TY - JOUR
T1 - Alpha-1-antitrypsin-deficiency is associated with lower cardiovascular risk
T2 - an approach based on federated learning
AU - Zöller, Daniela
AU - Haverkamp, Christian
AU - Makoudjou, Adeline
AU - Sofack, Ghislain
AU - Kiefer, Saskia
AU - Gebele, Denis
AU - Pfaffenlehner, Michelle
AU - Boeker, Martin
AU - Binder, Harald
AU - Karki, Kapil
AU - Seidemann, Christian
AU - Schmeck, Bernd
AU - Greulich, Timm
AU - Renz, Harald
AU - Schild, Stefanie
AU - Seuchter, Susanne A.
AU - Tibyampansha, Dativa
AU - Buhl, Roland
AU - Rohde, Gernot
AU - Trudzinski, Franziska C.
AU - Bals, Robert
AU - Janciauskiene, Sabina
AU - Stolz, Daiana
AU - Fähndrich, Sebastian
N1 - Publisher Copyright:
© 2023, The Author(s).
PY - 2024/12
Y1 - 2024/12
N2 - Background: Chronic obstructive pulmonary disease (COPD) is an inflammatory multisystemic disease caused by environmental exposures and/or genetic factors. Inherited alpha-1-antitrypsin deficiency (AATD) is one of the best recognized genetic factors increasing the risk for an early onset COPD with emphysema. The aim of this study was to gain a better understanding of the associations between comorbidities and specific biomarkers in COPD patients with and without AATD to enable future investigations aimed, for example, at identifying risk factors or improving care. Methods: We focused on cardiovascular comorbidities, blood high sensitivity troponin (hs-troponin) and lipid profiles in COPD patients with and without AATD. We used clinical data from six German University Medical Centres of the MIRACUM (Medical Informatics Initiative in Research and Medicine) consortium. The codes for the international classification of diseases (ICD) were used for COPD as a main diagnosis and for comorbidities and blood laboratory data were obtained. Data analyses were based on the DataSHIELD framework. Results: Out of 112,852 visits complete information was available for 43,057 COPD patients. According to our findings, 746 patients with AATD (1.73%) showed significantly lower total blood cholesterol levels and less cardiovascular comorbidities than non-AATD COPD patients. Moreover, after adjusting for the confounder factors, such as age, gender, and nicotine abuse, we confirmed that hs-troponin is a suitable predictor of overall mortality in COPD patients. The comorbidities associated with AATD in the current study differ from other studies, which may reflect geographic and population-based differences as well as the heterogeneous characteristics of AATD. Conclusion: The concept of MIRACUM is suitable for the analysis of a large healthcare database. This study provided evidence that COPD patients with AATD have a lower cardiovascular risk and revealed that hs-troponin is a predictor for hospital mortality in individuals with COPD.
AB - Background: Chronic obstructive pulmonary disease (COPD) is an inflammatory multisystemic disease caused by environmental exposures and/or genetic factors. Inherited alpha-1-antitrypsin deficiency (AATD) is one of the best recognized genetic factors increasing the risk for an early onset COPD with emphysema. The aim of this study was to gain a better understanding of the associations between comorbidities and specific biomarkers in COPD patients with and without AATD to enable future investigations aimed, for example, at identifying risk factors or improving care. Methods: We focused on cardiovascular comorbidities, blood high sensitivity troponin (hs-troponin) and lipid profiles in COPD patients with and without AATD. We used clinical data from six German University Medical Centres of the MIRACUM (Medical Informatics Initiative in Research and Medicine) consortium. The codes for the international classification of diseases (ICD) were used for COPD as a main diagnosis and for comorbidities and blood laboratory data were obtained. Data analyses were based on the DataSHIELD framework. Results: Out of 112,852 visits complete information was available for 43,057 COPD patients. According to our findings, 746 patients with AATD (1.73%) showed significantly lower total blood cholesterol levels and less cardiovascular comorbidities than non-AATD COPD patients. Moreover, after adjusting for the confounder factors, such as age, gender, and nicotine abuse, we confirmed that hs-troponin is a suitable predictor of overall mortality in COPD patients. The comorbidities associated with AATD in the current study differ from other studies, which may reflect geographic and population-based differences as well as the heterogeneous characteristics of AATD. Conclusion: The concept of MIRACUM is suitable for the analysis of a large healthcare database. This study provided evidence that COPD patients with AATD have a lower cardiovascular risk and revealed that hs-troponin is a predictor for hospital mortality in individuals with COPD.
KW - Alpha-1-antitrypsin deficiency
KW - COPD
KW - Cardiovascular
KW - Cholesterol
KW - Troponin
UR - http://www.scopus.com/inward/record.url?scp=85182685085&partnerID=8YFLogxK
U2 - 10.1186/s12931-023-02607-y
DO - 10.1186/s12931-023-02607-y
M3 - Article
C2 - 38238846
AN - SCOPUS:85182685085
SN - 1465-9921
VL - 25
JO - Respiratory Research
JF - Respiratory Research
IS - 1
M1 - 38
ER -