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ObjectivesTo identify: (i) risk of cardiovascular disease (CVD) in homeless versus housed individuals and (ii) interventions for CVD in homeless populations.MethodsWe conducted a systematic literature review in EMBASE until December 2018 using a search strategy for observational and interventional studies without restriction regarding languages or countries. Meta-analyses were conducted, where appropriate and possible. Outcome measures were all-cause and CVD mortality, and morbidity.ResultsOur search identified 17 articles (6 case-control, 11 cohort) concerning risk of CVD and none regarding specific interventions. Nine were included to perform a meta-analysis. The majority (13/17, 76.4%) were high quality and all were based in Europe or North America, including 765 459 individuals, of whom 32 721 were homeless. 12/17 studies were pre-2011. Homeless individuals were more likely to have CVD than non-homeless individuals (pooled OR 2.96; 95% CI 2.80 to 3.13; p<0.0001; heterogeneity p<0.0001; I2=99.1%) and had increased CVD mortality (age-standardised mortality ratio range: 2.6–6.4). Compared with non-homeless individuals, hypertension was more likely in homeless people (pooled OR 1.38–1.75, p=0.0070; heterogeneity p=0.935; I2=0.0%).ConclusionsHomeless people have an approximately three times greater risk of CVD and an increased CVD mortality. However, there are no studies of specific pathways/interventions for CVD in this population. Future research should consider design and evaluation of tailored interventions or integrating CVD into existing interventions.

Heart (British Cardiac Society), 2020-10, Vol.106 (19), p.1483-1488

Cardiovascular disease in homeless versus housed individuals: a systematic review of observational and interventional studies

