Studie - Innovations in Cardiovascular Disease Management: Latest surgical procedures, drugs and medical devices

Business Insights
182 Seiten

  • Europa
  • Asien / Pazifik
  • Mittlerer Osten / Afrika
  • Nordamerika / USA
  • Australien
  • Mittel- / Südamerika

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Despite significant advances in prevention and treatment, cardiovascular disease remains the leading cause of death in economically advanced countries. The developing world has also begun to experience a disconcerting growth in prevalence, where the insurgence of CVD has exacerbated the risk factors associated with indigenous communicable diseases. Keeping pace with epidemiological change in both the developed and developing world constitutes the overriding challenge for industrial players, and involves successfully integrating into localised healthcare systems and reimbursement structures, in addition to remaining aligned with product demand. In the medical device, pharmaceutical and biotechnology industries, this challenge is being met with a focus on products that reduce adverse effects, improve patient outcomes and extend the range of formulations for existing indications. ‘Innovations in Cardiovascular Disease Management’ is a new report published by Business Insights that will examine the major developments shaping the future of the cardiovascular industry. This report will analyse the future potential of new and emerging products from the medical device, pharmaceutical and biotechnology sectors, and measure their likely impact upon the existing market. The extent to which these products can stimulate the growth and development of the future market will also be assessed. Use this report to evaluate the potential of new and emerging products in the treatment of cardiovascular diseases, assess the strength of competitor pipelines and identify future market opportunities...
Table of Contents

