Abstract Body: Introduction:
Acute ischemic Stroke, of which minor ischemic stroke (MIS) accounts for more than half, remains the leading cause of disability and death worldwide. Approximately one-third of patients with MIS have a poor prognosis three months after stroke. This study aims to establish and validate a nomogram model for predicting 90-day unfavorable prognosis in patients with MIS receiving intravenous thrombolysis (IVT).

Method:
We conducted a retrospective analysis of the data from the TRAIS (a multicenter clinical Trial of Revascularization Treatment for Acute Ischemic Stroke) study, where eligible patients with MIS were randomly assigned to the derivation cohort (n = 1007) and validation cohort (n = 431). Inclusion criteria: (1) age≥18 years; (2) National Institute of Health Stroke Scale (NIHSS) score ≤ 5 on admission; (3) pre-stroke modified Rankin Scale (mRS) score of 0-1; (4) received IVT treatment within the time window. Logistic regression was used to determine the independent influencing factors of a 90-day poor prognosis.
Trial Registry Number: ChiCTR2000033456.

Result:
A total of 1438 participants were included, the median age was 65 years (interquartile range, 56-73 years), 167 (16.58%) and 58(13.46%) patients in the derivation and validation cohort observed unfavorable outcomes (mRS score ≥ 2), respectively. The final nomogram model includes the following variables: systolic blood pressure (SBP), Baseline NIHSS score, fasting blood glucose (FBG), renal dysfunction, international normalized ratio (INR), neutrophils count, and functional disability. The area under the curve was 0.796 (95%CI, 0.759-0.832) and 0.838 (95%CI, 0.782-0.895), indicating the model had good discrimination and calibration.

Conclusion:
The SPRIN₂G-D nomogram effectively predicts the 90-day unfavorable outcome in MIS patients treated with IVT therapy, providing a reference for clinical practice.