ABSTRACT NUMBER: ESOC2026A525 CHARACTERISTICS AND CLINICAL OUTCOMES IN PATIENTS WITH TIA BY ABCD2 SCORE: A RETROSPECTIVE OBSERVATIONAL STUDY OF A REPRESENTATIVE US EHR DATABASE

Abstract Background and aims ABCD2 scores predict early stroke risk after TIA; real-world characteristics and outcomes by risk group remain poorly characterised. We assessed patient charateristics and outcomes by ABCD2 risk group in routine practice. Methods A US retrospective observational study included adults with an inpatient or ED encounter for first TIA (based on ICD-10-CM codes) between 01/2017–12/2023 in the Truveta EHR database. Patient characteristics and 1-year outcomes across ABCD2 risk categories (low-risk [<4], moderate-risk [4–5] and high-risk [>5]) were assessed. ABCD2 scores were calculated from structured data and unstructured clinical notes processed with Truveta’s large language model. Results Of 54,392 patients with TIA, 4667 (8.6%) patients had ABCD2 scores available, with 50.6%, 41.9% and 7.5% classified as low-, moderate- and high-risk, respectively. High-risk patients had a higher risk of IS at all time points up to 1 year versus low- and moderate-risk patients; the incidence of IS was approximately twice as great in the high- versus low-risk group at all time points (Figure). High-risk patients also had increased inpatient admissions, longer hospital stays and more frequent discharges to nursing home or rehabilitation settings than low- or moderate-risk patients. Conclusions In real-world data, among patients with TIA, higher ABCD2 score was associated with the greatest incidence of IS through 1 year and greatest HCRU; relatively few of these patients with TIA were classified as high-risk. These findings may guide treatment decisions and resource planning. Conflict of interest This study was funded by Bayer AG. TNN reports serving as an Associate Editor of Stroke and consulting relationships with Bayer, Medtronic and Route92. MR declares no conflict of interest. SS’s institution received compensation from Bayer. AS reports research grants/contracts from AstraZeneca, Bayer, the Canadian Institutes of Health Research, Daiichi Sankyo Company, the Heart and Stroke Foundation of Canada, the National Institutes of Health, Octapharma USA, Inc. and Servier Affaires Medicales; has served on advisory boards for AstraZeneca, Bayer, Daiichi Sankyo Company and Takeda Pharmaceutical Company; and has served on a data and safety monitoring board for Bayer. MD and NT are employees of Truveta. SK, DRM, JX and KA are employees of Bayer. Figure 1 - belongs to Conclusions