Ischaemic stroke

Metadata

Name	Ischaemic stroke (Isch_stroke)
Category	Cardiovascular
Sex
Adult	Yes
UUID	64cdd7bb-f65f-48c9-b9be-e493c5641344
Definition	Tissue NECROSIS in any area of the brain, including the CEREBRAL HEMISPHERES, the CEREBELLUM, and the BRAIN STEM. Brain infarction is the result of a cascade of events initiated by inadequate blood flow through the brain that is followed by HYPOXIA and HYPOGLYCEMIA in brain tissue. Damage may be temporary, permanent, selective or pan-necrosis.

Ontologies

Disease Ontology (DOID)	DOID_2316
GWAS Catalogue	EFO_0003763
MeSH	D020520
SNOMED-CT	422504002
FinnGen	I9_STR_EXH

Key Summary Statistics

Cases from any source

Total	9179
Female (%)	3550 (39%)
Male (%)	5629 (61%)

Year first recorded

Cases linked in all UK Biobank sources

Cross-source concordance

Vertical bars correspond to number of cases per source/intersection; horizontal bars to left correspond to total number of cases per source.

Incidence & prevalence

Baseline prevalence stratified by sex

Female	30.29 (26.6,33.99)
Male	67.06 (61.07,73.04)

Incidence stratified by sex

Female	6.14 (5.49,6.79)
Male	12.96 (11.93,13.98)

Incidence stratified by age

Ages 40-44	2.32 (1.37,3.26)
Ages 45-49	2.53 (1.68,3.38)
Ages 50-54	5.72 (4.54,6.9)
Ages 55-59	7.32 (6.11,8.53)
Ages 60-64	10.37 (9.13,11.61)
Ages 65-69	20.5 (18.5,22.5)

Period prevalence

Methods

Comparison with general population

Sex-standardised prevalence from CALIBER study (Kuan et al. 2019)

Population	Ages 40-49	Ages 50-59	Ages 60-69
UK Biobank	32 (27,39)	73 (66,80)	150 (142,158)
CALIBER	32 (30,33)	85 (82,88)	207 (202,211)

Stratified by age and Townsend deprivation status

Deprivation status	Ages 40-49	Ages 50-59	Ages 60-69
Least deprived	18(9,31)	52(40,66)	112(98,128)
Low	23(13,38)	54(42,69)	133(117,151)
Medium	17(9,29)	67(54,83)	141(124,159)
High	43(30,59)	62(49,78)	145(127,164)
Most deprived	51(38,67)	123(105,144)	233(210,258)

Stratified by age and country

Country	Ages 40-49	Ages 50-59	Ages 60-69
England	34(28,41)	71(64,79)	143(135,152)
Scotland	32(18,52)	80(62,101)	188(162,216)
Wales	21(8,47)	77(55,106)	161(132,195)

Risk factors analysis

‘Healthy’ BMI, smoking status ‘never’, or no hypertension (absence of hypertension records) were considered as reference values.

Hazard Ratio (HR) values with P < 0.0002 were considered to show significant association with disease onset after correction for multiple-testing using the Bonferroni method

N=154060, Events=218

Factor	Level	Hazard Ratio	P value
BMI	overweight	0.89 (0.65, 1.23)	0.488
BMI	obese	1.16 (0.82, 1.63)	0.404
BMI	underweight	0 (0, Inf)	0.989
smoking	previous	1.75 (1.31, 2.35)	0.000182
smoking	current	2.37 (1.58, 3.55)	3.07e-05
hypertension	yes	1 (0.74, 1.36)	0.997

