III: Harm B-NR Recommendation reworded for clarity from 2015 IV Alteplase. COR and LOE amended to conform with ACC/AHA 2015 Recommendation Classification System. See Table XCV in online Data Supplement 1 for original wording. The recommendation refers to full treatment doses and not to prophylactic doses. The 2015 Scientific Rationale for the Inclusion and Exclusion Criteria for Intravenous Alteplase in Acute Ischemic Stroke stated, Intravenous alteplase in patients who have received a dose of LMWH within the previous 24 hours is not recommended. This applies to both prophylactic doses and treatment doses (COR III; Level of Evidence B). 14 This statement was updated in a subsequently published erratum to specify that the contraindication does not apply to prophylactic doses. 3.5.6. Post-alteplase Treatment COR LOE New, Revised, or Unchanged BP should be maintained at <180/105 mmHg for at least the first 24 hours after IV alteplase treatment. I B-R Recommendation reworded for clarity from 2013 AIS Guidelines. COR unchanged. LOE amended to conform with ACC/AHA 2015 Recommendation Classification System. See Table XCV in online Data Supplement 1 for original wording. Main elements of postthrombolysis care are listed in Table 9. ENCHANTED (Enhanced Control of Hypertension and Thrombolysis Stroke Study) randomized 2196 alteplase-eligible patients with AIS and systolic BP (SBP) 150 mmHg to receive intensive target SBP of 130 to 140 mmHg within 1 hour versus guideline target SBP <180 mmHg; 1081 were in the intensive group, and 1115 were in the guideline group.176 Median time from stroke onset to randomization was 3.3 hours. Mean SBP in the intensive group was 144.3 mmHg, and mean SBP in the guideline group was 149.8 mmHg. Primary outcome mRS score at 90 days did not differ between the 2 groups. 