVEF\strut
\end{minipage} & \begin{minipage}[t]{0.08\columnwidth}\raggedright\strut
60\emph{+}10\strut
\end{minipage} & \begin{minipage}[t]{0.08\columnwidth}\raggedright\strut
60\emph{+}11\strut
\end{minipage} & \begin{minipage}[t]{0.08\columnwidth}\raggedright\strut
60\emph{+}10\strut
\end{minipage} & \begin{minipage}[t]{0.08\columnwidth}\raggedright\strut
60\emph{+}10\strut
\end{minipage} & \begin{minipage}[t]{0.08\columnwidth}\raggedright\strut
61.1\emph{+}10.5\strut
\end{minipage} & \begin{minipage}[t]{0.08\columnwidth}\raggedright\strut
61.3\emph{+}12\strut
\end{minipage} & \begin{minipage}[t]{0.08\columnwidth}\raggedright\strut
63\emph{+}13\strut
\end{minipage} & \begin{minipage}[t]{0.08\columnwidth}\raggedright\strut
0.22\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.08\columnwidth}\raggedright\strut
LVPWT (mm)\strut
\end{minipage} & \begin{minipage}[t]{0.08\columnwidth}\raggedright\strut
11.67\selectlanguage{ngerman}±1.94\strut
\end{minipage} & \begin{minipage}[t]{0.08\columnwidth}\raggedright\strut
11.90\selectlanguage{ngerman}±2.42\strut
\end{minipage} & \begin{minipage}[t]{0.08\columnwidth}\raggedright\strut
12.04\selectlanguage{ngerman}±1.82\strut
\end{minipage} & \begin{minipage}[t]{0.08\columnwidth}\raggedright\strut
11.66\selectlanguage{ngerman}±1.82\strut
\end{minipage} & \begin{minipage}[t]{0.08\columnwidth}\raggedright\strut
12.17\selectlanguage{ngerman}±3.52\strut
\end{minipage} & \begin{minipage}[t]{0.08\columnwidth}\raggedright\strut
11.81\selectlanguage{ngerman}±7.62\strut
\end{minipage} & \begin{minipage}[t]{0.08\columnwidth}\raggedright\strut
11.44\selectlanguage{ngerman}±2.41\strut
\end{minipage} & \begin{minipage}[t]{0.08\columnwidth}\raggedright\strut
0.753\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.08\columnwidth}\raggedright\strut
PASP (mmHg)\strut
\end{minipage} & \begin{minipage}[t]{0.08\columnwidth}\raggedright\strut
41.62\selectlanguage{ngerman}±13.53\strut
\end{minipage} & \begin{minipage}[t]{0.08\columnwidth}\raggedright\strut
47.01\selectlanguage{ngerman}±13.50\strut
\end{minipage} & \begin{minipage}[t]{0.08\columnwidth}\raggedright\strut
46.91\selectlanguage{ngerman}±15.93\strut
\end{minipage} & \begin{minipage}[t]{0.08\columnwidth}\raggedright\strut
48.09\selectlanguage{ngerman}±15.63\strut
\end{minipage} & \begin{minipage}[t]{0.08\columnwidth}\raggedright\strut
46.57\selectlanguage{ngerman}±13.68\strut
\end{minipage} & \begin{minipage}[t]{0.08\columnwidth}\raggedright\strut
44.35\selectlanguage{ngerman}±13.03\strut
\end{minipage} & \begin{minipage}[t]{0.08\columnwidth}\raggedright\strut
44.83\selectlanguage{ngerman}±14.03\strut
\end{minipage} & \begin{minipage}[t]{0.08\columnwidth}\raggedright\strut
0.122\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.08\columnwidth}\raggedright\strut
LAD (mm)\strut
\end{minipage} & \begin{minipage}[t]{0.08\columnwidth}\raggedright\strut
42.67\selectlanguage{ngerman}±8.24\strut
\end{minipage} & \begin{minipage}[t]{0.08\columnwidth}\raggedright\strut
45.37\selectlanguage{ngerman}±9.65\strut
\end{minipage} & \begin{minipage}[t]{0.08\columnwidth}\raggedright\strut
45.97\selectlanguage{ngerman}±8.92\strut
\end{minipage} & \begin{minipage}[t]{0.08\columnwidth}\raggedright\strut
45.89\selectlanguage{ngerman}±9.99\strut
\end{minipage} & \begin{minipage}[t]{0.08\columnwidth}\raggedright\strut
47.19\selectlanguage{ngerman}±10.03\strut
\end{minipage} & \begin{minipage}[t]{0.08\columnwidth}\raggedright\strut
