Man S, Xian Y, Holmes DN, et al. - This retrospective cohort study was undertaken to determine if shorter door-to-needle times with intravenous tissue plasminogen activator (tPA) for acute ischemic stroke are correlated with improved long-term outcomes. The authors included Medicare beneficiaries aged 65 years or older who were treated for acute ischemic stroke with intravenous tPA within 4.5 hours from the time they were last considered to be well at Get With The Guidelines–Stroke participating hospitals between January 1, 2006, and December 31, 2016, with 1-year follow-up through December 31, 2017. Of the 61,426 patients treated within 4.5 hours with tPA, the median age was 80 years and 43.5% were male. Shorter door-to-needle times were related to lower all-cause mortality and lower all-cause readmission at 1 year in patients aged 65 years or older with acute ischemic stroke who were treated with tissue plasminogen activator. Such results support efforts to shorten thrombolytic therapy time.