IntroductionPatients with cardiac amyloidosis (CA) have an increased risk of developing ventricular arrhythmias (VA) but there remains limited evidence supporting the role of catheter ablation in this cohort.MethodsAn electronic database that uses natural language processing for data retrieval was used to identify all patients suspected of having CA who underwent catheter ablation for VA at our institution between January 2010 and December 2023. Patients who did not meet the diagnosis of CA and had a negative workup for CA who underwent catheter ablation for ventricular tachycardia (VT) or premature ventricular contractions (PVCs) were used to form a control group matched for age and left ventricular ejection fraction.Results11 controls and 11 CA patients were identified, including 8 with wild-type transthyretin (TTR)-CA, 2 with hereditary TTR-CA, and 1 with light chain (AL)-CA. Comparing the two groups at baseline (table 1), the mean age at index ablation was 67.8 ± 6.7 and 70.6 ± 6.3 years (p=0.32) and the proportion of males was 100% and 90.9% respectively. A significant majority in the CA group had chronic kidney disease (90.9%). Both groups had a high proportion of atrial fibrillation/flutter (72.7% vs. 100%, p=0.21) as well as a similar distribution of VT/PVCs at presentation (54.5%/45.5% vs. 45.5%/54.5%, p=0.665), use of antiarrhythmics (72.7% vs. 54.5%, p=0.59) and left ventricular ejection fraction (42.6% ± 13.8 vs. 42.6 ± 14.0, p=0.99). Before index ablation mean VA burden was 20.5% ± 15.3 vs. 28.8% ± 13.3 (p=0.266, table 2). Intraprocedural ablation time (61.3 ± 56.1 vs. 110.9 ± 52.8 mins, p=0.073, table 2) and total energy delivery time (1139.6 ± 1674.3 vs. 581.6 ± 527.3 secs, p=0.85, table 2) was comparable in the two groups. No major complications occurred following ablation in either the CA or control group (table 2). 4 patients (36.4%) in the CA group had a recurrence of the same arrhythmia compared to 6 (54.5%) in the control cohort (table 2). Postindex ablation mean VA burden was 4.8% ± 8.0 vs. 12.1% ± 17.1 (p=0.220).Mean follow-up time was 4.4 ± 3.1 and 4.7 ± 2.9 years (p=0.82) and there was no significant difference in the time from index ablation to recurrence between the CA and control group (2.61 ± 3.0 vs. 2.34 ± 2.90 years, p=0.496, Fig 1). However, in the CA group, time to recurrence was significantly shorter in patients with multiple types of VT or PVCs 433.2 ± 672.2 days vs. 1575.2 ± 1278.9 days (p=0.044, Fig 2) in patients with a single type of VT or PVC. Comparing time to recurrence in CA patients with a single type of VT or PVCs with their counterparts in the control cohort trended towards a longer time to recurrence 1575.2 ± 1278.9 vs. 722.6 ± 998.3 days (p=0.095, Fig 2).ConclusionsCatheter ablation appears to be safe and effective for VT and PVCs in patients with CA. CA patients with a single type of VT or PVC may respond more favourably compared to their counterparts with multiple types.Abstract 99 Table 1Demographic, clinical, and echocardiographic characteristics of the Cardiac Amyloidosis (n=11) and Control Cohort (n=11). Data are presented as mean ± standard deviation Variable Cardiac Amyloidosis (n=11) Control Cohort (n=11) P Value Age at Index Ablation (Years) 67.8 ± 6.7 70.6 ± 6.3 0.32 Male 100% (11) 90.9% (10) 1.00 BMI (kg/m2) 28.8 ± 4.3 30.7 ± 8.8 0.54 Hypertension 72.7% (8) 72.7% (8) 1.00 Chronic Kidney Disease 90.9% (10) 63.6% (7) 0.16 Coronary Artery Disease 27.3% (3) 45.5% (5) 0.66 Atrial Fibrillation or Flutter 72.7% (8) 100% (11) 0.21 Arrhythmia at Presentation VT PVC 54.5% (6)45.5% (5) 45.5% (5)54.5% (6) 0.665 Left Ventricular Ejection Fraction (%) prior to Index Ablation 42.6 ± 13.8 42.6 ± 14.0 0.99 Abstract 99 Table 2Intraprocedural Characteristics, Postablation Complications and Outcomes. Data are presented as mean ± standard deviation Variable Amyloid (n=11) Control Cohort (n=11) P Value Ablation Time (mins) 61.3 ± 56.1 110.9 ± 52.8 0.073 Baseline Study (mins) 71.9 ± 65.7 69.1 ± 68.2 0.94 Total Procedure Time (mins) 255.6 ± 97.8 245.9 ± 102.8 0.83 Total Energy Delivery Time (secs) 1478.3 ± 1427.2 1594.0 ± 476.5 0.85 Total Radiation (mGy) 1139.6 ± 1674.3 581.6 ± 527.3 0.35 Arrhythmia Burden (%)Prior to Index Ablation After Index Ablation 20.5 ± 15.34.8 ± 8.0 28.8 ± 13.312.1 ± 17.1 0.2660.22 Major Postablation Complications (e.g. Bleeding, Tamponade, MI, VTE, Phrenic Nerve Damage) 0% (0) 0% (0) 1.00 Recurrence of Identical VT or PVC in Study 36.4% (4) 54.5% (6) 0.67 Time to Recurrence in patients with a single type of PVC or VT (Years) 4.31 ± 3.5 1.98 ± 2.7 0.1 Abstract 99 Figure 1Kaplan-Meier Curve for survival curve for ventricular tachycardia or premature ventricular contraction recurrence post-index ablation (p=0.496)Abstract 99 Figure 2Comparison of time to recurrence in patients with single and multiple types of ventricular tachycardia (VT) or premature ventricular contraction (PVC) in the cardiac amyloidosis and control groupsConflict of InterestNone

