As there are scarce data regarding the outcomes of acute ischemic stroke (AIS) patients treated with intravenous thrombolysis (IVT) within 60 min from symptom onset ("golden hour"), we sought to compare outcomes between AIS patients treated within [GH(+)] and outside [GH(-)] the "golden hour" by analyzing propensity score matched data from the SITS-EAST registry. Clinical recovery (CR) at 2 and 24 h was defined as a reduction of ≥10 points on NIHSS-score or a total NIHSS-score of ≤3 at 2 and 24 h, respectively. A relative reduction in NIHSS-score of ≥40% at 2 h was considered predictive of complete recanalization (CREC). Symptomatic intracranial hemorrhage (sICH) was defined using SITS-MOST criteria. Favorable functional outcome (FFO) was defined as a mRS-score of 0-1 at 3 months. Out of 19,077 IVT-treated AIS patients, 71 GH(+) patients were matched to 6882 GH(-) patients, with no differences in baseline characteristics (p > 0.1). GH(+) had higher rates of CR at 2 (31.0 vs. 12.4%; p < 0.001) and 24 h (41 vs. 27%; p = 0.010), CREC at 2 h (39 vs. 21%; p < 0.001) and FFO (46.5 vs. 34.0%; p = 0.028) at 3 months. The rates of sICH and 3-month mortality did not differ (p > 0.2) between the two groups. GH(+) was associated with 2-h CR (OR: 5.34; 95% CI 2.53-11.03) and CREC (OR: 2.38; 95% CI 1.38-4.09), 24-h CR (OR: 1.88; 95% CI 1.08-3.26) and 3-month FFO (OR: 2.02; 95% CI 1.15-3.54) in multivariable logistic regression models adjusting for potential confounders. In conclusion, AIS treated with IVT within the GH seems to have substantially higher odds of early neurological recovery, CREC, 3-month FFO and functional improvement.

2nd Department of Neurology Attikon Hospital School of Medicine University of Athens Iras 39 Gerakas Attikis 15344 Athens Greece

2nd Department of Neurology Institute of Psychiatry and Neurology Warsaw Poland

Department of Experimental and Clinical Pharmacology Medical University of Warsaw Warsaw Poland

Department of Neurology and Neurosurgery Center for Neurology Vilnius University Vilnius Lithuania

Department of Neurology and Neurosurgery University of Tartu Tartu Estonia

Department of Neurology and Neurosurgery Vilnius University and Republican Vilnius University Hospital Vilnius Lithuania

Department of Neurology Medical and Health Science Center University of Debrecen Debrecen Hungary

Department of Neurology Sestre Milosrdnice University Hospital Centre Zagreb Croatia

Department of Neurology University of Ioannina Ioannina Greece

Department of Vascular Neurology and Neurological Intensive Care University Medical Centre Ljubljana Ljubljana Slovenia

International Clinical Research Center and Neurology Department St Anne's Hospital Brno Czech Republic

Medical Faculty of Masaryk University Brno Czech Republic

Neurology Department and Stroke Center Memorial Şişli Hospital Istanbul Turkey

Neurology Department University Hospital Nitra Nitra Slovakia

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