ABSTRACT NUMBER: ESOC2026A1449 INTRAVENOUS THROMBOLYSIS FOR ACUTE ISCHEMIC STROKE IN HIGH-QUALITY CENTERS ACROSS THE MIDDLE EAST AND NORTH AFRICA (2021–2023): RESULTS FROM THE SITS-MENA REGISTRY

Abstract Background and aims Intravenous thrombolysis (IVT) treatment for acute ischemic stroke in the Middle-East and North African (MENA) countries has increased in the last decade following the increase of dedicated stroke units. We aimed to study the outcomes of IVT-treated stroke patients at 3 months in high quality (HQ) stroke centers in MENA. Methods This was a prospective, observational study using the SITS Registry to compare outcomes of IVT-treated patients in HQ-MENA versus HQ-non-MENA centers. Results Of 29 928 patients with ischemic stroke registered in SITS between August 2021 and September 2023, 2768 (9.2%) were recruited in MENA. Compared to non-MENA, MENA patients were younger (65 vs 72 years-old), had higher NIHSS score at baseline (11 vs 9), shorter onset-to-needle times (145 vs 158 min) and door-to-needle times (30 vs 54 min). The most common risk factors in MENA versus non-MENA were hypertension (64.9 vs 69.8 %), diabetes (30.8 vs 20.1%), smoking (21 vs 26.1%), atrial fibrillation (20.1 vs 28.7%) and hyperlipidemia (12.2 vs 40.5%). Functional independence (mRS 0-2) at 3 months was similar (56.6% vs 57.7%, OR 0.89, CI 0.7-1.1), however mortality at 7 days was significantly higher in MENA (8.3% vs 5.3%, OR 1.9, CI:1.2-3.1, p=0.011). Symptomatic intracranial hemorrhage rates were low in both groups (<1.2% per SITS-MOST definition). Conclusions Early mortality by 7-day follow-up of patients treated with intravenous thrombolysis was increased in HQ-MENA centers. Access to mechanical thrombectomy to prevent the progress of stroke severity and the management of medical complications should be prioritized in the MENA region. Conflict of interest Maria Khan: nothing to disclose, Marius Matusevicius: nothing to disclose, Suhail Al Rukn: nothing to disclose, Abdoreza Ghoreishi: nothing to disclose, Mehdi Farhoudi: nothing to disclose, Payam Sariaslani: nothing to disclose, Tamer Roushdy: nothing to disclose, Naveed Akhtar: nothing to disclose, Niaz Ahmed: nothing to disclose, Tiago Moreira: nothing to disclose