Heart (British Cardiac Society), 2024-06, Vol.110 (Suppl 3), p.A104-A105

99 Outcomes of catheter ablation for ventricular arrhythmias in cardiac amyloidosis: a retrospective study

Abdelrazik Ahmed, 117, 124, 127, BS30 Abdi Ahmed, 101 Abdul Fairoz, 196 Abdulelah Ahmed, 24 Abdulelah Zaid, 24 Abdullah Alend, 125 Abid Husnain, 19 Ablott Jenna, 158 Abou Ezzeddine Omar F, 99 Abouelasaad Mohamed, 81 Abouelmagd Khaled, 127 Abu Elkhair Ahlam, 107 Abumanhal Masarweh Hanan, BS01 Abuzeinah Khalid, 42 Acharya Metesh, BS59 Adlam David, 45 Agarwal Sharad, 111 Agbabiaka Abdal-Aziz, 192 Aggarwal Shruti, 71, 119, 128 Ahamed Hisham, 127 Ahmad Mahmood, 160 Ahmad Muhammad, 123 Ahmad Syeda Saara, 28 Ahmed Fozia, 118 Ahmed Ishaa, 58 Ahmed Mushood, 71, 149 Ahmed Nida, 236 Ahmed Raheel, 71, 94, 119, 128, 149, 186 Ahmed Sabahat, 236 Ahmed-Jushuf Fiyyaz, 37 Ahsan Areeba, 149 Aitchision Katherine, 90 Akbari Tamim, 183, A Akhtar Zaki, 101 Akkaramani Sudhamai, 71, 119, 128 Aksentijevic Dunja, BS27 Al Balbissi Kais, 24 Al-atta Ayman, 61 Al-Ghafri Malik, 91 Al-Lamee Rasha, 37, A Al-Othman Sami, BS01 Al-Saaidi Omer, 91 Al-Sakini Nada, 31 Al-Shakarchi Nader James, 99 Al-Turaihi Samar, 215 Alaour Bashir, BS40 Alawami Mohammed, 65 Albasri Ali, 231 Alcock Frances, 42 Aldesouki Abdullah, 202 Alexander Lovissa, 171 Alfakih Khaled, 215 Alharbi Badr A, A Ali Ali, 67 Ali Hani, 10 Ali Shoaib, 119, 128 Alimo Audrey, 42 Alkhalil Mohammad, 61 Almalki Salman, BS07 Almeida Guilherme, 37 Almond Peter, 139 Almutawa Jude, 87 Alsaggaf Mohammed, BS08, BS47 Alshahrani Nasser S, A Alskaf Ebraham, 177 Alwasef Mohammad, 141 Alwi Nik Mohd, BS45 Alyahya Alaa, 32 Alzoubi Raha, 24 Aman Fai, 66 Ambrogetti Robert, 57, 212 Amin Reshma, 121 Anderson Lisa, 146 Andrew Ivan, BS03 Androulakis Emmanuel, 2 Androulakis Manos, 212 Ang Daniel, 207, 208 Antoun Ibrahim, 117, 131 Anwar Majid, 43 Appleby Clare, 60 Arabi Peyman, 167 Archbold Andrew, 236 Archer Ethan, 212 Argyle Rachel, 192 Arjun Sapna, BS11 Arnold Jayanth Ranjit, 156, 190 Arshad A, 167 Arunakumar Sarah, 234 Asare-Amankwah Yaw, BS09 Ashraf Nadeem, 231 Aslam Saadia, 7, 85, BS59 Assadi Hosamadin, 179 Asselbergs Folkert, 157 Asyifa Siti, 199 Athi Jai, 23 Augustine Daniel, 83, 189 Aung Nay, 14, 179 Austin David, 87, 110 Austin Philip, 159, 163 Awadalkareem Hozaifa, 31 Aye Yin Nwe, 33 Azzu Alessia, 94, 149, 186 Baahwain Saleh, 91 Babu Gokul Raj, 67 Back Matthew, 87 Backhouse Mark, 162 Badiani Sveeta, 12, 13 Bagnall Timothy, 226 Bagri Gurvir S, 125 Bahl Rahul, 37 Bailey Janice, 100 Bailey Kristian, 32 Baines Olivia, BS10, BS52 Bakhai Ameet, 219 Baksi