46.55\selectlanguage{ngerman}±9.42\strut
\end{minipage} & \begin{minipage}[t]{0.08\columnwidth}\raggedright\strut
45.07\selectlanguage{ngerman}±10.06\strut
\end{minipage} & \begin{minipage}[t]{0.08\columnwidth}\raggedright\strut
0.07\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.08\columnwidth}\raggedright\strut
Serum sodium (mEq/L)\strut
\end{minipage} & \begin{minipage}[t]{0.08\columnwidth}\raggedright\strut
138.62\selectlanguage{ngerman}±4.67\strut
\end{minipage} & \begin{minipage}[t]{0.08\columnwidth}\raggedright\strut
138.86\selectlanguage{ngerman}±4.79\strut
\end{minipage} & \begin{minipage}[t]{0.08\columnwidth}\raggedright\strut
137.79\selectlanguage{ngerman}±12.44\strut
\end{minipage} & \begin{minipage}[t]{0.08\columnwidth}\raggedright\strut
138.32\selectlanguage{ngerman}±5.11\strut
\end{minipage} & \begin{minipage}[t]{0.08\columnwidth}\raggedright\strut
139.33\selectlanguage{ngerman}±4.81\strut
\end{minipage} & \begin{minipage}[t]{0.08\columnwidth}\raggedright\strut
138.70\selectlanguage{ngerman}±5.00\strut
\end{minipage} & \begin{minipage}[t]{0.08\columnwidth}\raggedright\strut
139.20\selectlanguage{ngerman}±4.94\strut
\end{minipage} & \begin{minipage}[t]{0.08\columnwidth}\raggedright\strut
0.025\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.08\columnwidth}\raggedright\strut
Serum potassium (mEq/L)\strut
\end{minipage} & \begin{minipage}[t]{0.08\columnwidth}\raggedright\strut
4.46\selectlanguage{ngerman}±0.57\strut
\end{minipage} & \begin{minipage}[t]{0.08\columnwidth}\raggedright\strut
4.37\selectlanguage{ngerman}±0.64\strut
\end{minipage} & \begin{minipage}[t]{0.08\columnwidth}\raggedright\strut
4.44\selectlanguage{ngerman}±0.54\strut
\end{minipage} & \begin{minipage}[t]{0.08\columnwidth}\raggedright\strut
4.36\selectlanguage{ngerman}±0.63\strut
\end{minipage} & \begin{minipage}[t]{0.08\columnwidth}\raggedright\strut
4.30\selectlanguage{ngerman}±0.59\strut
\end{minipage} & \begin{minipage}[t]{0.08\columnwidth}\raggedright\strut
4.28\selectlanguage{ngerman}±0.61\strut
\end{minipage} & \begin{minipage}[t]{0.08\columnwidth}\raggedright\strut
4.27\selectlanguage{ngerman}±0.60\strut
\end{minipage} & \begin{minipage}[t]{0.08\columnwidth}\raggedright\strut
\textless{}0.001\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.08\columnwidth}\raggedright\strut
Etiology of HF\strut
\end{minipage} & \begin{minipage}[t]{0.08\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.08\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.08\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.08\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.08\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.08\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.08\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.08\columnwidth}\raggedright\strut
\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.11\columnwidth}\raggedright\strut
Hypertensive\strut
\end{minipage} & \begin{minipage}[t]{0.11\columnwidth}\raggedright\strut
101 (51\%)\strut
\end{minipage} & \begin{minipage}[t]{0.11\columnwidth}\raggedright\strut
196 (65\%)\strut
\end{minipage} & \begin{minipage}[t]{0.11\columnwidth}\raggedright\strut
84 (61\%)\strut
\end{minipage} & \begin{minipage}[t]{0.11\columnwidth}\raggedright\strut
178 (68\%)\strut
\end{minipage} & \begin{minipage}[t]{0.11\columnwidth}\raggedright\strut
145 (62\%)\strut
\end{minipage} & \begin{minipage}[t]{0.11\columnwidth}\raggedright\strut
