PMID- 38238846 OWN - NLM STAT- MEDLINE DCOM- 20240131 LR - 20240131 IS - 1465-993X (Electronic) IS - 1465-9921 (Print) IS - 1465-9921 (Linking) VI - 25 IP - 1 DP - 2024 Jan 18 TI - Alpha-1-antitrypsin-deficiency is associated with lower cardiovascular risk: an approach based on federated learning. PG - 38 LID - 10.1186/s12931-023-02607-y [doi] LID - 38 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. CI - (c) 2023. The Author(s). FAU - Zoller, Daniela AU - Zoller D AD - Institute of Medical Biometry and Statistics, Faculty of Medicine and Medical Centre - University of Freiburg, Freiburg, Germany. daniela.zoeller@uniklinik-freiburg.de. AD - Freiburg Centre for Data Analysis and Modelling, University of Freiburg, Freiburg, Germany. daniela.zoeller@uniklinik-freiburg.de. FAU - Haverkamp, Christian AU - Haverkamp C AD - Institute of Digitalization in Medicine, Faculty of Medicine and Medical Centre - University of Freiburg, Freiburg, Germany. FAU - Makoudjou, Adeline AU - Makoudjou A AD - Institute of Medical Biometry and Statistics, Faculty of Medicine and Medical Centre - University of Freiburg, Freiburg, Germany. AD - Freiburg Centre for Data Analysis and Modelling, University of Freiburg, Freiburg, Germany. FAU - Sofack, Ghislain AU - Sofack G AD - Institute of Medical Biometry and Statistics, Faculty of Medicine and Medical Centre - University of Freiburg, Freiburg, Germany. AD - Freiburg Centre for Data Analysis and Modelling, University of Freiburg, Freiburg, Germany. FAU - Kiefer, Saskia AU - Kiefer S AD - Institute of Medical Biometry and Statistics, Faculty of Medicine and Medical Centre - University of Freiburg, Freiburg, Germany. AD - Freiburg Centre for Data Analysis and Modelling, University of Freiburg, Freiburg, Germany. FAU - Gebele, Denis AU - Gebele D AD - Institute of Medical Biometry and Statistics, Faculty of Medicine and Medical Centre - University of Freiburg, Freiburg, Germany. AD - Freiburg Centre for Data Analysis and Modelling, University of Freiburg, Freiburg, Germany. FAU - Pfaffenlehner, Michelle AU - Pfaffenlehner M AD - Institute of Medical Biometry and Statistics, Faculty of Medicine and Medical Centre - University of Freiburg, Freiburg, Germany. AD - Freiburg Centre for Data Analysis and Modelling, University of Freiburg, Freiburg, Germany. FAU - Boeker, Martin AU - Boeker M AD - Institute of Artificial Intelligence and Informatics in Medicine, Medical Centre Rechts der Isar, School of Medicine, Technical University of Munich, Munich, Germany. FAU - Binder, Harald AU - Binder H AD - Institute of Medical Biometry and Statistics, Faculty of Medicine and Medical Centre - University of Freiburg, Freiburg, Germany. AD - Freiburg Centre for Data Analysis and Modelling, University of Freiburg, Freiburg, Germany. FAU - Karki, Kapil AU - Karki K AD - Data Integration Centre, Medical Faculty, Philipps-University Marburg, Marburg, Germany. FAU - Seidemann, Christian AU - Seidemann C AD - Data Integration Centre, Medical Faculty, Philipps-University Marburg, Marburg, Germany. FAU - Schmeck, Bernd AU - Schmeck B AD - Institute for Lung Research, Universities of Giessen and Marburg Lung Centre, Philipps-University Marburg, Marburg, Germany. AD - Department of Medicine, Pulmonary and Critical Care Medicine, University Hospital Giessen and Marburg, Philipps-University Marburg, Marburg, Germany. AD - German Centres for Lung Research (DZL) and for Infectious Disease Research (DZIF), SYNMIKRO Centre for Synthetic