Heart failure is a condition in which the heart is unable to generate a cardiac output sufficient to meet the demands of the body. Chronic heart failure develops slowly over a period of time. It can result from any cardiac disease that compromises ventricular systolic or diastolic function or both. Conditions leading to chronic heart failure are high blood pressure, diabetes, faulty heart valves, coronary artery disease, inherited heart defects, infection, and damaged or inflamed heart. It is a physiological condition that has an adverse impact on the pumping efficiency of cardiac muscles. Accumulation of fluid occurs around the heart leading to inefficient pumping and deposition of fluid in lungs, abdomen, liver, and lower body. Therapeutic goals of chronic heart failure management are stop blood clotting, management of high blood pressure and cholesterol, and management and control of angina.
Increasing disease prevalence and unmet medical needs are projected to boost the growth of the chronic heart failure market. Drivers of the market are poor diet, lack of exercise, changing lifestyles, increasing stress, unhealthy weights, and increasing smoking and alcohol consumption. Diseases that have synergistic effect on prevalence of chronic heart failure such as coronary artery diseases, sleep apnea, heart defects, irregular heartbeats, diabetes mellitus, obesity, and kidney problems are also propelling the chronic heart failure market.
The chronic heart failure market can be segmented based on type of treatment and region. In terms of type of treatment, the market can be segmented into surgery, medicines, vaccines, and medical devices. Some common types of surgery are coronary revascularization, cardiac resynchronization, heart valve replacement, coronary artery bypass grafting, and heart transplant. Based on drug class, the major classes of drugs used in the management of chronic heart failure are anti-clotting (aspirin), antiplatelet medicines (clopidogrel, prasugrel, and ticagrelor), anticoagulant medicines (warfarin), blood pressure maintaining agents (angiotensin converting enzyme (ACE) inhibitors), angiotensin II receptor blockers (ARB), statins, diuretics, and nitrates.
According to Randomized Aldactone Evaluation Study, 30% reduction in mortality and hospitalizations rates was observed with the use of spironolactone in patients with chronic HFrEF (heart failure with reduced ejection factor). Long term anticoagulants therapy is recommended for patients with chronic HF with permanent/persistent/paroxysmal atrial fibrillation and an additional risk factor for cardio embolic stroke. Apart from this, omega-3 fatty acids are recommended for chronic heart failure patients. Influenza vaccine is an emerging market for the prevention of chronic heart failure caused due to infections. Calcium channel blockers and statins find limited use in the management of chronic heart failure.
Medical devices used in chronic heart failure can be segmented into implantable left ventricular assist device (LVAD), biventricular pacemaker, implantable cardioverter-defibrillators (ICDs), continuous positive air pressure device (CPAP), bi-level positive air pressure device (BiPAP), and heart pumps. The CPAP and BiPAP device market is growing due to increasing number of chronic heart failure patients with sleep apnea. In patients with end-stage chronic heart failure, heart transplantation is the only therapeutic option. However, rapidly increasing demand and decreasing willingness for organ donation is expanding the waiting list. High unmet medical need of safe and effective therapy and increasing prevalence of chronic heart failure are anticipated to drive demand for these devices. However, stringent regulatory requirements and high cost of these devices are likely to hamper market growth.
Geographically, the chronic heart failure market can be classified into North America, Latin America, Europe, Asia Pacific, and Middle East & Africa. North America and Europe dominate the market. The prevalence of heart disease is high in countries in Eastern Europe and is increasing in some countries in Asia and South America. Factors contributing to the growth of the chronic heart failure market are increasing incidence of cardiac disorders, aging population, lack of exercise, diet containing high fat and salt content, stress, increasing alcohol consumption, and smoking. China, Japan, Malaysia, and India hold major share of the chronic heart failure market in Asia Pacific due to increasing economic potential of individuals.
Key players in the chronic heart failure market are 7 Eleven, Stanley Pharmaceuticals, New Haven Pharmaceuticals, Inc., Boston Scientific Corporation, HeartWare International, Inc., Pfizer, GlaxoSmithKline plc, Novartis International AG, Biovail Corporation, Bristol-Myers Squibb Company, Merck Sharp & Dohme, AstraZeneca, Abiomed, Inc., Symplmed Pharmaceuticals, Berlin Heart GmbH, Medtronic plc, ReliantHeart, Inc., St. Jude Medical Inc., and Cardiokinetix, among others.
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