EpiCast Report: Acute Ischemic Stroke - Epidemiology Forecast to 2022

Summary

Stroke occurs when the blood supply to the brain is blocked or interrupted, either by blood clots or ruptured blood vessels, depriving the brain of oxygen and nutrients, ultimately leading to the death of brain cells. Stroke is a major cause of death, morbidity, and long-term disability. To forecast the incident and prevalent cases of stroke in the 6MM, GlobalData epidemiologists selected studies that used the WHO definition of stroke: “rapidly developing clinical signs of focal disturbance of cerebral function, lasting more than 24 hours or leading to death, with no apparent cause other than that of vascular origin.” This definition excludes cases of transient ischemic attacks (TIAs), which are neurological deficits lasting less than 24 hours. This report also provides the incident cases of AIS segmented by the TOAST (Trial of Org 10172 in Acute Stroke Treatment) criteria subtypes and the proportion of recurrent cases of AIS out of the total cases of AIS (total cases of AIS = incident cases of first-ever AIS + recurrent cases of AIS) in these major markets.

GlobalData epidemiologists forecast that the incident cases of AIS in the 6MM will increase by 20.10% over the next decade, from 1.25 million cases in 2012 to 1.50 million cases in 2022, with more than 50% of the cases being in the US alone. The number of prevalent cases of AIS in the 6MM will increase by 18.6% over the forecast period, from 9.48 million cases in 2012 to 11.24 million cases in 2022. The substantially higher number of prevalent cases of AIS compared with the number of incident cases indicates that a higher proportion of stroke victims survive after the event for longer time periods. However, these stroke survivors will live with serious disabilities, making stroke a major burden for the affected individual and the entire healthcare system in each country.

Scope

- The Acute Ischemic Stroke (AIS) EpiCast Report provides an overview of the risk factors, comorbidities and the global epidemiological trends for AIS in the six major markets (6MM: US, France, Germany, Italy, Spain, and UK). In addition, this report includes a 10-year epidemiological forecast of the incident cases of AIS (all new cases of a first-ever AIS in a defined population in a specified time period) and the prevalent cases of AIS (all survivors of a first-ever AIS in a defined population at a specified point in time) segmented by sex and age (ages 20–85+ years). This report also provides the incident cases of AIS segmented by the TOAST criteria subtypes and the proportion of recurrent cases of AIS out of the total cases of AIS.
- The AIS epidemiology report is written and developed by Masters- and PhD-level epidemiologists.
- The EpiCast Report is in-depth, high quality, transparent and market-driven, providing expert analysis of disease trends in the 6MM.

Reasons to buy

- Develop business strategies by understanding the trends shaping and driving the global AIS market.

- Quantify patient populations in the global AIS market to improve product design, pricing, and launch plans.

- Organize sales and marketing efforts by identifying the age groups and sex that present the best opportunities for AIS therapeutics in each of the markets covered.

- Identify the percentage of each TOAST subtype among incident cases of AIS.

Table Of Contents

Table of Contents

1 Table of Contents 4
1.1 List of Tables 6
1.2 List of Figures 7
2 Introduction 8
2.1 Catalyst 8
3 Epidemiology 10
3.1 Disease Background 10
3.2 Risk Factors and Comorbidities 12
3.2.1 Atrial fibrillation increases the risk of AIS by as much as 15times 13
3.2.2 Hypertension elevates the risk of AIS by more than three times 14
3.2.3 The risk of AIS is almost identical in obese men and women 15
3.2.4 The risk of AIS increases with the duration of diabetes 15
3.2.5 Smoking increases the risk of AIS, which varies with the number of cigarettes smoked 16
3.2.6 Age is a strong predictor of AIS in both men and women 17
3.2.7 A family history of stroke, particularly a paternal history, is a strong predictor of stroke 18
3.2.8 Race/ethnicity is a strong predictor of AIS, and the risk varies with the different subtypes of AIS 19
3.3 Global Trends 20
3.3.1 US 22
3.3.2 France 26
3.3.3 Germany 28
3.3.4 Italy 30
3.3.5 Spain 32
3.3.6 UK 34
3.4 Forecast Methodology 36
3.4.1 Sources Used 40
3.4.2 Forecast Assumptions and Methods -Incident Cases of AIS 47
3.4.3 Forecast Assumptions and Methods-Prevalent Cases of AIS 51
3.4.4 Forecast Assumptions and Methods -AIS Recurrence Rate (%) 54
3.4.5 Sources Not Used 55
3.5 Epidemiological Forecast for AIS (2012-2022) 57
3.5.1 Incidence 57
3.5.2 Prevalence 65
3.5.3 AIS Recurrence Rate (%) 71
3.6 Discussion 72
3.6.1 Conclusions on Epidemiology Trends 72
3.6.2 Limitations of the Analysis 73
3.6.3 Strengths of the Analysis 74
4 Appendix 76
4.1 Bibliography 76
4.2 About the Authors 82
4.2.1 Epidemiologists 82
4.2.2 Reviewers 83
4.2.3 Global Director of Epidemiology and Health Policy 84
4.2.4 Global Head of Healthcare 84
4.3 About GlobalData 85
4.4 About EpiCast 85
4.5 Disclaimer 85



