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. 2024 Jan 18;25(1):38.
doi: 10.1186/s12931-023-02607-y.

Alpha-1-antitrypsin-deficiency is associated with lower cardiovascular risk: an approach based on federated learning

Daniela Zöller  1   2 , Christian Haverkamp  3 , Adeline Makoudjou  4   5 , Ghislain Sofack  4   5 , Saskia Kiefer  4   5 , Denis Gebele  4   5 , Michelle Pfaffenlehner  4   5 , Martin Boeker  6 , Harald Binder  4   5 , Kapil Karki  7 , Christian Seidemann  7 , Bernd Schmeck  8   9   10 , Timm Greulich  9   10 , Harald Renz  11 , Stefanie Schild  12 , Susanne A Seuchter  12 , Dativa Tibyampansha  13 , Roland Buhl  14 , Gernot Rohde  15 , Franziska C Trudzinski  16 , Robert Bals  17 , Sabina Janciauskiene  18 , Daiana Stolz  19 , Sebastian Fähndrich  19
Affiliations

Alpha-1-antitrypsin-deficiency is associated with lower cardiovascular risk: an approach based on federated learning

Daniela Zöller et al. Respir Res. .

Abstract

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.

Keywords: Alpha-1-antitrypsin deficiency; COPD; Cardiovascular; Cholesterol; Troponin.

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Conflict of interest statement

All authors declare they have no conflicts of interest to disclose with the exception of Robert Bals, who is a member of the editorial board of Respiratory Research.

Figures

Fig. 1
Fig. 1
Forest plot showing the adjusted influence of AATD status on different comorbidities. Odd ratios (OR) are reported as ln (Odds), and confounders include age, gender and nicotine abuse
See this image and copyright information in PMC

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