I read with great interest the article by Rigutini and colleagues regarding all-cause mortality and early cardiovascular complications in relation to lesion location and stroke subtype in the Perugia Stroke Registry. The authors should be commended for advancing our understanding of how lesion topography modulates stroke-heart syndrome (SHS) risk across both ischaemic and haemorrhagic stroke phenotypes. Their demonstration that non-lacunar posterior strokes and atypical haemorrhagic lesions independently predict higher mortality and composite adverse outcomes represents a meaningful contribution to the emerging topography-informed framework of post-stroke cardiovascular vulnerability.
