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. 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.
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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.
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.