ABSTRACT
Background and aims: During the COVID-19 pandemic, outpatient services transitioned mostly to virtual care. It is unknown if virtual Urgent TIA Clinic care outcomes are comparable to those of in-person visits. We, therefore, compared the risk of major adverse cardiovascular events (MACE) at 12 months between first virtual and in-person Urgent TIA Clinic visits. Methods: A virtual TIA Clinic was implemented in March 2020 in a Regional Stroke Center as an urgent response to the COVID-19 pandemic. We conducted a retrospective observational study by interrogating prospectively collected data from the London Ontario Stroke Registry. We used 26 epidemiological weeks from 2019 (in-person, prepandemic) and 2020 (virtual, pandemic). We included patients with and without a final diagnosis of stroke or TIA. The primary outcome was MACE (stroke, acute coronary syndromes, heart failure hospitalizations, and cardiovascular death) at 12 months. We applied propensity score weighted Cox regression analyses to control for risk factors, vascular comorbidities, presenting symptoms, diagnostic investigations, and secondary prevention therapies (see table for a comprehensive list), further adjusted for the final diagnosis (cerebrovascular vs. non-cerebrovascular event). Results: We included1153 patients, 700 assessed in-person and 453 virtually. The median age was 70 years, and 53% were females. MACE occurred in 27 (3.9%) in-person and 14 (3.1%) virtual care patients at 12 months, a statistically non-significant difference (adjusted HR 0.95, 95%CI 0.46 to 1.99;P=0.90). Conclusions: We found no differences in MACE at 12 months between in-person and virtual care visits in an Urgent TIA Clinic. (Table Presented).