{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T13:43:24Z","timestamp":1792417404454,"version":"4.4.0"},"reference-count":23,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"5","license":[{"start":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T00:00:00Z","timestamp":1788220800000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background and Objectives:<\/jats:title>\n                    <jats:p>Prothrombotic states (PSs) are important but underrecognized contributors to acute ischemic stroke (AIS), particularly in resource-limited settings where thrombophilia testing is not routinely available. This study estimated the prevalence and spectrum of PSs in AIS and compared clinical characteristics and outcomes across risk categories.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>This study used multicenter registry-based observational cohort data from 77 Indian Council of Medical Research-National Institute of NCD Epidemiology (ICMR-NINE) Hospital-Based Stroke Registries in India (2020\u20132025). Adults (\u226518 years) with clinically and radiologically confirmed AIS were included. Clinical characteristics were compared across hyperhomocysteinemia and inherited (H&amp;I), acquired, and triggering PSs, conventional risk factors, and no-risk-factor categories. Binary logistic regression identified predictors of poor 90-day functional outcome (modified Rankin Scale \u22653).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Among 69,734 AIS patients, 3,109 (4.5%) had documented PSs. H&amp;I (3.12%) was most common, followed by acquired (0.75%) and triggering conditions (0.72%). Patients with PSs were younger and had fewer conventional risk factors. Large artery atherosclerosis, multiple brain-area involvement, and multi-territory infarcts were more frequent. Acquired states were more frequent among patients with greater stroke severity and were observed more frequently among those who experienced higher in-hospital mortality (11.6%) and 90-day mortality (32.1%). In adjusted analyses, acquired states independently predicted poor outcomes [adjusted odds ratio (aOR): 1.91; 95% confidence interval: 1.53\u20132.40], whereas H&amp;I (aOR: 0.63) and triggering states (aOR: 0.75) were associated with lower odds of poor outcome than conventional risk factors.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>PSs account for a small but clinically important proportion of AIS in India. Acquired PSs are associated with worse prognosis, underscoring the need for targeted evaluation and context-specific guidelines in resource-limited settings.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4103\/aian.aian_825_26","type":"journal-article","created":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T09:00:09Z","timestamp":1792054809000},"page":"810-817","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Prothrombotic States in Acute Ischemic Stroke: Real-world Evidence on Clinical Features and Outcomes from Hospital-Based Stroke Registry Program in India"],"prefix":"10.4103","volume":"29","author":[{"given":"Deepadarshan","family":"Huliyappa","sequence":"first","affiliation":[{"name":"Indian Council of Medical Research - National Institute of NCD Epidemiology, Bengaluru, Karnataka, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thilagavathi","family":"Ramamoorthy","sequence":"additional","affiliation":[{"name":"Indian Council of Medical Research - National Institute of NCD Epidemiology, Bengaluru, Karnataka, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kizhessery","family":"Rahna","sequence":"additional","affiliation":[{"name":"Indian Council of Medical Research - National Institute of NCD Epidemiology, Bengaluru, Karnataka, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kalentavida","family":"Anilkumar","sequence":"additional","affiliation":[{"name":"Indian Council of Medical Research - National Institute of NCD Epidemiology, Bengaluru, Karnataka, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rahul Rajendra","family":"Koli","sequence":"additional","affiliation":[{"name":"Indian Council of Medical Research - National Institute of NCD Epidemiology, Bengaluru, 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