EpiCast Report: Acute Coronary Syndrome (ACS) - Epidemiology Forecast to 2023


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107pages

GlobalData

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Acute coronary syndrome (ACS) is a serious cardiovascular disease associated with high healthcare costs, frequent recurrences and hospitalizations, and high risks of sudden death and short-term mortality. The ACS incidence increases with age and will be a significant public health problem as the elderly population increases around the world. ACS is classified into three disease entities based on evidence of heart muscle damage inferred from a persons symptoms, changes in the ST-tracing of the electrocardiogram (ECG), and levels of cardiac biomarkers that signify heart muscle death: ST-elevation myocardial infarction (STEMI), non-ST-elevation myocardial infarction (NSTEMI), and unstable angina (UA). These three disease entities differ in their clinical characteristics, treatment approaches, and survival probabilities.

The epidemiology of ACS in the 7MM has changed significantly during the past two decades and varies between the western and Japanese markets. In order to capture the country-specific trends and provide detailed patient population segmentation, GlobalData epidemiologists built separate forecasts for (myocardial infarction) (MI) and UA in the 7MM and used a case-flow methodology to determine the number of cases that survived until hospital discharge and for one year after hospital discharge.

GlobalData epidemiologists forecast that in the 7MM, the hospitalized incident cases of ACS will increase from 1.29 million cases in 2013 to 1.47 million cases in 2023 at the rate of 1.40% per year. The US constitutes around 40% of the total hospitalized incident ACS cases in the 7MM and will be the market with the highest number of cases during the forecast period. The majority of the cases occurred in men (58.15%) and in those ages =65 years (69.34%). For the 7MM, about 33% of the ACS cases were STEMI, 44% were NSTEMI, and 23% were UA. The proportions varied depending on the market.

Scope

  • The ACS EpiCast Report provides an overview of the ACS risk factors and comorbidities, a discussion of the ACS global and historical trends, and a 10-year epidemiological patient forecast for ACS from 2013 to 2023 in the seven major markets (7MM) (US, France, Germany, Italy, Spain, UK, and Japan).
  • Hospitalized incident cases of ACS, segmented by STEMI, NSTEMI, and UA
  • ACS cases that survived until hospital discharge, segmented by STEMI, NSTEMI, and UA
  • ACS cases that survived for one year post-hospital discharge, segmented by STEMI, NSTEMI, and UA
  • Diagnosed prevalent cases of myocardial infarction (MI) segmented by STEMI and NSTEMI from 2013 to 2023 in the six major markets (6MM) (US, France, Germany, Italy, Spain, and UK)
  • The ACS epidemiology report is written and developed by Mastersand PhD-level epidemiologists.
  • The EpiCast Report is in-depth, high quality, transparent and market-driven, providing expert analysis of disease trends in the 7MM.

Reasons to buy

  • Develop business strategies by understanding the trends shaping and driving the global ACS market.
  • Quantify patient populations in the global ACS market to improve product design, pricing, and launch plans.
  • Organize sales and marketing efforts by identifying the patient segmentations that present the best opportunities for ACS therapeutics in each of the markets covered.
  • Identify the number of ACS cases survived to key time periods.
Table of Content