197 (63\%)\strut
\end{minipage} & \begin{minipage}[t]{0.11\columnwidth}\raggedright\strut
312 (66\%)\strut
\end{minipage} & \begin{minipage}[t]{0.11\columnwidth}\raggedright\strut
0.420\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.11\columnwidth}\raggedright\strut
Ischemic\strut
\end{minipage} & \begin{minipage}[t]{0.11\columnwidth}\raggedright\strut
80 (40\%)\strut
\end{minipage} & \begin{minipage}[t]{0.11\columnwidth}\raggedright\strut
48 (16\%)\strut
\end{minipage} & \begin{minipage}[t]{0.11\columnwidth}\raggedright\strut
40 (29\%)\strut
\end{minipage} & \begin{minipage}[t]{0.11\columnwidth}\raggedright\strut
54 (21\%)\strut
\end{minipage} & \begin{minipage}[t]{0.11\columnwidth}\raggedright\strut
36 (15\%)\strut
\end{minipage} & \begin{minipage}[t]{0.11\columnwidth}\raggedright\strut
67 (21\%)\strut
\end{minipage} & \begin{minipage}[t]{0.11\columnwidth}\raggedright\strut
60 (13\%)\strut
\end{minipage} & \begin{minipage}[t]{0.11\columnwidth}\raggedright\strut
\textless{}0.001\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.11\columnwidth}\raggedright\strut
Alcoholic\strut
\end{minipage} & \begin{minipage}[t]{0.11\columnwidth}\raggedright\strut
0\strut
\end{minipage} & \begin{minipage}[t]{0.11\columnwidth}\raggedright\strut
1 (0.33\%)\strut
\end{minipage} & \begin{minipage}[t]{0.11\columnwidth}\raggedright\strut
1 (0.73\%)\strut
\end{minipage} & \begin{minipage}[t]{0.11\columnwidth}\raggedright\strut
0\strut
\end{minipage} & \begin{minipage}[t]{0.11\columnwidth}\raggedright\strut
4 (1.7\%)\strut
\end{minipage} & \begin{minipage}[t]{0.11\columnwidth}\raggedright\strut
0\strut
\end{minipage} & \begin{minipage}[t]{0.11\columnwidth}\raggedright\strut
1 (0.21\%)\strut
\end{minipage} & \begin{minipage}[t]{0.11\columnwidth}\raggedright\strut
0.459\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.11\columnwidth}\raggedright\strut
Toxic\strut
\end{minipage} & \begin{minipage}[t]{0.11\columnwidth}\raggedright\strut
0\strut
\end{minipage} & \begin{minipage}[t]{0.11\columnwidth}\raggedright\strut
0\strut
\end{minipage} & \begin{minipage}[t]{0.11\columnwidth}\raggedright\strut
1 (0.73\%)\strut
\end{minipage} & \begin{minipage}[t]{0.11\columnwidth}\raggedright\strut
0\strut
\end{minipage} & \begin{minipage}[t]{0.11\columnwidth}\raggedright\strut
0\strut
\end{minipage} & \begin{minipage}[t]{0.11\columnwidth}\raggedright\strut
0\strut
\end{minipage} & \begin{minipage}[t]{0.11\columnwidth}\raggedright\strut
2 (0.42\%)\strut
\end{minipage} & \begin{minipage}[t]{0.11\columnwidth}\raggedright\strut
1.000\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.11\columnwidth}\raggedright\strut
Hypertrophic\strut
\end{minipage} & \begin{minipage}[t]{0.11\columnwidth}\raggedright\strut
3 (1.5\%)\strut
\end{minipage} & \begin{minipage}[t]{0.11\columnwidth}\raggedright\strut
11 (3.7\%)\strut
\end{minipage} & \begin{minipage}[t]{0.11\columnwidth}\raggedright\strut
2 (1.5\%)\strut
\end{minipage} & \begin{minipage}[t]{0.11\columnwidth}\raggedright\strut
2 (0.76\%)\strut
\end{minipage} & \begin{minipage}[t]{0.11\columnwidth}\raggedright\strut
4 (1.7\%)\strut
\end{minipage} & \begin{minipage}[t]{0.11\columnwidth}\raggedright\strut
7 (2.2\%)\strut
\end{minipage} & \begin{minipage}[t]{0.11\columnwidth}\raggedright\strut
18 (3.8\%)\strut
\end{minipage} & \begin{minipage}[t]{0.11\columnwidth}\raggedright\strut
0.300\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.11\columnwidth}\raggedright\strut
