SERPINE1 and Stroke: As the most important inhibitor of t‐PA, the relative balance between PAI‐1 and t‐PA plays an important regulatory role in fibrinolysis.6 Elevated PAI‐1 levels have been long identified as risk factor for cardiovascular disease and stroke.6, 7, 8 Surprisingly, much less evidence is available on changes in PAI‐1 levels during thrombolysis in stroke patients and its association with outcomes.