1 Table of Contents 4
1.1 List of Tables 7
1.2 List of Figures 8

2 Introduction 10
2.1 Catalyst 10
2.2 Upcoming Reports 10

3 Epidemiology 11
3.1 Disease Background 11
3.2 Risk Factors and Comorbidities 12
3.2.1 Controlling hypertension can decrease the CHD incidence by 20-25% 13
3.2.2 Every 1% decrease in cholesterol levels is associated with a 2% decrease in the CHD risk 14
3.2.3 Women who have diabetes have a higher risk of developing CHD than men with diabetes 15
3.2.4 Cigarette smoking increases the risk of CHD and also increases the risk of developing other risk factors for CHD 16
3.2.5 Obese and physically inactive persons are more likely to develop CHD through an increased risk of developing the traditional risk factors 16
3.2.6 Non-modifiable risk factors, such as family history, age, and sex, contribute to CHD development 17
3.2.7 Comorbidities 17
3.3 Global Trends - MI 18
3.3.1 MI Incidence and Mortality Trends 18
3.3.2 STEMI and NSTEMI Trends 28
3.3.3 Trends in MI Mortality and Case-Fatality Rates 30
3.3.4 MI Prevalence 32
3.4 Global Trends - UA 33
3.5 Forecast Methodology 35
3.5.1 Forecast Case Flow Map 37
3.5.2 Sources Used 43
3.5.3 Sources Not Used 52
3.5.4 Forecast Assumptions and Methods, Hospitalized MI Incident Cases 53
3.5.5 Forecast Assumptions and Methods, STEMI and NSTEMI Cases that Survived until Hospital Discharge 58
3.5.6 Forecast Assumptions and Methods, STEMI and NSTEMI Cases that Survived for One Year after Discharge 60
3.5.7 Forecast Assumptions and Methods, Diagnosed Prevalent Cases of MI 61
3.5.8 Forecast Assumptions and Methods, Hospitalized Cases of UA 63
3.5.9 Forecast Assumptions and Methods, UA Cases that Survived until Hospital Discharge and for One Year Post-Discharge 65
3.6 Epidemiological Forecast for ACS (2013-2023) - Hospitalized Incident Cases 65
3.6.1 Hospitalized Incident Cases of ACS 65
3.6.2 Age-Specific Hospitalized Incident Cases of ACS 67
3.6.3 Sex-Specific Hospitalized Incident Cases of ACS 69
3.6.4 Hospitalized Incident Cases of ACS by STEMI, NSTEMI, and UA 71
3.6.5 ACS Cases that Survived until Hospital Discharge and for One Year 73
3.6.6 Age-Specific ACS Cases that Survived until Hospital Discharge 76
3.6.7 Age-Standardized Incidence of ACS 77
3.7 Epidemiological Forecast for MI (2013-2023) - Prevalent Cases 78
3.7.1 Diagnosed Prevalent Cases of MI 78
3.7.2 Diagnosed Prevalent Cases of MI Segmented by STEMI and NSTEMI 80
3.7.3 Age-Specific Diagnosed Prevalent Cases of MI 81
3.7.4 Sex-Specific Diagnosed Prevalent Cases of MI 83
3.7.5 Age-Standardized Diagnosed Prevalence of MI 84
3.8 Discussion 85
3.8.1 Epidemiological Forecast Insight 85
3.8.2 Limitations of the Analysis 86
3.8.3 Strengths of the Analysis 87

4 Appendix 90
4.1 Bibliography 90
4.2 About the Authors 101
4.2.1 Epidemiologists 101
4.2.2 Reviewers 101
4.2.3 Global Director of Epidemiology and Health Policy 103
4.2.4 Global Head of Healthcare 104
4.3 About GlobalData 105
4.4 About EpiCast 105
4.5 Disclaimer 106