Others\strut
\end{minipage} & \begin{minipage}[t]{0.11\columnwidth}\raggedright\strut
14 (7.1\%)\strut
\end{minipage} & \begin{minipage}[t]{0.11\columnwidth}\raggedright\strut
44 (15\%)\strut
\end{minipage} & \begin{minipage}[t]{0.11\columnwidth}\raggedright\strut
9 (6.6\%)\strut
\end{minipage} & \begin{minipage}[t]{0.11\columnwidth}\raggedright\strut
28 (11\%)\strut
\end{minipage} & \begin{minipage}[t]{0.11\columnwidth}\raggedright\strut
45 (19\%)\strut
\end{minipage} & \begin{minipage}[t]{0.11\columnwidth}\raggedright\strut
44 (14\%)\strut
\end{minipage} & \begin{minipage}[t]{0.11\columnwidth}\raggedright\strut
78 (17\%)\strut
\end{minipage} & \begin{minipage}[t]{0.11\columnwidth}\raggedright\strut
\textless{}0.001\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.11\columnwidth}\raggedright\strut
NT-ProBNP\strut
\end{minipage} & \begin{minipage}[t]{0.11\columnwidth}\raggedright\strut
4328.45\selectlanguage{ngerman}± 5623.14\strut
\end{minipage} & \begin{minipage}[t]{0.11\columnwidth}\raggedright\strut
5054.05\selectlanguage{ngerman}± 6646.79\strut
\end{minipage} & \begin{minipage}[t]{0.11\columnwidth}\raggedright\strut
4774.06\selectlanguage{ngerman}± 4989.90\strut
\end{minipage} & \begin{minipage}[t]{0.11\columnwidth}\raggedright\strut
4703.97\selectlanguage{ngerman}± 6593.10\strut
\end{minipage} & \begin{minipage}[t]{0.11\columnwidth}\raggedright\strut
4963.54\selectlanguage{ngerman}± 6093.54\strut
\end{minipage} & \begin{minipage}[t]{0.11\columnwidth}\raggedright\strut
5155.51\selectlanguage{ngerman}± 5689.35\strut
\end{minipage} & \begin{minipage}[t]{0.11\columnwidth}\raggedright\strut
5729.33\selectlanguage{ngerman}± 7147.94\strut
\end{minipage} & \begin{minipage}[t]{0.11\columnwidth}\raggedright\strut
0,135\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.08\columnwidth}\raggedright\strut
New York Heart Association Class\strut
\end{minipage} & \begin{minipage}[t]{0.08\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.08\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.08\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.08\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.08\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.08\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.08\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.08\columnwidth}\raggedright\strut
\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.11\columnwidth}\raggedright\strut
I\strut
\end{minipage} & \begin{minipage}[t]{0.11\columnwidth}\raggedright\strut
23 (12\%)\strut
\end{minipage} & \begin{minipage}[t]{0.11\columnwidth}\raggedright\strut
12 (4.0\%)\strut
\end{minipage} & \begin{minipage}[t]{0.11\columnwidth}\raggedright\strut
9 (6.5\%)\strut
\end{minipage} & \begin{minipage}[t]{0.11\columnwidth}\raggedright\strut
12 (4.6\%)\strut
\end{minipage} & \begin{minipage}[t]{0.11\columnwidth}\raggedright\strut
16 (6.8\%)\strut
\end{minipage} & \begin{minipage}[t]{0.11\columnwidth}\raggedright\strut
37 (12\%)\strut
\end{minipage} & \begin{minipage}[t]{0.11\columnwidth}\raggedright\strut
64 (14\%)\strut
\end{minipage} & \begin{minipage}[t]{0.11\columnwidth}\raggedright\strut
\textless{}0.001\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.11\columnwidth}\raggedright\strut
II\strut
\end{minipage} & \begin{minipage}[t]{0.11\columnwidth}\raggedright\strut
118 (59\%)\strut
\end{minipage} & \begin{minipage}[t]{0.11\columnwidth}\raggedright\strut