Jonh, 94, 149, 186 Balachandran Kanarath, 222 Balaji Gothandaraman, 129 Balasubramanian Sendhil, BS57 Banerjee Prithwish, 17, 154, BS57 Banning Adrian, 51 Barakat Khalid, 63 Baral Ranu, 134 Bareke Polen, 97 Barker Joseph, 117, 131, 206 Barker Thomas, BS57 Barnes Gareth, 201, 226 Baron Julia, 131 Baross Stephanie, 28 Barraclough Dong, 107 Barton Janet, 102 Barton Paul, BS03 Baruah Resham, 3, 135 Barwise Sophie, 87 Basalay Maryna, BS11 Bashir Ahmed, 29 Bassett Paul, A Bastiaenen Rachel, 121 Basu Joyee, 2 Bates Matthew, 119, 128 Bawamia Bilal, 61 Bayani Kim, 55 Bayraktar Semih, BS44 Beale Andy, 20, 202 Beech David, 9 Begley David, 104, 111 Behr Elijah, 2 Beikoghli Kalkhoran Siavash, BS11 Bell Robert, 97 Benenati Stefano, 51 Bennett Derrick, 36 Benson Sean, BS12 Bergan Natalie, 1 Bernstein Brett, 134 Berry Colin, 207, 208 Betemariam Tesfamariam, 105 Bhagra Catriona, BS58 Bhaskara-Pillai Jain, BS57 Bhat Aditya, 40, 46, 48, 54, 106, 185, 191, 197 Bhatia Raghav, 2, 212, 215 Bhattacharyya Sanjeev, 12, 13 Bhatti Alysha, 75 Bhatty Asad, 204 Bhimineni Durga Prasad, 55 Bhiri Mohammed, BS19 Bhuva Anish, 95 Biddle Michael, BS59 Bijman Laura, 4, 11 Bilak Joanna, 165 Bilham James, 101 Billson Jeremy, BS34 Bingcang Jose, 26 Bioh Gabriel, 193 Bird Richard, 55 Birkhoelzer Sarah, 141, 150, 217 Bista Anushritu, 132 Biswas Dhruva, 134 Blain Alasdair, 32 Blaxill Jonathan Mark, 38, 50 Boleti Olga, 5 Bolger Aidan, 15 Bond Christopher, 31 Boos Chris, 142 Borbas Zoltan, 102 Borhani Saifollah, 42 Boriani Giuseppe, 126 Borland Samantha, BS13 Borlotti Alessandra, 180 Botis Ioannis, 176 Botnar René, 211, BS17 Bower Colette, 168 Bower Peter, 231 Bowker Timothy J, 167 Boyes Laura, 90 Boyne Morgan, BS14 Bradding Peter, BS59 Bradley Conor, 208 Bradtke Sarah, 80 Brady Emer, 156 Brecker Stephen, 4, 11 Broadway-Stringer Sophie, BS22 Brogan Richard, 207, 208 Bromage Daniel, 134 Brown Ben, 176 Brown Jane, BS53 Brown Oliver, 133 Brown Pamela, 25 Brown Sam, 134 Brown Stewart, 100, 113 Bruce Katie, BS24 Brunssen Coy, BS47 Bryan Leoni, 4, 11 Bu’Lock Frances, 15 Bui Thuy Anh, BS51 Bulluck Heerajnarain, 38, 50 Bunce Nick, 182 Bunting Karina, 96 Burbidge Kerry, 171 Burchell Thomas, 41, 49, 52 Burgess Ruth, 86 Burrage Matthew, 180, BS49 Butterworth Karl T, BS01 Cader Aaysha, 66 Calmon Guillaume, BS19 Calvert Peter, 102 Camelliti Patrizia, BS41, BS50, BS55 Cameron Ruiz Miren, BS15 Camm Fielder, 115 Campbell Philip, 142 Cannata Antonio, 134 Caplin Ben, BS11 Cappa Oisin, BS08 Captur Gabriella, BS19 Carberry Jaclyn, 208 Card Erin, BS16 Carr Fiona, 116 Carrick David, 207, 208 Carson