0
Original Research: COPD |

Clinical Characteristics of Subjects With Symptoms of α1-Antitrypsin Deficiency Older Than 60 Years

Michael A. Campos, MD; Saleh Alazemi, MD; Guoyan Zhang, MD, MPH; Matthias Salathe, MD, FCCP; Adam Wanner, MD, FCCP; Robert A. Sandhaus, MD, FCCP; Horst Baier, MD, FCCP
Author and Funding Information

*From the Miller School of Medicine (Drs. Campos, Alazemi, Salathe, Wanner, and Baier), University of Miami, Miami, FL; the Miami-Dade Health Department (Dr. Zhang), Miami, FL; and AlphaNet (Dr. Sandhaus), Miami, FL.

Correspondence to: Michael A. Campos, MD, Division of Pulmonary and Critical Care Medicine, University of Miami School of Medicine, PO Box 016960 (R-47), Miami, FL 33101; e-mail: mcampos1@med.miami.edu


Funding for this study was provided by AlphaNet, Inc., Miami, FL.

The authors have reported to the ACCP that no significant conflicts of interest exist with any companies/organizations whose products or services may be discussed in this article.

Reproduction of this article is prohibited without written permission from the American College of Chest Physicians (www.chestjournal.org/misc/reprints.shtml).

For editorial comment see page 591


Chest. 2009;135(3):600-608. doi:10.1378/chest.08-1129
Text Size: A A A
Published online

Background:  The clinical characteristics of elderly subjects with α1-antitrypsin deficiency (AATD)-associated COPD have not been described.

Methods:  The clinical, demographic, health-related quality of life (HRQoL) characteristics and 1-year exacerbation rates of 275 subjects with AATD and COPD receiving augmentation therapy aged > 59 years (mean [± SD] age, 66.3 ± 5.7 years) were compared to those of 354 subjects aged 50 to 59 years (mean age, 54.3 ± 2.8 years) and 293 subjects < 50 years (mean age, 43.9 ± 3.8 years).

Results:  Older subjects received diagnoses later in life (mean age at diagnosis, 55.0 ± 8.5 years) and had a longer diagnostic delay (mean age at diagnosis, 12.9 ± 14.3 years) than subjects in the other two age groups. Although the proportion of lifetime nonsmokers was higher in the older group, the majority (64%) had significant tobacco exposure but with a longer interval of tobacco abstinence. The mean FEV1 values (n = 641) were similar between the three age groups, suggesting a slower disease progression in the oldest group. Subjects in the older group were less symptomatic, had less concomitant asthma, and had significantly better scores in most domains of two HRQoL instruments. During follow-up, older subjects had fewer acute exacerbations.

Conclusions:  Subjects with AATD-associated COPD who reach an older age exhibit a more indolent clinical course than younger affected individuals, possibly related in part to differences in tobacco exposure. This finding supports current guidelines that recommend screening of all patients with COPD for AATD, regardless of their age and prior smoking history.

Figures in this Article

Sign In to Access Full Content

MEMBER & INDIVIDUAL SUBSCRIBER

Want Access?

NEW TO CHEST?

Become a CHEST member and receive a FREE subscription as a benefit of membership.

Individuals can purchase this article on ScienceDirect.

Individuals can purchase a subscription to the journal.

Individuals can purchase a subscription to the journal or buy individual articles.

Learn more about membership or Purchase a Full Subscription.

INSTITUTIONAL ACCESS

Institutional access is now available through ScienceDirect and can be purchased at myelsevier.com.

Sign In to Access Full Content

MEMBER & INDIVIDUAL SUBSCRIBER

Want Access?

NEW TO CHEST?

Become a CHEST member and receive a FREE subscription as a benefit of membership.

Individuals can purchase this article on ScienceDirect.

Individuals can purchase a subscription to the journal.

Individuals can purchase a subscription to the journal or buy individual articles.

Learn more about membership or Purchase a Full Subscription.

INSTITUTIONAL ACCESS

Institutional access is now available through ScienceDirect and can be purchased at myelsevier.com.

Figures

Tables

References

NOTE:
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).

Some tools below are only available to our subscribers or users with an online account.

Sign In to Access Full Content

MEMBER & INDIVIDUAL SUBSCRIBER

Want Access?

NEW TO CHEST?

Become a CHEST member and receive a FREE subscription as a benefit of membership.

Individuals can purchase this article on ScienceDirect.

Individuals can purchase a subscription to the journal.

Individuals can purchase a subscription to the journal or buy individual articles.

Learn more about membership or Purchase a Full Subscription.

INSTITUTIONAL ACCESS

Institutional access is now available through ScienceDirect and can be purchased at myelsevier.com.

Related Content

Customize your page view by dragging & repositioning the boxes below.

Find Similar Articles
CHEST Journal Articles
PubMed Articles
  • CHEST Journal
    Print ISSN: 0012-3692
    Online ISSN: 1931-3543