Efficacy of Tissue Plasminogen Activator (tPA) vs. Aspirin in Patients with a National Institute of Health Stroke Scale (NIHSS) Score Under 5 (P3.9-058)

Objective: To evaluate the efficacy of tPA vs. Aspirin in stroke patients with NIHSS scores under 5 at 3-months using a modified Rankin Scale in retrospective analysis. Background: Tissue Plasminogen Activator (tPA) is a treatment of choice for stroke patients; however, the effects of the medication on patients with NIHSS scores under 5 have not been well studied. Design/Methods: In this retrospective study, we evaluated all stroke patients from 2015 to 2018. A total of 3,100 patients were seen, with 375 patients presenting an NIHSS score under 5. One hundred two patients (n=102) received tPA followed by 325mg of Aspirin daily. Two hundred seventy-seven patients (n=277) received only 325mg of Aspirin daily. The age group of patients ranged from 45–76 years old (mean age = 68), and 62% of patients were male. Patient medical profiles included Hypertension (76%), Diabetes (62%), Hyperlipidemia (68%), and Ischemic Heart Disease (72%). Results: At 3-months, both groups displayed a Modified Rankin Scale score between 0–2 (98%). One patient in the TPA group had a non-significant Hemorrhagic Conversion. Conclusions: In our retrospective analysis, tPA treatment at 3-months offered no advantage over anti-platelet therapy with Aspirin in stroke patients with NIHSS scores under 5. tPA may also be associated with a higher rate of hemorrhagic transformation of infarction. Disclosure: Dr. Hameed has nothing to disclose. Dr. Ahmed has nothing to disclose. Dr. Moritz has nothing to disclose. Dr. Lee has nothing to disclose.