Definition

UK Biobank field id	Description	Code	Value
20002	Non-cancer illness code, self-reported	1583	ischaemic stroke
41202	Diagnoses - main ICD10	I63.0	Cerebral infarction due to thrombosis of precerebral arteries
41202	Diagnoses - main ICD10	I63.1	Cerebral infarction due to embolism of precerebral arteries
41202	Diagnoses - main ICD10	I63.2	Cerebral infarction due to unspecified occlusion or stenosis of precerebral arteries
41202	Diagnoses - main ICD10	I63.3	Cerebral infarction due to thrombosis of cerebral arteries
41202	Diagnoses - main ICD10	I63.4	Cerebral infarction due to embolism of cerebral arteries
41202	Diagnoses - main ICD10	I63.5	Cerebral infarction due to unspecified occlusion or stenosis of cerebral arteries
41202	Diagnoses - main ICD10	I63.8	Other cerebral infarction
41202	Diagnoses - main ICD10	I63.9	Cerebral infarction, unspecified
41202	Diagnoses - main ICD10	I69.3	Sequelae of cerebral infarction
41204	Diagnoses - secondary ICD10	I63.0	Cerebral infarction due to thrombosis of precerebral arteries
41204	Diagnoses - secondary ICD10	I63.1	Cerebral infarction due to embolism of precerebral arteries
41204	Diagnoses - secondary ICD10	I63.2	Cerebral infarction due to unspecified occlusion or stenosis of precerebral arteries
41204	Diagnoses - secondary ICD10	I63.3	Cerebral infarction due to thrombosis of cerebral arteries
41204	Diagnoses - secondary ICD10	I63.4	Cerebral infarction due to embolism of cerebral arteries
41204	Diagnoses - secondary ICD10	I63.5	Cerebral infarction due to unspecified occlusion or stenosis of cerebral arteries
41204	Diagnoses - secondary ICD10	I63.8	Other cerebral infarction
41204	Diagnoses - secondary ICD10	I63.9	Cerebral infarction, unspecified
41204	Diagnoses - secondary ICD10	I69.3	Sequelae of cerebral infarction
40001	Underlying (primary) cause of death: ICD10	I63.0	Cerebral infarction due to thrombosis of precerebral arteries
40001	Underlying (primary) cause of death: ICD10	I63.1	Cerebral infarction due to embolism of precerebral arteries
40001	Underlying (primary) cause of death: ICD10	I63.2	Cerebral infarction due to unspecified occlusion or stenosis of precerebral arteries
40001	Underlying (primary) cause of death: ICD10	I63.3	Cerebral infarction due to thrombosis of cerebral arteries
40001	Underlying (primary) cause of death: ICD10	I63.4	Cerebral infarction due to embolism of cerebral arteries
40001	Underlying (primary) cause of death: ICD10	I63.5	Cerebral infarction due to unspecified occlusion or stenosis of cerebral arteries
40001	Underlying (primary) cause of death: ICD10	I63.8	Other cerebral infarction
40001	Underlying (primary) cause of death: ICD10	I63.9	Cerebral infarction, unspecified
40001	Underlying (primary) cause of death: ICD10	I69.3	Sequelae of cerebral infarction
40002	Contributory (secondary) causes of death: ICD10	I63.0	Cerebral infarction due to thrombosis of precerebral arteries
40002	Contributory (secondary) causes of death: ICD10	I63.1	Cerebral infarction due to embolism of precerebral arteries
40002	Contributory (secondary) causes of death: ICD10	I63.2	Cerebral infarction due to unspecified occlusion or stenosis of precerebral arteries
40002	Contributory (secondary) causes of death: ICD10	I63.3	Cerebral infarction due to thrombosis of cerebral arteries
40002	Contributory (secondary) causes of death: ICD10	I63.4	Cerebral infarction due to embolism of cerebral arteries
40002	Contributory (secondary) causes of death: ICD10	I63.5	Cerebral infarction due to unspecified occlusion or stenosis of cerebral arteries
40002	Contributory (secondary) causes of death: ICD10	I63.8	Other cerebral infarction
40002	Contributory (secondary) causes of death: ICD10	I63.9	Cerebral infarction, unspecified
40002	Contributory (secondary) causes of death: ICD10	I69.3	Sequelae of cerebral infarction
42040	GP clinical event records	G63..11	Infarction - precerebral
42040	GP clinical event records	G63y000	Cerebral infarct due to thrombosis of precerebral arteries
42040	GP clinical event records	G63y100	Cerebral infarction due to embolism of precerebral arteries
42040	GP clinical event records	G640000	Cerebral infarction due to thrombosis of cerebral arteries
42040	GP clinical event records	G640.00	Cerebral thrombosis
42040	GP clinical event records	G641000	Cerebral infarction due to embolism of cerebral arteries
42040	GP clinical event records	G641.00	Cerebral embolism
42040	GP clinical event records	G641.11	Cerebral embolus
42040	GP clinical event records	G64..00	Cerebral arterial occlusion
42040	GP clinical event records	G64..11	CVA - cerebral artery occlusion
42040	GP clinical event records	G64..12	Infarction - cerebral
42040	GP clinical event records	G64..13	Stroke due to cerebral arterial occlusion
42040	GP clinical event records	G64z000	Brainstem infarction
42040	GP clinical event records	G64z100	Wallenberg syndrome
42040	GP clinical event records	G64z111	Lateral medullary syndrome
42040	GP clinical event records	G64z200	Left sided cerebral infarction
42040	GP clinical event records	G64z300	Right sided cerebral infarction
42040	GP clinical event records	G64z400	Infarction of basal ganglia
42040	GP clinical event records	G64z.00	Cerebral infarction NOS
42040	GP clinical event records	G64z.11	Brainstem infarction NOS
42040	GP clinical event records	G64z.12	Cerebellar infarction
42040	GP clinical event records	G683.00	Sequelae of cerebral infarction
42040	GP clinical event records	G6W..00	Cereb infarct due unsp occlus/stenos precerebr arteries
42040	GP clinical event records	G6X..00	Cerebrl infarctn due/unspcf occlusn or sten/cerebrl artrs
42040	GP clinical event records	Gyu6300	[X]Cerebrl infarctn due/unspcf occlusn or sten/cerebrl artrs
42040	GP clinical event records	Gyu6400	[X]Other cerebral infarction
42040	GP clinical event records	Gyu6G00	[X]Cereb infarct due unsp occlus/stenos precerebr arteries
42040	GP clinical event records	Xa00K	Brainstem infarction
42040	GP clinical event records	XaJgQ	Infarction of basal ganglia
42040	GP clinical event records	XaBEC	Left sided cerebral infarction
42040	GP clinical event records	XE0VG	Precerebral arterial occlusion
42040	GP clinical event records	XE0VI	Cerebral arterial occlusion
42040	GP clinical event records	XaBED	Right sided cerebral infarction
42040	GP clinical event records	XE0VJ	Cerebral infarction NOS
42040	GP clinical event records	Xa00M	Wallenberg syndrome