What does this research mean for the field?

Non-lacunar posterior ischemic strokes and atypical hemorrhagic strokes increase the risk of all-cause death by 3.35 and 2.80 times, respectively, compared to lacunar strokes, and are key determinants of Stroke-Heart Syndrome. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

What question did this study set out to answer?

This analysis investigates the relationship between stroke subtype, lesion location, and the risk of early cardiovascular complications and mortality.

March 16, 2026Open Access

All-cause mortality and early cardiovascular complications in relation to lesion location and stroke subtype in haemorrhagic and ischaemic stroke: the Perugia stroke registry

Key Result

Non-lacunar posterior ischemic strokes and atypical hemorrhagic strokes increased all-cause death risk by 3.35 and 2.80 times, respectively, compared to lacunar strokes.

Key Points

This analysis investigates the relationship between stroke subtype, lesion location, and the risk of early cardiovascular complications and mortality.
Performed a retrospective analysis of the Perugia Stroke Registry data from 2005 to 2019.
Classified patients with acute neurological symptoms as ischaemic stroke (IS) or haemorrhagic stroke (HS).
Used logistic regression to identify risk factors related to stroke subtype and in-hospital complications.
Conducted subgroup analyses for first-ever versus recurrent strokes and various lesion locations.
Patients with HS had a higher composite outcome rate (26%) compared to IS (14%).
All-cause death was significantly higher in HS (21.2%) versus IS (8.8%).
Non-lacunar posterior and anterior strokes were linked to increased risk of complications and mortality in IS (OR 1.97, 1.61).
Atypical lesions in HS also raised the risk of composite outcomes (OR 2.51) and mortality (OR 2.80).

Structured PICO

Does stroke subtype and lesion location predict the risk of early cardiovascular complications and mortality (Stroke-Heart Syndrome) in patients with acute stroke?

Population

2,080 patients admitted to the Stroke Unit with acute neurological symptoms and radiologically confirmed ischaemic stroke (n=1,788) or haemorrhagic stroke (n=292). Mean age 72.8 years, 57% male, based in Italy. Excluded: subarachnoid haemorrhages, venous sinus occlusion, and stroke mimics.

Intervention

Exposure to specific stroke subtypes and lesion locations (ischaemic vs haemorrhagic; non-lacunar anterior, non-lacunar posterior, or lacunar for ischaemic; typical vs atypical for haemorrhagic)

Comparator

Internal comparators across stroke subtypes and lesion locations (e.g., ischaemic vs haemorrhagic, lacunar vs non-lacunar, typical vs atypical)

Outcome

Composite of all-cause death, cardiac events (acute heart failure and acute coronary syndrome), and venous thromboembolic events (pulmonary embolism with or without deep vein thrombosis) during Stroke Unit staycomposite

Lesion location and stroke subtype are significant predictors of early stroke-heart syndrome, with non-lacunar posterior ischaemic strokes and atypical haemorrhagic strokes carrying the highest risk for cardiovascular complications and mortality.

Main Result

Absolute Event Rate: 0% vs 0%

Abstract

Background: Acute stroke is frequently complicated by new-onset cardiac or thromboembolic events, referred to as Stroke-Heart Syndrome (SHS).The role of stroke subtype and lesion location in determining SHS risk remains underexplored.Methods: We conducted a retrospective analysis of data from the hospital-based Perugia Stroke Registry (March 2005-September 2019).Patients with acute neurological symptoms were classified as ischaemic stroke (IS) or haemorrhagic stroke (HS) based on neuroimaging.Logistic regression identified predictors of stroke subtype and in-hospital complications.Subgroup analyses compared first-ever versus recurrent strokes, and lesion location (lacunar, non-lacunar anterior, or non-lacunar posterior for IS; typical versus atypical for HS).The primary outcome was a composite of all-cause death, cardiac events and venous thromboembolic events during Stroke Unit stay.Secondary outcomes were each component.Results: Among 2080 patients (mean age 72.8 12.5 years; 57% male), 1788 (86%) had IS and 292 (14%) HS.During Stroke Unit stay (median 8 days, IQR 5-14), HS patients had higher rates of the composite outcome (26% vs 14%) and all-cause death (21.2% vs 8.8%) than IS.In IS, non-lacunar posterior and anterior strokes were associated with increased risk of composite outcome (OR 1.97, OR 1.61,) and all-cause death (OR 3.35, OR 2.90,) versus lacunar strokes.Among HS, atypical lesions increased risk of composite outcome (OR 2.51,) and all-cause death (OR 2.80, 95%CI 1.31-6.17).Conclusions: Lesion location is a key determinant of SHS.Non-lacunar posterior stroke and atypical HS predict higher mortality and cardiovascular complications.

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Cite This Study

Rigutini et al. (Sun,) reported a other. Non-lacunar posterior ischemic strokes and atypical hemorrhagic strokes increased all-cause death risk by 3.35 and 2.80 times, respectively, compared to lacunar strokes.

synapsesocial.com/papers/69b79e7c8166e15b153abd98 https://doi.org/https://doi.org/10.1016/j.ejim.2026.106822

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