Kevin, 41, 49, 52 Cartwright Elizabeth J, BS01, BS37 Carver Caleb, 71, 119, 128 Casadei Barbara, 36, 92 Cash Lizette, 9 Caspi Talia, 167 Castle James, 227 Castro Fernando, BS41 Catapano Alberico L, 230 Cavalcante João, 179 Cerquetani Elena, 222 Chackochen Sijimole, 102 Chafer Kris, 157 Chahal Anwar, 119, 128 Chaher Nadia, BS17 Chai Jason, 51, 227 Chakrabarti Gautam, 222 Chakraborty Turja, 42 Chakravorty Mollika Keya, 42 Chambers John, 203 Chamié Daniel, 37 Champsi Asgher, 19, 96 Chan Fiona, BS19 Chan Shing, 36 Chan Will, 104 Chan WX, D Chandramohan Nitin, 16 Chandrasekaran Badrinathan, 93, 162 Chang Lisa, 110 Chang Yi, 42 Channon Keith, 51, 180 Chapman Michael, 110 Charalampopoulos Athanasios, 158 Charman Sarah, 32 Chatrath Nikhil, 2, 212, 215 Chaturvedi Nish, BS19 Chauhan Reshma, BS30 Chawla Harsh, 16 Chelliah Raj, 67 Chen Qishan, BS05 Chen Yang, 126, 157 Chen Zhong, 101 Cheng Chew, BS18 Chennapragada Suma Sri, 128 Cherukad Sanjana, 58 Cheverton Rosanna, 201 Chew Pei, 192 Chhabra Yuvraj, 65 Chiew Kayla, 140 Chin Carven Yee Shean, 22 Chin Shui Hao, 117, 124 Chintarlapalli Chandana, 42 Chiong Justin, 62 Chiribiri Amedeo, 177, E Chong Victor, 142 Chotalia Ravi, 127 Choudhry Taimur, 65 Choudry Fizzah, 63 Chowdhary Amrit, 8, 9, 209 Chowdhury Nabeel, 112 Chu Miao, 51 Church Smith Claudia, 90 Clark Alexander, 225 Clark Andrew, 148 Clarke Kieran, 138 Clarkson Nichola, 102 Clavane Eva, BS53 Clayton Aled, BS50, BS55 Cleland John, 137, 142, 183 Clerk Angela, BS21 Coats Caroline, 6 Coburn Jamie, 155 Coey James, 194 Collins Jane, 55 Collins Peter, 94, 149, 186 Collison Damien, 207, 208 Condliffe Robin, 158 Coney Andrew, BS12 Conkie Andrew, 143 Conning-Rowland Marcella, BS18 Constant Benjamin, BS33 Cook Stuart, BS03 Cooper Robert, 10 Cordell Heather, 205 Corianò Mattia, 144, 151 Corp Nadia, 229 Cotton James M, 59 Couch Liam, 51 Cowan Elena, 141, 150 Cowie Lucy, 31 Cowley Alice, 156 Cox Brian, 155 Cox Steve, 2 Cox-Pridmore Dannielle, BS41 Crabb Michael, 211 Crapper Ryan, 116 Crawley Richard, 177 Crilley Jenifer, 30, 120 Cruz Gastao, BS17 Cubbon Richard, 8, 133, BS18, BS53 Cullen Fenn, BS27 Cumberland Max, BS12, C Currie Susan, BS15, BS42 Curzen N, D Cuthbert Joe, 148 Cuthbertson Dan, 18 Cutter David, BS49 D’sa Anthony, 196 Dall’Armellina Erica, 184 Danaeian Sepehr, 97 Dandekar Uday, BS57 Dar Owais, 94, 162 Darby Sarah, BS49 Dargan James, 4, 11 Darlay Rebecca, 205 Darnley Adam, 60 Das Arka, 184 Das Moloy, 108 Dastidar Amardeep, 76, 147 Dattani Abhishek, 156, 190 David Sarojini, 215 Davidson Sean, BS11, BS50, BS55 Davies Claire, 214 Davison Benjamin, 67 