Innovations in Cardiovascular Disease Management

Executive Summary 10

The Management of Cardiovascular Disease 10

Cardiovascular and Interventional Procedures 11

Emerging Coronary Stents and Stent Systems 12

Innovations in Minimally Invasive Cardiac Surgery 13

Cardiovascular Drugs in Early Stage Development 14

New and Emerging Cardiovascular Drugs 14

Chapter 1 The Management of

Cardiovascular Disease 18

Summary 18

Introduction 19

The Global Burden of Cardiovascular Disease 19

CVD remains the leading cause of death in the United States 19

CVD Rates in Central and Eastern Europe 21

Noncommunicable Diseases in the Developing World 21

Background to the Major Cardiovascular Conditions 23

Coronary Artery Disease (CAD) 23

Atherosclerosis 23

Angina Pectoris 25

Acute Myocardial Infarction (MI) 27

Heart Valve Disorders 29

Aortic heart valve 29

Mitral Valve Disease 30

Pulmonary Valve Disease 32

Tricuspid Valve Disease 32

High Blood Pressure: Hypertension 32

Heart Rhythm Disorders (Heart Arrhythmia) 33

Peripheral Vascular Disease 35

Peripheral Artery Disease (PAD) 35

Peripheral Venous Disorders (PVD) 37

Stroke or Cerebrovascular Accidents (CVA) 38

Ischaemic Stroke 38

Haemorrhagic stroke 38

Chapter 2 Latest Developments in

Cardiovascular and PCI

Procedures 42

Summary 42

Introduction to Percutaneous Coronary Interventions 43

Indications for PCI 44

PCI Procedural Volumes 44

PCI Used Primarily to Treat Unstable Angina and acute ST-elevation MI 45

Inter-country Variance in PCI Procedural Rates 46

China and India: Huge growth potential and market development 47

Latest Developments in PCI Procedures 49

Embolic Protection Devices 49

Current Products 50

Development Stage Products and Current Status 55

Future Technologies and Trends 58

Coronary Atherectomy 59

Rotational Coronary Atherectomy (Rotoblation) 59

Directional Coronary Atherectomy (DCA) 59

Orbital Atherectomy 60

Ablative laser-assisted angioplasty 60

Chapter 3 Emerging Coronary Stents and

Stent Systems 64

Summary 64

Emerging Coronary Stents and Stent Systems 65

Key Events 65

Introduction of Drug-Eluting Stents (DES) 67

Development of Drug-Eluting Stents 70

Sirolimus (Rapamycin) 70

Paclitaxel 71

Tacrolimus 72

Everolimus (RAD-001) 73

Zotarolimus (also called ABT-578) 73

DES — Recent News, Product Developments and Clinical Trial Updates 74

Market Developments and Forecasts for Drug-Eluting Stents 77

Emergence of Bioabsorbable Stents 82

Biomaterials and Bioabsorbable Polymers 83

Further Coronary Stent Developments and Technological Trends 85

Novel Coating Technologies 85

Gene Therapy technologies and its Potential Use to Prevent Restenosis 86

Coronary Stents and Endothelial Progenitor Cells (EPCs) 87

Nanotechnologies and Drug-Eluting Coronary Stents 88

Development of Novel Estradiol Containing Drug-Eluting Stents 88

Stem-Cell Derived Endovascular Cells 89

Chapter 4 Innovations in Minimally Invasive

Cardiac Surgery (MICS) 92

Summary 92

Introduction 93

Minimally Invasive Direct Coronary Artery Bypass (MID-CAB) 93

Indications for MIDCAB 94

Off-Pump Coronary Artery Bypass (OP-CAB) 94

Indications for OP-CAB 94

Minimally Invasive Port Access 95

Indications for Minimally Invasive Port Access 96

Robotic Assisted Coronary Artery Bypass (RA-CAB) 96

Current and Emerging Technologies 98

Robotics in Minimally Invasive Cardiac Surgery 98

Robotic Systems 98

Computer Aided Cardiac Surgery 100

Virtual Reality in Cardiac Surgery 100

Laser Heart Surgery or transmyocardial Laser revascularization (TMLR) 101

The CO2 Heart Laser System 101

The holmium:YAG (yttrium aluminium garnet) laser 102

The excimer laser 102

Chapter 5 Cardiovascular Drugs in Early

Stage Development 106

Summary 106

Introduction 107

Early Developments in Key Cardiovascular Disease Classes 107

Angina 107

Arrhythmiasis 110

Atherosclerosis 112

Atrial Fibrillation 115

Congestive Heart Failure 116

Hypercholesterolemia 118

Hypertension 120

Myocardial Infarction 122

Thrombosis 124

Chapter 6 New and Emerging

Cardiovascular Drugs 128

Summary 128

Introduction 129

Anti-Hypertensives 129

Tekturna (Aliskiren) 130

Development of a New Class of Renin Inhibitors 132

Exforge (valsartan plus amlodipine) 133

CHF-1521 134

Cleviprex(TM) (Clevidipine) 135

Antihypertensives: Current Pipeline and Late Stage Development 136

Cardoxal (MC-4232) (MC-1 cardioprotectant plus lisinopril) 138

Darusentan 139

Ambrisentan 139

Nebivolol 140

Zanipress® / Zanitek® 140

Thelin™ (Sitaxsentan) 141

TBC3711 142

Anti-Dyslipidemics 143

Pfizer discontinues torcetrapib development 144

R1658 145

Simcor (Niaspan® (extended-release niacin) and simvastatin (generic

Zocor®)) 145

CRESTOR® (rosuvastatin) and CRESTOR/ABT-335 combination 147

Synordia 149

Lapaquistat (TAK-475) 150

SLx-4090 151

AEGR-733 152

Compound Number 256073 and 501516 153

LBM642 153

Dyslipidaemia: Current Pipeline and Late Stage Development 154

Anti-Thrombotics 156

Rivaroxaban (BAY59-7939) 156

Rendix (dabigatran etexilate, BIBR-1048) 157

Idraparinux 157

Apixaban 158

SSR-126517 158

Exanta/ximelagatran 159

Anti-Thrombotics: Current Pipeline and Late Stage Development 160

Anti-Arrhythmics 161

Stedicor (Azimilide) 163

Multaq (Dronedarone) 164

Vernakalalant (RSD 1235) 165

Tecadenoson CVT510 167

Pulzium IV (Tedisamil) 167

Anti-Arrhythmics: Current Pipeline and Late Stage Development 168

Chapter 7 Appendix 170

Methodology Statement 170

Primary Data and Information Gathering 170

Secondary Data and Information Gathering 170

Market Share Analysis and Market Forecast Predictions 171

Glossary 173

Index 182

List of Figures

Figure 1.1: Breakdown of Deaths from Cardiovascular Diseases, USA 2002 20

Figure 1.2: Leading causes of death in developing countries, 2002 23

Figure 2.3: Use of Percutaneous Coronary Intervention in Europe, 2005 46

Figure 3.4: Estimated number of Stent Procedures (BMS & DES) % Total Number of PTCA

Procedures 69

Figure 3.5: Actual and projected revenues from Coronary Stents, Worldwide sales- 2006 81

Figure 3.6: Market Share Analysis, DES v BMS World, 2006 82

List of Tables

Table 1.1: Age- and gender-specific incidence of recognised MI 28

Table 1.2: Age- and gender-specific incidence of unrecognised MI 28

Table 2.3: Estimated volume of cardiovascular procedures by region (US 2002) 45

Table 2.4: PCI procedure rates in Selected Countries, 2005 49

Table 5.5: Selected Early Stage Anti Anginal Drug Developments 108

Table 5.6: Selected Early Stage Anti Arrhythmiasis Drug Developments 110

Table 5.7: Selected Early Stage Atherosclerosis Drug Developments 112

Table 5.8: Selected Early Stage Atrial Fibrillation Drug Developments 115

Table 5.9: Selected Early Stage Congestive Heart Failure Drug Developments 116

Table 5.10: Selected Early Stage Hypercholesterolemia Drug Developments 118

Table 5.11: Selected Early Stage Hypertension Drug Developments 120

Table 5.12: Selected Early Stage Myocardial Infarction Drug Developments 122

Table 5.13: Selected Early Stage Thrombosis Drug Developments 125

Table 6.14: Characteristics of Major Classes of Lipoproteins 144

Table 6.15: AstraZeneca’s Current Anti-Dyslipidaemia Pipeline 149

Table 6.16: Classification of Anti-Arrhythmics 162

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