ABSTRACT NUMBER: ESOC2026A1886 REAL WORLD EXPERIENCE OF THROMBOLYSIS IN PATIENTS WITH MINOR STROKE: DATA FROM THE UK NATIONAL STROKE REGISTRY (SSNAP)

Abstract Background and aims There is debate whether thrombolysis should be considered in patients with minor stroke. This study explores the process of care, safety and outcome data for patients with minor stroke receiving thrombolysis in the UK. Methods Data from the National Stroke Registry for England, Wales, and Northern Ireland (The Sentinel Stroke National Audit Programme: SSNAP) were analysed for patients admitted to hospital with minor stroke (NIHSS 0-4) and non minor stroke (NIHSS >4) receiving thrombolysis between January 2019 and December 2025. Results Of 82,672 patients who received thrombolysis, 15792 (19.1%) had an NIHSS 0-4, while 66,880 (80.9%) had an NIHSS>4. Door to needle times were longer in patients with minor stroke (58 minutes, IQR: 41-86 vs 53 minutes, IQR: 38-76, P<0.05). TIme from onset to arrival in hospital was also longer in patients with minor stroke (107 minutes, IQR: 75-153 vs 100 minutes, IQR: 72-144, P<0.05). Fewer patients with minor stroke experienced symptomatic intracranial haemorrhage (1.9% vs 3.5%, P< 0.05). Median improvement of NIHSS after 24 hours of thrombolysis was greater in patients with non minor stroke (5, IQR: 2-12 vs 1, IQR: 0-3, P<0.05). Higher proportion of patients with minor stroke were independent at discharge (modifed Rankin Score 0-2; 75.2% vs 41.7%, P<0.05) with lower inpatient mortality (2.8% vs 13.7%, P< 0.05). Conclusions Although there were delays in processes of care for patients with minor stroke receiving thrombolysis, real world safety data for this group of patients is reassuring in light of recent published trial evidence. Conflict of interest Kaili Stanley: Nothing to disclose; Kevin Vasquez: Nothing to disclose; Ajay Bhalla: Nothing to disclose; Martin James: I have received speaker fees from Boehringer Ingelheim