心血管疾患管理における技術革新：最新の外科的処置、薬剤および医療機器動向

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

• The Management of Cardiovascular Disease
• Cardiovascular and Interventional Procedures
• Emerging Coronary Stents and Stent Systems
• Innovations in Minimally Invasive Cardiac Surgery
• Cardiovascular Drugs in Early Stage Development
• New and Emerging Cardiovascular Drugs

• Summary
• Introduction
• The Global Burden of Cardiovascular Disease
• CVD remains the leading cause of death in the United States
• CVD Rates in Central and Eastern Europe
• Noncommunicable Diseases in the Developing World
• Background to the Major Cardiovascular Conditions
• Coronary Artery Disease (CAD)
• Atherosclerosis
• Angina Pectoris
• Acute Myocardial Infarction (MI)
• Heart Valve Disorders
• Aortic heart valve
• Mitral Valve Disease
• Pulmonary Valve Disease
• Tricuspid Valve Disease
• High Blood Pressure: Hypertension
• Heart Rhythm Disorders (Heart Arrhythmia)
  • Peripheral Vascular Disease
  • Peripheral Artery Disease (PAD)
  • Peripheral Venous Disorders (PVD)
  • Stroke or Cerebrovascular Accidents (CVA)
  • Ischaemic Stroke
  • Haemorrhagic stroke

• Summary
• Introduction to Percutaneous Coronary Interventions
• Indications for PCI
• PCI Procedural Volumes
• PCI Used Primarily to Treat Unstable Angina and acute ST-elevation MI
• Inter-country Variance in PCI Procedural Rates
• China and India: Huge growth potential and market development
• Latest Developments in PCI Procedures
• Embolic Protection Devices
• Current Products
• Development Stage Products and Current Status
• Future Technologies and Trends
• Coronary Atherectomy
• Rotational Coronary Atherectomy (Rotoblation)
• Directional Coronary Atherectomy (DCA)
• Orbital Atherectomy
• Ablative laser-assisted angioplasty

• Summary
• Emerging Coronary Stents and Stent Systems
• Key Events
• Introduction of Drug-Eluting Stents (DES)
• Development of Drug-Eluting Stents
• Sirolimus (Rapamycin)
• Paclitaxel
• Tacrolimus
• Everolimus (RAD-001)
• Zotarolimus (also called ABT-578)
• DES - Recent News, Product Developments and Clinical Trial Updates
• Market Developments and Forecasts for Drug-Eluting Stents
• Emergence of Bioabsorbable Stents
• Biomaterials and Bioabsorbable Polymers
• Further Coronary Stent Developments and Technological Trends
• Novel Coating Technologies
• Gene Therapy technologies and its Potential Use to Prevent Restenosis
• Coronary Stents and Endothelial Progenitor Cells (EPCs)
• Nanotechnologies and Drug-Eluting Coronary Stents
• Development of Novel Estradiol Containing Drug-Eluting Stents
• Stem-Cell Derived Endovascular Cells

• Summary
• Introduction
• Minimally Invasive Direct Coronary Artery Bypass (MID-CAB)
• Indications for MIDCAB
• Off-Pump Coronary Artery Bypass (OP-CAB)
• Indications for OP-CAB
• Minimally Invasive Port Access
• Indications for Minimally Invasive Port Access
• Robotic Assisted Coronary Artery Bypass (RA-CAB)
• Current and Emerging Technologies
• Robotics in Minimally Invasive Cardiac Surgery
• Robotic Systems
• Computer Aided Cardiac Surgery
• Virtual Reality in Cardiac Surgery
• Laser Heart Surgery or transmyocardial Laser revascularization (TMLR)
• The CO2 Heart Laser System
• The holmium:YAG (yttrium aluminium garnet) laser
• The excimer laser

• Summary
• Introduction
• Early Developments in Key Cardiovascular Disease Classes
• Angina
• Arrhythmiasis
• Atherosclerosis
• Atrial Fibrillation
• Congestive Heart Failure
• Hypercholesterolemia
• Hypertension
• Myocardial Infarction
• Thrombosis

• Summary
• Introduction
• Anti-Hypertensives
• Tekturna (Aliskiren)
• Development of a New Class of Renin Inhibitors
• Exforge (valsartan plus amlodipine)
• CHF-1521
• Cleviprex(TM) (Clevidipine)
• Antihypertensives: Current Pipeline and Late Stage Development
• Cardoxal (MC-4232) (MC-1 cardioprotectant plus lisinopril)
• Darusentan
• Ambrisentan
• Nebivolol
• Zanipress® / Zanitek®
• Thelin™ (Sitaxsentan)
• TBC3711
• Anti-Dyslipidemics
• Pfizer discontinues torcetrapib development
• R1658
• Simcor (Niaspan® (extended-release niacin) and simvastatin (generic Zocor®))
• CRESTOR® (rosuvastatin) and CRESTOR/ABT-335 combination
• Synordia
• Lapaquistat (TAK-475)
• SLx-4090
• AEGR-733
• Compound Number 256073 and 501516
• LBM642
• Dyslipidaemia: Current Pipeline and Late Stage Development
• Anti-Thrombotics
• Rivaroxaban (BAY59-7939)
• Rendix (dabigatran etexilate, BIBR-1048)
• Idraparinux
• Apixaban
• SSR-126517
• Exanta/ximelagatran
• Anti-Thrombotics: Current Pipeline and Late Stage Development
• Anti-Arrhythmics
• Stedicor (Azimilide)
• Multaq (Dronedarone)
• Vernakalalant (RSD 1235)
• Tecadenoson CVT510
• Pulzium IV (Tedisamil)
• Anti-Arrhythmics: Current Pipeline and Late Stage Development

• Methodology Statement
• Primary Data and Information Gathering
• Secondary Data and Information Gathering
• Market Share Analysis and Market Forecast Predictions
• Glossary
• Index

• Figure 1.1: Breakdown of Deaths from Cardiovascular Diseases, USA 2002
• Figure 1.2: Leading causes of death in developing countries, 2002
• Figure 2.3: Use of Percutaneous Coronary Intervention in Europe, 2005
• Figure 3.4: Estimated number of Stent Procedures (BMS & DES) % Total Number of PTCA Procedures
• Figure 3.5: Actual and projected revenues from Coronary Stents, Worldwide sales- 2006
• Figure 3.6: Market Share Analysis, DES v BMS World, 2006

• Table 1.1: Age- and gender-specific incidence of recognised MI
• Table 1.2: Age- and gender-specific incidence of unrecognised MI
• Table 2.3: Estimated volume of cardiovascular procedures by region (US 2002)
• Table 2.4: PCI procedure rates in Selected Countries, 2005
• Table 5.5: Selected Early Stage Anti Anginal Drug Developments
• Table 5.6: Selected Early Stage Anti Arrhythmiasis Drug Developments
• Table 5.7: Selected Early Stage Atherosclerosis Drug Developments
• Table 5.8: Selected Early Stage Atrial Fibrillation Drug Developments
• Table 5.9: Selected Early Stage Congestive Heart Failure Drug Developments
• Table 5.10: Selected Early Stage Hypercholesterolemia Drug Developments
• Table 5.11: Selected Early Stage Hypertension Drug Developments
• Table 5.12: Selected Early Stage Myocardial Infarction Drug Developments
• Table 5.13: Selected Early Stage Thrombosis Drug Developments
• Table 6.14: Characteristics of Major Classes of Lipoproteins
• Table 6.15: AstraZeneca' s Current Anti-Dyslipidaemia Pipeline
• Table 6.16: Classification of Anti-Arrhythmics