Microbiology, Philipps-University Marburg, Marburg, Germany. FAU - Greulich, Timm AU - Greulich T AD - Department of Medicine, Pulmonary and Critical Care Medicine, University Hospital Giessen and Marburg, Philipps-University Marburg, Marburg, Germany. AD - German Centres for Lung Research (DZL) and for Infectious Disease Research (DZIF), SYNMIKRO Centre for Synthetic Microbiology, Philipps-University Marburg, Marburg, Germany. FAU - Renz, Harald AU - Renz H AD - Institute of Laboratory Medicine, German Centre for Lung Research (DZL) and the Universities of Giessen and Marburg Lung Centre (UGMLC), Philipps-University Marburg, Marburg, Germany. FAU - Schild, Stefanie AU - Schild S AD - Medical Centre for Information and Communication Technology, University Hospital Erlangen, Erlangen, Germany. FAU - Seuchter, Susanne A AU - Seuchter SA AD - Medical Centre for Information and Communication Technology, University Hospital Erlangen, Erlangen, Germany. FAU - Tibyampansha, Dativa AU - Tibyampansha D AD - Institute of Medical Biostatistics, Epidemiology and Informatics, University Medical Centre of the Johannes Gutenberg-University Mainz, Mainz, Germany. FAU - Buhl, Roland AU - Buhl R AD - Pulmonary Department, University Medical Centre of the Johannes Gutenberg-University Mainz, Mainz, Germany. FAU - Rohde, Gernot AU - Rohde G AD - Department of Respiratory Medicine, Medical Clinic I, Goethe University Frankfurt, University Hospital, Frankfurt/Main, Germany. FAU - Trudzinski, Franziska C AU - Trudzinski FC AD - Department of Pneumology and Critical Care Medicine, German Centre for Lung Research (DZL), Translational Lung Research Centre Heidelberg (TLRC-H), University of Heidelberg, Thoraxklinik, Heidelberg, Germany. FAU - Bals, Robert AU - Bals R AD - Department of Internal Medicine V - Pulmonology, Allergology, Critical Care Medicine, Saarland University Medical Centre, Saarland University Hospital, 66421, Homburg/Saar, Germany. FAU - Janciauskiene, Sabina AU - Janciauskiene S AD - Department of Pulmonary and Infectious Diseases and BREATH German Centre for Lung Research (DZL), Hannover Medical School, Hannover, Germany. FAU - Stolz, Daiana AU - Stolz D AD - Department of Pneumology, University Medical Centre Freiburg, Freiburg, Germany. FAU - Fahndrich, Sebastian AU - Fahndrich S AD - Department of Pneumology, University Medical Centre Freiburg, Freiburg, Germany. LA - eng PT - Journal Article DEP - 20240118 PL - England TA - Respir Res JT - Respiratory research JID - 101090633 RN - 0 (Troponin) RN - 0 (SERPINA1 protein, human) SB - IM MH - Humans MH - *alpha 1-Antitrypsin Deficiency/diagnosis/epidemiology/genetics MH - *Cardiovascular Diseases/diagnosis/epidemiology/genetics MH - Heart Disease Risk Factors MH - *Pulmonary Disease, Chronic Obstructive/diagnosis/epidemiology/etiology MH - Risk Factors MH - Troponin PMC - PMC10797985 OTO - NOTNLM OT - Alpha-1-antitrypsin deficiency OT - COPD OT - Cardiovascular OT - Cholesterol OT - Troponin COIS- 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. EDAT- 2024/01/19 00:42 MHDA- 2024/01/22 06:42 PMCR- 2024/01/18 CRDT- 2024/01/18 23:43 PHST- 2023/08/27 00:00 [received] PHST- 2023/11/14 00:00 [accepted] PHST- 2024/01/22 06:42 [medline] PHST- 2024/01/19 00:42 [pubmed] PHST- 2024/01/18 23:43 [entrez] PHST- 2024/01/18 00:00 [pmc-release] AID - 10.1186/s12931-023-02607-y [pii] AID - 2607 [pii] AID - 10.1186/s12931-023-02607-y [doi] PST - epublish SO - Respir Res. 2024 Jan 18;25(1):38. doi: 10.1186/s12931-023-02607-y.