173 (57\%)\strut
\end{minipage} & \begin{minipage}[t]{0.11\columnwidth}\raggedright\strut
67 (48\%)\strut
\end{minipage} & \begin{minipage}[t]{0.11\columnwidth}\raggedright\strut
158 (61\%)\strut
\end{minipage} & \begin{minipage}[t]{0.11\columnwidth}\raggedright\strut
130 (56\%)\strut
\end{minipage} & \begin{minipage}[t]{0.11\columnwidth}\raggedright\strut
198 (63\%)\strut
\end{minipage} & \begin{minipage}[t]{0.11\columnwidth}\raggedright\strut
277 (59\%)\strut
\end{minipage} & \begin{minipage}[t]{0.11\columnwidth}\raggedright\strut
0.353\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.11\columnwidth}\raggedright\strut
III\strut
\end{minipage} & \begin{minipage}[t]{0.11\columnwidth}\raggedright\strut
53 (27\%)\strut
\end{minipage} & \begin{minipage}[t]{0.11\columnwidth}\raggedright\strut
109 (36\%)\strut
\end{minipage} & \begin{minipage}[t]{0.11\columnwidth}\raggedright\strut
56 (40\%)\strut
\end{minipage} & \begin{minipage}[t]{0.11\columnwidth}\raggedright\strut
88 (34\%)\strut
\end{minipage} & \begin{minipage}[t]{0.11\columnwidth}\raggedright\strut
81 (35\%)\strut
\end{minipage} & \begin{minipage}[t]{0.11\columnwidth}\raggedright\strut
72 (23\%)\strut
\end{minipage} & \begin{minipage}[t]{0.11\columnwidth}\raggedright\strut
118 (25\%)\strut
\end{minipage} & \begin{minipage}[t]{0.11\columnwidth}\raggedright\strut
\textless{}0.001\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.11\columnwidth}\raggedright\strut
IV\strut
\end{minipage} & \begin{minipage}[t]{0.11\columnwidth}\raggedright\strut
5 (2.5\%)\strut
\end{minipage} & \begin{minipage}[t]{0.11\columnwidth}\raggedright\strut
7 (2.3\%)\strut
\end{minipage} & \begin{minipage}[t]{0.11\columnwidth}\raggedright\strut
7 (5.0\%)\strut
\end{minipage} & \begin{minipage}[t]{0.11\columnwidth}\raggedright\strut
3 (1.1\%)\strut
\end{minipage} & \begin{minipage}[t]{0.11\columnwidth}\raggedright\strut
7 (3.0\%)\strut
\end{minipage} & \begin{minipage}[t]{0.11\columnwidth}\raggedright\strut
6 (1.9\%)\strut
\end{minipage} & \begin{minipage}[t]{0.11\columnwidth}\raggedright\strut
11 (2.3\%)\strut
\end{minipage} & \begin{minipage}[t]{0.11\columnwidth}\raggedright\strut
1.000\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.08\columnwidth}\raggedright\strut
Medications\strut
\end{minipage} & \begin{minipage}[t]{0.08\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.08\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.08\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.08\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.08\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.08\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.08\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.08\columnwidth}\raggedright\strut
\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.11\columnwidth}\raggedright\strut
ACEi/ARB\strut
\end{minipage} & \begin{minipage}[t]{0.11\columnwidth}\raggedright\strut
148 (74\%)\strut
\end{minipage} & \begin{minipage}[t]{0.11\columnwidth}\raggedright\strut
222 (73\%)\strut
\end{minipage} & \begin{minipage}[t]{0.11\columnwidth}\raggedright\strut
92 (66\%)\strut
\end{minipage} & \begin{minipage}[t]{0.11\columnwidth}\raggedright\strut
186 (71\%)\strut
\end{minipage} & \begin{minipage}[t]{0.11\columnwidth}\raggedright\strut
156 (66\%)\strut
\end{minipage} & \begin{minipage}[t]{0.11\columnwidth}\raggedright\strut
190 (60\%)\strut
\end{minipage} & \begin{minipage}[t]{0.11\columnwidth}\raggedright\strut
