{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,28]],"date-time":"2026-07-28T15:02:58Z","timestamp":1785250978437,"version":"3.55.0"},"reference-count":49,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"9","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2026,5,5]]},"abstract":"<jats:sec xml:lang=\"en\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p xml:lang=\"en\">Anemia predicts poor outcomes after intravenous thrombolysis in acute ischemic stroke. Whether morphological anemia subtypes differentially affect prognosis remains unclear. We evaluated the impact of microcytic, normocytic, and macrocytic anemia on outcomes in patients with acute ischemic stroke receiving intravenous thrombolysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p xml:lang=\"en\">In this multicenter, prospective cohort study of 1367 patients with acute ischemic stroke treated with intravenous thrombolysis, anemia was defined using World Health Organization criteria and classified by mean corpuscular volume. Multivariable logistic regression and mediation analyses were performed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p xml:lang=\"en\">Among 1367 patients (median age 66\u2009years, 64.7% male), 379 (27.7%) had anemia: 123 (8.9%) microcytic, 202 (14.7%) normocytic, and 54 (3.9%) macrocytic. After full adjustment, microcytic and normocytic anemia were independently associated with increased risks of 3\u2010month death or severe disability (microcytic: adjusted odds ratio [aOR], 2.13 [95% CI, 1.34\u20133.38]; normocytic: aOR, 2.07 [95% CI, 1.39\u20133.09]) and 3\u2010month mortality (microcytic: aOR, 1.76 [95% CI, 1.05\u20132.96]; normocytic: aOR, 1.88 [95% CI, 1.21\u20132.91]). Normocytic anemia was additionally associated with in\u2010hospital neurological deterioration (aOR, 1.83 [95% CI, 1.10\u20133.04]), stroke\u2010associated pneumonia (aOR, 2.35 [95% CI, 1.57\u20133.51]), and in\u2010hospital gastrointestinal bleeding (aOR, 2.58 [95% CI, 1.18\u20135.64]). Stroke\u2010associated pneumonia mediated 22.09%, 45.91% and 27.05% of the effect of normocytic anemia on 3\u2010month death or severe disability, 3\u2010month mortality, and in\u2010hospital neurological deterioration, respectively. Macrocytic anemia showed no significant associations with outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p xml:lang=\"en\">Morphological anemia subtypes have distinct prognostic implications in intravenous thrombolysis\u2010treated patients with acute ischemic stroke. Microcytic and normocytic anemia are independently associated with poor outcomes and mortality, with in\u2010hospital complications, particularly stroke\u2010associated pneumonia, mediating substantial risk.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Registration<\/jats:title>\n                    <jats:p xml:lang=\"en\">\n                      URL:\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/www.chictr.org.cn\/\">https:\/\/www.chictr.org.cn\/<\/jats:ext-link>\n                      ; Unique Identifier: ChiCTR2000033456.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/jaha.125.047255","type":"journal-article","created":{"date-parts":[[2026,4,22]],"date-time":"2026-04-22T09:41:03Z","timestamp":1776850863000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Beyond Hemoglobin Levels: Integrating Anemia Phenotyping Into Prognostic Models for Patients With Stroke Following Intravenous Thrombolysis"],"prefix":"10.1161","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-6195-6075","authenticated-orcid":false,"given":"Senwei","family":"Tan","sequence":"first","affiliation":[{"name":"Union Hospital, Tongji Medical College, Huazhong University of Science and Technology","place":["Wuhan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shengcai","family":"Chen","sequence":"additional","affiliation":[{"name":"Union Hospital, Tongji Medical College, Huazhong University of Science and Technology","place":["Wuhan, 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