Primary outcome mRS score at 90 days did not differ between the 2 groups. Although fewer patients in the intensive group had ICH, the number of patients with serious adverse events did not differ between the 2 groups. Although intensive BP lowering was observed to be safe, the observed reduction in ICH did not lead to improved clinical outcome compared with guideline treatment. See Table XLI in online Data Supplement 1. The risk of antithrombotic therapy (other than IV aspirin) within the first 24 hours after treatment with IV alteplase (with or without mechanical thrombectomy) is uncertain. Use might be considered in the presence of concomitant conditions for which such treatment given in the absence of IV alteplase is known to provide substantial benefit or withholding such treatment is known to cause substantial risk. IIb B-NR New recommendation. A retrospective analysis of consecutive ischemic stroke patients admitted to a single center in Seoul, South Korea, found no increased risk of hemorrhage with early initiation of antiplatelet or anticoagulant therapy (<24 hours) after IV alteplase or EVT compared with initiation >24 hours. However, this study may have been subject to selection bias, and the timing of the initiation of antiplatelet therapy or anticoagulation should be based on an individual level, balancing risk and benefit.177 See Table XLII in online Data Supplement 1. 3.5.5. Bleeding Risk (Continued) COR LOE New, Revised, or Unchanged Table 6. 