324 (68\%)\strut
\end{minipage} & \begin{minipage}[t]{0.11\columnwidth}\raggedright\strut
0.004\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.11\columnwidth}\raggedright\strut
Beta-blockers\strut
\end{minipage} & \begin{minipage}[t]{0.11\columnwidth}\raggedright\strut
128 (64\%)\strut
\end{minipage} & \begin{minipage}[t]{0.11\columnwidth}\raggedright\strut
172 (57\%)\strut
\end{minipage} & \begin{minipage}[t]{0.11\columnwidth}\raggedright\strut
71 (51\%)\strut
\end{minipage} & \begin{minipage}[t]{0.11\columnwidth}\raggedright\strut
158 (60\%)\strut
\end{minipage} & \begin{minipage}[t]{0.11\columnwidth}\raggedright\strut
94 (40\%)\strut
\end{minipage} & \begin{minipage}[t]{0.11\columnwidth}\raggedright\strut
179 (57\%)\strut
\end{minipage} & \begin{minipage}[t]{0.11\columnwidth}\raggedright\strut
255 (54\%)\strut
\end{minipage} & \begin{minipage}[t]{0.11\columnwidth}\raggedright\strut
0.003\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.11\columnwidth}\raggedright\strut
Loop diuretics\strut
\end{minipage} & \begin{minipage}[t]{0.11\columnwidth}\raggedright\strut
176 (88\%)\strut
\end{minipage} & \begin{minipage}[t]{0.11\columnwidth}\raggedright\strut
281 (93\%)\strut
\end{minipage} & \begin{minipage}[t]{0.11\columnwidth}\raggedright\strut
127 (91\%)\strut
\end{minipage} & \begin{minipage}[t]{0.11\columnwidth}\raggedright\strut
229 (87\%)\strut
\end{minipage} & \begin{minipage}[t]{0.11\columnwidth}\raggedright\strut
210 (89\%)\strut
\end{minipage} & \begin{minipage}[t]{0.11\columnwidth}\raggedright\strut
260 (82\%)\strut
\end{minipage} & \begin{minipage}[t]{0.11\columnwidth}\raggedright\strut
409 (86\%)\strut
\end{minipage} & \begin{minipage}[t]{0.11\columnwidth}\raggedright\strut
0.007\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.11\columnwidth}\raggedright\strut
Thiazides\strut
\end{minipage} & \begin{minipage}[t]{0.11\columnwidth}\raggedright\strut
24 (12\%)\strut
\end{minipage} & \begin{minipage}[t]{0.11\columnwidth}\raggedright\strut
37 (12\%)\strut
\end{minipage} & \begin{minipage}[t]{0.11\columnwidth}\raggedright\strut
16 (11\%)\strut
\end{minipage} & \begin{minipage}[t]{0.11\columnwidth}\raggedright\strut
36 (14\%)\strut
\end{minipage} & \begin{minipage}[t]{0.11\columnwidth}\raggedright\strut
16 (6.8\%)\strut
\end{minipage} & \begin{minipage}[t]{0.11\columnwidth}\raggedright\strut
33 (10\%)\strut
\end{minipage} & \begin{minipage}[t]{0.11\columnwidth}\raggedright\strut
41 (8.6\%)\strut
\end{minipage} & \begin{minipage}[t]{0.11\columnwidth}\raggedright\strut
0.009\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.11\columnwidth}\raggedright\strut
Potassium- sparing diuretics\strut
\end{minipage} & \begin{minipage}[t]{0.11\columnwidth}\raggedright\strut
34 (17\%)\strut
\end{minipage} & \begin{minipage}[t]{0.11\columnwidth}\raggedright\strut
76 (25\%)\strut
\end{minipage} & \begin{minipage}[t]{0.11\columnwidth}\raggedright\strut
31 (22\%)\strut
\end{minipage} & \begin{minipage}[t]{0.11\columnwidth}\raggedright\strut
62 (24\%)\strut
\end{minipage} & \begin{minipage}[t]{0.11\columnwidth}\raggedright\strut
55 (23\%)\strut
\end{minipage} & \begin{minipage}[t]{0.11\columnwidth}\raggedright\strut
52 (16\%)\strut
\end{minipage} & \begin{minipage}[t]{0.11\columnwidth}\raggedright\strut
99 (21\%)\strut
\end{minipage} & \begin{minipage}[t]{0.11\columnwidth}\raggedright\strut
0.220\strut
\end{minipage}\tabularnewline
\bottomrule
\end{longtable}

