{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T05:00:00Z","timestamp":1785301200333,"version":"3.55.0"},"reference-count":32,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2026,7,13]],"date-time":"2026-07-13T00:00:00Z","timestamp":1783900800000},"content-version":"vor","delay-in-days":12,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T00:00:00Z","timestamp":1782864000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["CNS Neurosci Ther"],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>In large\u2010core anterior\u2010circulation large\u2010vessel occlusion (LVO), differing admission clinical\u2010imaging profiles complicate interpretation of prognostic differences between large\u2010artery atherosclerosis (LAA) and cardioembolism (CE). We assessed whether these differences persisted after adjustment and whether endovascular thrombectomy (EVT)\u2013outcome associations differed by etiology.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We analyzed 631 patients with Alberta Stroke Program Early CT Score (ASPECTS) \u2264\u20095 from the 38\u2010center MAGIC registry; 404 underwent EVT plus medical therapy and 227 received medical therapy alone. The primary outcome was 90\u2010day modified Rankin Scale (mRS) 0\u20133. Mixed\u2010effects models assessed etiology\u2013outcome associations and treatment\u2010by\u2010etiology interaction. Among EVT\u2010treated patients, Shapley decomposition quantified domain contributions to attenuation of the LAA\u2013CE contrast.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among EVT\u2010treated patients, higher crude odds of mRS 0\u20133 with LAA (OR 1.59, 95% CI 1.05\u20132.42) were substantially attenuated after adjustment (aOR 0.92, 95% CI 0.53\u20131.59). No adjusted LAA\u2013CE contrast was evident with medical therapy alone (aOR 1.12, 95% CI 0.47\u20132.65). In a separate fixed\u2010effects decomposition model, the absolute log\u2010odds contrast was attenuated by 96.2% after inclusion of measured pretreatment domains, with imaging\/collateral features, demographics, and stroke severity contributing most. For the secondary mRS 0\u20132 outcome, adjusted odds favored CE (aOR 0.46, 95% CI 0.25\u20130.84). No treatment\u2010by\u2010etiology interaction was detected (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.944).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Interpretation<\/jats:title>\n                    <jats:p>Admission clinical\u2010imaging phenotype clarified the apparent LAA\u2013CE prognostic contrast and may help reconcile discordant findings across EVT cohorts. These findings reinforce established clinical\u2010imaging criteria as the basis for hyperacute EVT selection rather than LAA versus CE etiology alone.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial Registration<\/jats:title>\n                    <jats:p>\n                      Chinese Clinical Trial Registry (\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"http:\/\/chictr.org.cn\">ChiCTR.org.cn<\/jats:ext-link>\n                      ); ChiCTR2100051664;\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"https:\/\/www.chictr.org.cn\/\">https:\/\/www.chictr.org.cn\/<\/jats:ext-link>\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/cns.71029","type":"journal-article","created":{"date-parts":[[2026,7,14]],"date-time":"2026-07-14T05:11:02Z","timestamp":1784005862000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Admission Phenotype Clarifies the Apparent Prognostic Contrast Between\n                    <scp>TOAST<\/scp>\n                    Etiologic Subtypes in Large\u2010Core Anterior\u2010Circulation Large\u2010Vessel Occlusion"],"prefix":"10.1002","volume":"32","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0703-0224","authenticated-orcid":false,"given":"Chengsong","family":"Yue","sequence":"first","affiliation":[{"name":"Department of Neurology No. 924 Hospital of Joint Logistic Support Force of Chinese PLA  GuangXi China"},{"name":"Department of Neurology Xinqiao Hospital and The Second Affiliated Hospital, Army Medical University (Third Military Medical University)  Chongqing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-9628-4938","authenticated-orcid":false,"given":"Shihai","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Neurology Xinqiao Hospital and The Second Affiliated Hospital, Army Medical University (Third Military Medical University)  Chongqing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiongxiong","family":"Hou","sequence":"additional","affiliation":[{"name":"Department of Neurology The Second Hospital &amp; Clinical Medical School, Lanzhou University  Lanzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jingfu","family":"Ma","sequence":"additional","affiliation":[{"name":"Department of Neurology No. 924 Hospital of Joint Logistic Support Force of Chinese PLA  GuangXi China"},{"name":"Department of Neurology Xinqiao Hospital and The Second Affiliated Hospital, Army Medical University (Third Military Medical University)  Chongqing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xu","family":"Xu","sequence":"additional","affiliation":[{"name":"Department of Neurology No. 924 Hospital of Joint Logistic Support Force of Chinese PLA  GuangXi China"},{"name":"Department of Neurology Xinqiao Hospital and The Second Affiliated Hospital, Army Medical University (Third Military Medical University)  Chongqing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-2463-2826","authenticated-orcid":false,"given":"Xiaolei","family":"Shi","sequence":"additional","affiliation":[{"name":"Department of Neurology Xinqiao Hospital and The Second Affiliated Hospital, Army Medical University (Third Military Medical University)  Chongqing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Linyu","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Neurology Xinqiao Hospital and The Second Affiliated 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