A Study of the Efficacy and Safety of Alteplase in Participants With Mild Stroke

Exclusion Criteria

• •Computed tomography (CT) or magnetic resonance imaging (MRI) findings of one of the following:
• •1. CT with clear large hypodensity that is greater than (\>) one-third middle cerebral artery (MCA) territory (or \>100 cubic centimeter \[cc\] if not in MCA territory)
• •2. MRI with clear large hyperintensity on concurrent diffusion-weighted (DW) and fluid-attenuated inversion recovery (FLAIR) that is greater than one-third MCA territory (or greater than 100 cc if not in MCA territory),
• •3. Imaging lesion consistent with acute hemorrhage, or
• •4. Evidence of intraparenchymal tumor
• •Disability prior to the presenting stroke
• •Standard contraindications to IV alteplase within 3 hours of symptom onset, including:
• •1. Head trauma, myocardial infarction, or previous stroke within the previous 3 months
• •2. Gastrointestinal or urinary tract hemorrhage within the previous 21 days
• •3. Major surgery within the previous 14 days
• •4. Arterial puncture at non-compressible site within the previous 7 days
• •5. Any history of ICH with the exception of those less than (\<) 5 chronic microbleeds on MRI
• •6. Elevated blood pressure defined by systolic blood pressure \>185 millimeters of mercury (mm Hg) or diastolic blood pressure \>110 mm Hg, or treatments requiring aggressive measures to achieve acceptable levels
• •7. Treatment with unfractioned heparin within past 48 hours and activated partial thromboplastin time outside normal range
• •8. Blood glucose \<50 milligrams per deciliter (mg/dL)
• •9. International normalized ratio \>1.7
• •10. Platelet count \<100,000 per cubic millimeter (/mm\^3)
• •11. Treatment with a direct thrombin inhibitor (dabigatran) or a factor Xa inhibitor (apixaban, rivaroxaban, edoxaban) within the last 48 hours
• •Allergic reaction to study drug, aspirin, or nonsteroidal anti-inflammatory drugs (NSAIDs)
• •Females of childbearing age who are known to be pregnant and/or lactating
• •Inability to swallow, which would prevent oral intake of aspirin or aspirin placebo tablet
• •Other serious, advanced, or terminal illness that would confound the clinical outcome at 90 days
• •Current or recent (within 3 months) participation in another investigational drug treatment protocol
• •Anticipated inability to obtain 3-month follow-up assessments
• •Previous enrollment in PRISMS
• •Any other condition deemed by the investigator that would pose hazard to the participant with alteplase treatment