Quantitative variables are shown as mean (standard deviation).
Qualitative variables are shown as absolute number (percentage).

ACEi/ARB: angiotensin-converting enzyme inhibitor/angiotensin receptor
blocker; CCI: Charlson comorbidity index; HR: heart rate; LAD: left
atrium diameter; LVEF: Left ventricular ejection fraction; LVPWT: left
ventricular posterior wall thickening; NT-ProBNP: N-terminal pro b-type
natriuretic peptide; PASP: pulmonary artery systolic pressure.

Table 3: Cox regression analysis\selectlanguage{english}
\begin{longtable}[]{@{}lllllll@{}}
\toprule
\begin{minipage}[b]{0.12\columnwidth}\raggedright\strut
VARIABLE\strut
\end{minipage} & \begin{minipage}[b]{0.12\columnwidth}\raggedright\strut
HR\strut
\end{minipage} & \begin{minipage}[b]{0.12\columnwidth}\raggedright\strut
95\% CI\strut
\end{minipage} & \begin{minipage}[b]{0.12\columnwidth}\raggedright\strut
P\strut
\end{minipage} & \begin{minipage}[b]{0.12\columnwidth}\raggedright\strut
HR\strut
\end{minipage} & \begin{minipage}[b]{0.12\columnwidth}\raggedright\strut
95\% CI\strut
\end{minipage} & \begin{minipage}[b]{0.12\columnwidth}\raggedright\strut
P\strut
\end{minipage}\tabularnewline
\midrule
\endhead
\begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
Heart failure mortality and readmissions\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
Heart failure mortality and readmissions\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
Heart failure mortality and readmissions\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
Overall mortality and readmissions\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
Overall mortality and readmissions\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
Overall mortality and readmissions\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
Age\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
1.02\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
(1.01-1.03)\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
0.001\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
1.01\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
(1.01-1.02)\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
\textless{}0.001\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
CCI\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
1.11\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
(1.08-1.14)\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
\textless{}0.001\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
1.11\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
(1.08-1.14)\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
\textless{}0.001\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
Barthel Index\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
0.99\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
(0.99-0.99)\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
\textless{}0.001\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
0.99\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
(0.99-0.99)\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
\textless{}0.001\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
LVEF\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
0.99\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
(0.98-1.00)\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
0.157\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
0.99\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
(0.99-1.00)\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
0.076\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
eGFR\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
0.99\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
(0.98-0.99)\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
\textless{}0.001\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
0.99\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
(0.99-0.99)\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
\textless{}0.001\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
Serum sodium\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
0.98\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
(0.97-0.99)\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
\textless{}0.001\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
0.98\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
(0.97-0.99)\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
\textless{}0.001\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
ACEi/ARB\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
0.91\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
(0.76-1.08)\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
0.272\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
0.97\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
(0.85-1.11)\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
0.676\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
Beta-blockers\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
0.93\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
(0.79-1.09)\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
0.361\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
0.95\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
(0.84-1.07)\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
0.398\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
Loop diuretics\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
1.3\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
(0.99-1.71)\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
0.061\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
1.19\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
(0.98-1.44)\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
0.079\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
Clusters\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.12\columnwidth}\raggedright\strut
\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
Cluster 1\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
Ref.\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
\textless{}0.001\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
Ref.\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
0.002\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
Cluster 2\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
1.42\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
(1.01-2.02)\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
0.047\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
1.16\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
(0.91-1.49)\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
0.23\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
Cluster 3\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
2\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
(1.36-2.93)\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
\textless{}0.001\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
1.62\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
(1.22-2.16)\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
\textless{}0.001\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
Cluster 4\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
1.65\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
(1.16-2.34)\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
0.005\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
1.3\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
(1.01-1.67)\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
0.043\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
Cluster 5\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
1.3\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
(0.90-1.88)\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
0.167\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
1.11\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
(0.85-1.44)\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
0.442\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
Cluster 6\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
1.22\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
(0.86-1.74)\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
0.267\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
1\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
(0.77-1.28)\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
0.981\strut
\end{minipage}\tabularnewline
\begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
Cluster 7\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
1.1\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
(0.78-1.54)\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
0.589\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
1.05\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
(0.83-1.32)\strut
\end{minipage} & \begin{minipage}[t]{0.14\columnwidth}\raggedright\strut
0.703\strut
\end{minipage}\tabularnewline
\bottomrule
\end{longtable}

