Abstract TP170: Racial Disparities in Post-Stroke Major Adverse Cardiovascular Events (MACE): A Comparative Analysis of Black and White Patients Using Real-World Data

Background: Racial disparities in post-stroke (ischemic and hemorrhagic) outcomes remain a critical public health concern. This study compared the risk of major adverse cardiovascular events (MACE) and mortality between Black and White stroke survivors using a large-scale electronic health records database. Methods: A retrospective cohort analysis was conducted using the TriNetX Global Collaborative Network, comprising 154 healthcare organizations. We identified 916,976 White (Cohort A) and 221,742 Black (Cohort B) adult stroke survivors without prior myocardial infarction (MI), heart failure, or cancer. Propensity score matching (1:1) balanced baseline demographics and comorbidities, yielding 221,443 patients per cohort. Outcomes assessed included MI, heart failure, stroke recurrence, and death, analyzed via risk differences, survival analysis, and incidence rates over a 20-year follow-up. Results: After matching, Black stroke survivors had a higher risk of heart failure (Risk Difference [RD] -0.006, p