Angina is a kind of chest pain or discomfort caused by poor flow of
blood in the heart. This often occurs due to narrowing of blood
arteries (atherosclerosis) caused by plaque formation or blood clot.
People with obesity, history of heart disease, diabetes, high level
of blood cholesterol and smoking are high risk of getting affected
with angina. Some common symptoms associated with angina include
pain, pressure or strange feeling in chest, shortness of breath,
lightheadedness, irregular heartbeat, nausea or vomiting and
weakness. Angina may be of two types: stable angina and unstable
angina. Stable angina is the most common type of angina and is
characterized by predictable pattern of chest pain. On the other
hand, unstable angina has no typical pattern of chest pain. Stable
angina happens when the heart does not get enough oxygen to perform a
work which has been asked to do such as exercise or lifting heavy
weight which may also occur due to cold weather and emotional
stress.
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Diagnosis of chronic stable angina includes medical history
examination by a doctor and few tests such as coronary angiography,
coronary risk profile (special blood tests), ECG, exercise tolerance
test (stress test or treadmill test), stress echocardiogram and
nuclear medicine (thallium) stress test. The treatment options for
chronic stable angina include lifestyle changes such as daily
exercise and quitting smoking, medications, and procedures such as
angioplasty and stent placement and sometimes heart bypass surgery.
Most commonly used medications include nitrates, ACE inhibitors and
calcium channel blockers. Nicorandil, ranolazine and ivabradine are
some of the latest anti-anginal agents which are also used for
treating chronic stable angina.
The global market for chronic stable angina therapeutics is expected
to grow at a moderate CAGR. Some major factors driving the market
growth include high prevalence of the disease, extensive research and
development of new more effective molecules. According to National
Institute for Health and Clinical Excellence, an estimated 2 million
people suffered from with stable angina in England in 2010. American
Heart Association claims that around 9.1 million people are living
with stable angina in the United States.
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Since stable angina cannot be cured immediately, it is expected that
the base population of affected people will increase over the years
and such high prevalence will drive market growth particularly in
developed countries. The market for chronic stable angina
therapeutics is likely to face significant challenges owing to patent
expiry of major drugs such as bivalirudin (Angiomax/Angiox) in 2015
in Europe and rosuvastatin (Crestor) in 2016. These patent expiries
are expected to attract generic manufacturers who will intensify the
competition by selling drugs at low prices.
Geographically, North America represents the largest market, followed
by Europe, Asia-Pacific and Rest of the World. In Asia-Pacific, rapid
urbanization leading to life style changes and emerging economy of
key countries such as India and China are expected to drive the
market growth. Obesity, stress and cardiovascular diseases have
become very common and will drive the market in developing countries
significantly. Rapidly evolving medical tourism industry will also
play a key role in driving the market growth in the region as a large
number of people come from foreign countries to countries like India,
Indonesia, Thailand and Singapore for the treatment of chronic stable
angina.
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There are many pharmaceutical companies and research institutes which
are engaged in the development, manufacturing and marketing of drugs
for treating chronic stable angina. Some major companies and research
institutes include Pfizer, Inc., Mylan, Inc., Actavis Inc., Chong Kun
Dang Pharmaceutical Corp., Roxane Laboratories, Inc., Gilead
Sciences, Inc., CNS, Inc., Nanjing University and King\'s College
London.
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