Dayer Mark, 100, 113 de Belder Mark, 45 De Bie Eckart, 158 de Braal Victoria, 227 De Maria Giovanni, 51 de Marvao Antonio, 3, 135 De Sumantra Kumar, 235 De Waard Guus, 37 Deanfield John, 45 Debiec Radek, 15 Dedeoglu Bilge Eylem, 174 Dehghan Abbas, 203 Delibegovic Mirela, BS14 Demetriades Polyvios, 26, 161 Dev Damanpreet, 66 Dewhurst Matthew, 110 Dhillon Sukhmeet, 71, 119, 128 Dhinoja Mehul, 95 Dhutia Harshil, 127 Dicken Benjamin, 172 Digilio Giuseppe, BS17 Ding Wern Yew, 102 Dispenzieri Angela, 99 Dixon Lana, 155 Dixon Samantha, 231 Dobson Rebecca, 18 Dobson Richard, 134 Doherty Aiden, 36, 92 Donnelly Patrick, 34, 89, 137 Douglas Homeyra, 139 Doyle Niamh, 4, 11 Drozd Michael, 133 Duchniewicz Michal, 104 Duffy Mark Stephen, BS59 Dumitriu Ingrid, BS32 Dutta Roy Smita, 167 Duvva Dileep, 60, 168 Dweck Mark, 8, 9 Eales James, 205 Eather Samuel, 187 Ebeid Armia, 15 Echavarria-Pinto Maura, 37 Edgar Kevin, BS08, BS43, BS47 Edwards Carey, 172 Edwards Ian, 97 Edwards Nehemiah, 25 Eggett Christopher, 32 Egred Mohaned, 61 Ekkert Aleksandra, 214 El-Din Mohammed, 66 El-Jemali Line, 77 El-omar Magdi, 65 Elawady Abdula, 55 ELAWADY Abdula, 192 Eldeeb Hany, 127 Eleftheriou Perla, 161 Elguindy Mostafa, 47 Elkammash Amr, 16 Elliot Charlie, 158 Elliott Paul, 203 Elvey Rebecca, 231 Elyass Mohammed, 104 Eteiba Hany, 208 Fabritz Larissa, BS56 Facchi Cecilia, BS01, BS13 Fairbairn Timothy, 83, 189 Fairhurst Natalie, 134 Falconer Debbie, BS19 Fan Lampson, 79 FARAG Mohamed, 61 Farooq Vasim, 22 Farooqui Azhar, 66 Fellows Adam, BS20 Ferreira Barbara, 167 Ferreira Vanessa, 180, BS49 Ferro Charles, BS24 Fiddy Robert, 123 Field Ella, 5, 103 Fielding Alison, 6 Finocchiaro Gherardo, 2, 212, 215 Firescu Mihai, 132 Firoozi Sami, 4, 11 Fischer Miriam, 72, 73 Fleming Suzannah,

Heart (British Cardiac Society), 2024-06, Vol.110 (Suppl 3), p.A291-A297

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Cardiovascular disease in homeless versus housed individuals: a systematic review of observational and interventional studies

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99 Outcomes of catheter ablation for ventricular arrhythmias in cardiac amyloidosis: a retrospective study

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Cardiovascular disease in homeless versus housed individuals: a systematic review of observational and interventional studies

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99 Outcomes of catheter ablation for ventricular arrhythmias in cardiac amyloidosis: a retrospective study

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