List of Tables

Table 1: TOAST Classification of Subtypes of AIS 11
Table 2: Risk Factors and Comorbidities for AIS 13
Table 3: Trends in the Age-Adjusted Incidence Rates of Stroke in the US (per 100,000 Population) 23
Table 4: Trend in the Crude Mortality Rate of Stroke in the US (per 100,000 Population), 1970-2008 24
Table 5: Trends in the Age-Adjusted Prevalence (%) of Stroke in the US, Ages ?18 Years, 2006-2010 25
Table 6: Trends in the Age-Adjusted Incidence Rates* of Stroke in France (per 100,000 Population) 26
Table 7: Trends in the Age-Specific Prevalence of Stroke (per 100,000 Population) in France, 2000 27
Table 8: Trends in the Crude Annual Incidence Rates of Stroke in Germany (per 100,000 Population) 28
Table 9: Trends in the Age-Specific Prevalence of Stroke (per 100,000 Population) in Germany, 2000 29
Table 10: Trends in the Total Crude Incidence Rates of Stroke in Italy (per 100,000 Population), All Ages 30
Table 11: Trends in the Age-Specific Prevalence of Stroke (per 100,000 Population) in Italy, 2000 31
Table 12: Trends in the Age-Adjusted Incidence Rates of Stroke in Spain (per 100,000 Population) 32
Table 13: Trends in the Age-Specific Prevalence of Stroke (per 100,000 Population) in Spain, 2000 33
Table 14: Trends in the Age-Adjusted Mortality Rate of Stroke in the UK (per 100,000 Population), 1981-2009 34
Table 15: Trends in the Prevalence (%) of Stroke in the UK, 1994-2011 35
Table 16:Sources of AIS Incidence Data 37
Table 17:Sources of AIS Prevalence Data 38
Table 18: Sources of AIS Recurrence (%) Data 39
Table 19: Sources of AIS Subtypes (%) Data 39
Table 20: 6MM, Incident Cases of AIS, Ages ?20 Years, Both Sexes, N, 2012-2022 57
Table 21: 6MM, Incident Cases of AIS, by Age, Both Sexes, N, Row (%), 2012 59
Table 22: 6MM, Incident Cases of AIS by Sex, Ages ?20 Years, N, Row (%), 2012 60
Table 23: 6MM, Incident Cases of AIS by Subtypes, Ages ?20 Years, Both Sexes, N (Row %), 2012 63
Table 24: 6MM, Prevalent Cases of AIS, Ages ?20 Years, Both Sexes, N, 2012-2022 65
Table 25: 6MM, Prevalent Cases of AIS, by Age, Both Sexes, N, Row (%), 2012 67
Table 26: 6MM, Prevalent Cases of AIS, Ages ?20 Years, by Sex, N, Row (%), 2012 68



List of Figures

Figure 1: Trends in the Age-Adjusted Incidence Rates of Stroke in the US (per 100,000 Population) 23
Figure 2: Trend in the Crude Mortality Rate of Stroke in the US, Both Sexes (per 100,000 Population), 1970-2008 24
Figure 3: Trends in the Age-Adjusted Prevalence (%) of Stroke in the US, Ages ?18 Years, 2006-2010 25
Figure 4: Trends in the Age-Adjusted Incidence Rates* of Stroke in France (per 100,000 Population) 26
Figure 5: Trends in the Age-Adjusted Mortality Rate of Stroke in the UK, Both Sexes (per 100,000 Population), 1981-2009 35
Figure 6: Trends in the Prevalence (%) of Stroke in the UK, 1994-2011 36
Figure 7: 6MM, Incident Cases of AIS, Ages ?20 Years, Both Sexes, N, 2012-2022 58
Figure 8: 6MM, Incident Cases of AIS, by Age, Both Sexes, N, 2012 59
Figure 9: 6MM, Incident Cases of AIS, by Sex, Ages ?20 Years, N, 2012 61
Figure 10: 6MM, Age-Standardized Incidence of AIS (per 100,000 Population), Ages ?20 Years, by Sex, 2012 62
Figure 11: 6MM, AIS Subtypes (%), Ages ?20 Years, Both Sexes, 2012 64
Figure 12: 6MM, Incident Cases of AIS by Subtypes (N), Ages ?20 Years, Both Sexes, 2012 64
Figure 13: 6MM, Prevalent Cases of AIS, Ages ?20 Years, Both Sexes, N, 2012-2022 66
Figure 14: 6MM, Prevalent Cases of AIS, by Age, Both Sexes, N, 2012 67
Figure 15: 6MM, Prevalent Cases of AIS, Ages ?20 Years, by Sex, N, Row (%), 2012 69
Figure 16: 6MM, Age-Standardized Prevalence (%) of AIS, Ages ?20 Years, by Sex, 2012 70
Figure 17: 6MM, Recurrence Rate (%) of AIS, Ages ?20 Years, Both Sexes, 2012 71

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