ACEi/ARB: angiotensin-converting-enzyme inhibitor/angiotensin receptor
blocker; CCI: Charlson comorbidity index; eGFR: estimated glomerular
filtration rate; LVEF: left ventricular ejection fraction.

FIGURE LEGENDS

Figure 1: Study flowchart

Figure 2: Dissimilarity matrix defined by Kendall distance and
multiscale bootstrap resampling. In the matrix square, the color level
is proportional to the similarity value between the observations. If it
is red, the distance between the variables is 0 (high similarity) and if
it is green, the distance is the highest (low similarity). In the
multiscale bootstrap resampling {[}approximately unbiased probability
(AU) in red; bootstrap probability (BP) in green{]}. The greater the
value of both, the more significantly representative the grouping of the
variables included.

Panel A: Patients with HFpEF and T2DM. Panel B: Patients with HFpEF and
without T2DM.

BMI: body mass index; COPD: Chronic obstructive pulmonary disease; eGFR:
estimated glomerular filtration ratio by MDRD formula; HB: hemoglobin;
SBP: systolic blood pressure.

Figure 3: Descriptive figure of the clusters (above) and Kaplan Meier
curves (below).

Supplementary figure 1: Dendrograms of patients with and without type 2
diabetes mellitus, with their corresponding clusters.

APPENDIX 1

Membership of RICA registry:

\selectlanguage{ngerman}Álvarez Rocha P, Anarte L, Arévalo-Lorido JC, Carrascosa S,
Carretero-Gómez J, Cepeda JM, Díez-Manglano J, Epelde F, Fabra Juana S,
García Escrivá D, García López P, Gómez Huelgas R, González Franco A,
León Acuña A, Llàcer P, López-Castellanos G, Manzano L,
Montero-Pérez-Barquero M, Ormaechea G, Pérez Silvestre J, Quesada Simón
MA, Roca Villanueva B, Ruiz Ortega R, Soler Rangel ML, Suárez Pedreira
I, Trullàs JC.\selectlanguage{english}
\begin{figure}[H]
\begin{center}
\includegraphics[width=0.70\columnwidth]{figures/FIgure-1-flowchart/FIgure-1-flowchart}

\end{center}
\end{figure}\selectlanguage{english}
\begin{figure}[H]
\begin{center}
\includegraphics[width=0.70\columnwidth]{figures/Figure-2-matrix/Figure-2-matrix}

\end{center}
\end{figure}\selectlanguage{english}
\begin{figure}[H]
\begin{center}
\includegraphics[width=0.70\columnwidth]{figures/Figure-3-kaplan/Figure-3-kaplan}

\end{center}
\end{figure}\selectlanguage{english}
\begin{figure}[H]
\begin{center}
\includegraphics[width=0.70\columnwidth]{figures/dendrogamas/dendrogamas}

\end{center}
\end{figure}

\selectlanguage{english}
\FloatBarrier
\end{document}

