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Angelo Cascio Rizzo: Ischemic Stroke Phenotyping in ESUS – Insights from a Real-World Cohort
Angelo Cascio Rizzo/LinkedIn
Sep 26, 2026, 04:58

Angelo Cascio Rizzo: Ischemic Stroke Phenotyping in ESUS – Insights from a Real-World Cohort

Angelo Cascio Rizzo, Angelo Cascio Rizzo, Vascular Neurologist at Niguarda Ca’ Granda Hospital, shared a post on LinkedIn about a recent article he and his colleagues co-authored, published in Journal of the American Heart Association, adding:

“Check out our latest paper published in the JAHA — Journal of the American Heart Association.

We assessed how the Ischemic Stroke Phenotyping System 2025 performs in 802 consecutive patients with ESUS admitted to Niguarda Hospital in Milan.

Key findings:

  • ISPS25 assigned a pathogenetic category to 313 patients (39.0%), most commonly cardioembolism.
  • The remaining 489 patients (61.0%) still classified as undetermined?
  • Second-pass diagnostic testing was performed less often in patients who remained undetermined than in those who were reassigned (46.2% vs 70.3%).
  • Additional potential embolic sources outside the ISPS25 framework were more frequent in undetermined patients (62.0% vs 42.5%). These included atrial cardiopathy, AFib first detected more than 12 months after stroke, high-risk PFO in patients aged 60 years or older, and nonstenotic carotid plaque with increased wall thickness.

ISPS25 is a useful tool for stroke classification.

To identify more potential mechanisms, we need more complete diagnostic testing and a broader assessment of potential embolic sources.”

Title: Application of the Ischemic Stroke Phenotyping System 2025 in a Real‐World Embolic Stroke of Undetermined Source Cohort: Advantages and Limitations

Authors: Angelo Cascio Rizzo, Ghil Schwarz

Angelo Cascio Rizzo: Ischemic Stroke Phenotyping in ESUS - Insights from a Real-World Cohort

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Angelo Cascio Rizzo Atrial Cardiopathy Atrial Fibrillation Cardioembolism Carotid Plaque Embolic Stroke ESUS Ghil Schwarz Hemostasis News Hemostasis Today Ischemic stroke ISPS25 JAHA Journal of the American Heart Association Neurology PFO Stroke Classification Stroke Phenotyping Vascular Neurology
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