Table 1: Risk Factors and Comorbidities for CHD and ACS 13
Table 2: Germany, MI Incidence and Re-Infarction Rates (Cases per 100,000 Population), 1985-1987 and 2001-2003 22
Table 3: Spain, MI Incidence Rate (Cases per 100,000 Population) and Incidence Trends, 2000 and 2013 24
Table 4: England and Scotland, Temporal Trends in the MI Incidence (Cases per 100,000 Population), 2002-2010 24
Table 5: 7MM, Summary of STEMI and NSTEMI In-Hospital and One-Year Case-Fatality Rates 31
Table 6: Global, Crude Total Population Prevalence Percentages of Angina Pectoris and Mean Age of Study Participants 34
Table 7: 7MM, Sources of MI and UA Incidence Data 39
Table 8: 7MM, Sources of Diagnosed Prevalence Data for MI 41
Table 9: 7MM, Data Sources of STEMI and NSTEMI Proportions Among Hospitalized Cases of MI 42
Table 10: 7MM, Hospitalized Incident Cases of ACS, Ages ≥25 Years, Both Sexes, N (Col %), Selected Years, 2013-2023 66
Table 11: 7MM, Age-Specific Hospitalized Incident Cases of ACS, Both Sexes, N (Row %). 2013 68
Table 12: 7MM, Sex-Specific Hospitalized Incident Cases of ACS, Ages ≥25 Years, N (Row %), 2013 70
Table 13: 7MM, Hospitalized Incident Cases of ACS Segmented by STEMI, NSTEMI, and UA (N, Row %), Ages ≥25 Years, Both Sexes, 2013 72
Table 14: 7MM, ACS Cases that Survived until Hospital Discharge, Ages ≥25 Years, Both Sexes, N, 2013 75
Table 15: 7MM, ACS Cases that Survived for One Year Post-Discharge, Ages≥25 Years, Both Sexes, N, 2013 75
Table 16: 7MM, Age-Specific ACS Cases that Survived until Hospital Discharge and for One Year, Post-Discharge Both Sexes, N, 2013 77
Table 17: 6MM, Diagnosed Prevalent Cases of MI, Ages ≥25 Years, Both Sexes, N (Col %), Select Years, 2013-2023 79
Table 18: 6MM, Diagnosed Prevalent Cases of MI Segmented by STEMI and NSTEMI, Ages ≥25 Years, Both Sexes, N (Row %), 2013 80
Table 19: 6MM, Age-Specific Diagnosed Prevalent Cases of MI, Both Sexes, N (Row %), 2013 82
Table 20: 6MM, Sex-Specific Diagnosed Prevalent Cases of MI, Ages ≥25 Years, N (Row %), 2013 83
Table 21: 7MM, Historical Data Validation 89

Figure 1: US, Temporal Trend in the Hospitalized MI Incidence from the Worcester Heart Attack Study, All Ages, 1975-2005 20
Figure 2: UK, Age-Adjusted MI Incidence and Hospitalized Incidence (Cases per 100,000 Population), Men, 2002-2010 25
Figure 3: UK, Age-Adjusted MI Incidence and Hospitalized Incidence (Cases per 100,000 Population), Women, 2002-2010 26
Figure 4: England and Scotland, Age-Adjusted Temporal Trends in MI Mortality, Deaths per 100,000 Population, Men and Women, 2002-2010 27
Figure 5: US, Germany, and UK, Crude Diagnosed MI Prevalence in Men and Women, 1990-2008 32
Figure 6: Global, Crude Total Population Prevalence Percentages of Angina Pectoris (%) 35
Figure 7: MI Forecast Case Flow Map 38
Figure 8: 7MM, Hospitalized Incident Cases of ACS, Ages ≥25 Years, Both Sexes, N, Select Years, 2013-2023 67
Figure 9: 7MM, Age-Specific Hospitalized Incident Cases of ACS, Both Sexes, N, 2013 69
Figure 10: 7MM, Sex-Specific Hospitalized Incident Cases of ACS, Ages ≥25 Years, N, 2013 71
Figure 11: 7MM, Hospitalized Incident Cases of ACS Segmented by STEMI, NSTEMI, and UA, Ages ≥25 Years, Both Sexes, N, 2013 73
Figure 12: 7MM, Survival of Hospitalized Incident Cases of ACS, Ages ≥25 Years, Both Sexes, %, 2013 74
Figure 13: 7MM, Age-Specific Survival of Hospitalized Incident Cases of ACS, Both Sexes, %, 2013 76
Figure 14: 7MM, Age-Standardized Incidence of ACS (Cases per 100,000 Population), Ages ≥25 Years, 2013 78
Figure 15: 6MM, Diagnosed Prevalent Cases of MI, Ages ≥25 Years, Both Sexes, N, 2013-2023 79
Figure 16: 6MM, Diagnosed Prevalent Cases of MI Segmented by STEMI and NSTEMI, Ages ≥25 Years, Both Sexes, N, 2013 81
Figure 17: 6MM, Age-Specific Diagnosed Prevalent Cases of MI, Both Sexes, N, 2013 82
Figure 18: 6MM, Sex-Specific Diagnosed Prevalent Cases of MI, Ages ≥25 Years, N, 2013 84
Figure 19: 6MM, Age-Standardized Diagnosed Prevalence of MI, Ages ≥25 Years, %, 2013 85