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Refractory Angina Market Insight, Epidemiology and Market Forecast

DelveInsight’s “Refractory Angina Market Insight, Epidemiology and Market Forecast – 2034” report delivers an in-depth understanding of the refractory angina treatment market, historical and forecasted epidemiology, as well as market trends across major markets. The report comprehensively evaluates the current treatment landscape, emerging therapies, market share of individual treatments, and refractory angina market forecasts through 2034, providing crucial insights for stakeholders in the refractory angina therapeutic area.

The refractory angina treatment market is projected to grow substantially with a decent CAGR during the forecast period, driven by an enhanced understanding of refractory angina mechanisms, biomarker development, and personalized medicine approaches.

Download the Refractory Angina Market report to understand which factors are driving the refractory angina therapeutic market trends.

Refractory Angina Epidemiological Trends

According to DelveInsight’s analysis, the angina epidemiology reveals a significant public health impact. The overall angina prevalence is approximately 4% in adults aged 20 and older, which translates to about 8 million people in the United States alone. This prevalence varies widely across populations, ranging from 0.73% to 14.4% in women and 0.76% to 15.1% in men.

The more severe form, refractory angina, is estimated to affect 300K to 900K patients in the United States, with 25K to 75K new cases diagnosed each year. Similarly, Europe sees 30K to 50K new cases annually. Furthermore, among patients with stable coronary artery disease, the refractory angina pectoris prevalence is estimated at 5% to 10%. Patients with chronic refractory angina are distinct in that they often maintain left ventricular function despite severe disease and have a lower mortality rate of about 5%, though their angina is debilitating. The most severe subset, those with no-option disabling refractory angina, is estimated to include 35,000 to 50,000 patients. In a related context, nearly 2.3 million people in the UK are living with some form of coronary artery disease, highlighting the broader burden of this condition.

Discover evolving trends in the refractory angina patient pool forecasts through detailed epidemiological analysis.

Refractory Angina Treatment Landscape

The DelveInsight report also discusses the current and evolving refractory angina treatment landscape. The refractory angina treatment landscape remains challenging, with limited approved therapeutic options available. Current refractory angina management approaches typically include the optimization of conventional anti-anginal medications, enhanced external counterpulsation (EECP), and investigational therapies. The market continues to seek innovative solutions for this difficult-to-treat patient population.

The refractory angina therapies pipeline includes several novel treatments in various stages of development. Promising candidates include Vericiguat (Merck) in late-stage trials showing potential to reduce angina episodes, Ralinepag (United Therapeutics) in Phase III with encouraging results in decreasing attacks, KBP-5074 (Kaleido Biosciences) exploring novel metabolic pathways in early trials, and Setrusumab (Mereo Biopharma) entering Phase II for anti-anginal effects. Beyond these, the landscape features soluble guanylate cyclase stimulators and endothelin-1 receptor blockers repurposed for angina without obstructive coronary disease, alongside groundbreaking therapeutic angiogenesis from companies like Caladrius Biosciences and Angionetics, focusing on restoring blood supply through cell- and gene-based therapies in late-stage development.

Refractory Angina Recent Developments

The refractory angina treatment has witnessed significant advances in 2024 and early 2025, with major breakthroughs in device-based therapies, gene therapy reaching critical milestones, and the emergence of promising new technologies. The most significant advancement in device-based therapy came with the publication of the ORBITA-COSMIC trial results in April 2024. The trial established the symptomatic benefits of the Coronary Sinus Reducer (CSR), even though it failed to demonstrate the hypothesized mechanism of improved myocardial blood flow.

The EXACT trial results, published in May 2024, represent a major milestone for gene therapy in cardiovascular medicine. The Phase 2 portion treated 32 patients with no-option refractory angina using XC001, a novel adenoviral vector designed to express multiple VEGF isoforms.

Furthermore, a major systematic review published in January 2025 consolidated evidence for Spinal Cord Stimulation in refractory angina, demonstrating consistent benefits across multiple domains. Another, 25-year-long study published in June 2025 confirmed sustained benefits of Spinal Cord Stimulation in refractory angina with acceptable safety profiles over extended periods.

A significant development in 2025 is the emphasis on establishing Comprehensive Angina Relief (CARE) clinics that provide individualized, multidisciplinary management for complex refractory angina cases. These clinics focus on standardized assessment tools for angina and psychosocial factors, personalized treatment algorithms combining multiple therapeutic modalities and long-term efficacy and safety monitoring of novel treatments.

Discover recent advancements in the refractory angina landscape @ Refractory Angina Recent Developments.

Refractory Angina Competitive Landscape

The refractory angina market presents a highly fragmented competitive landscape with medium market concentration, characterized by diverse therapeutic approaches spanning gene therapy, medical devices, and pharmaceuticals, yet no single player commanding dominant market share.

The refractory angina landscape features a mix of established pharmaceutical giants, specialized biotech companies, and medical device manufacturers competing across multiple therapeutic modalities. Major players include established cardiovascular companies like Abbott Laboratories, Boston Scientific Corporation, and Medtronic in the device space, alongside specialized firms such as XyloCor Therapeutics (with $67.5 million Series B funding in January 2025 for gene therapy XC001), Miracor Medical,, and Imbria Pharmaceuticals and Angionetics Inc. in the pharmaceutical arena.

The competitive intensity is expected to increase as gene therapy approaches Phase 3 trials and device-based therapies gain broader regulatory approvals, potentially consolidating the market around proven therapeutic modalities while maintaining innovation-driven competition among specialized players.

Future Outlook

Looking ahead, the refractory angina market is expected to witness continued innovation driven by an enhanced understanding of disease mechanisms, biomarker development, and personalized medicine approaches. While significant unmet medical needs remain in this patient population, challenges persist in developing effective therapies that can provide meaningful symptom relief and improve quality of life. Emerging therapies focusing on novel mechanisms, including cardiac regenerative approaches, neuromodulation techniques, and targeted anti-anginal agents, hold promise for addressing these unmet needs and transforming the refractory angina treatment landscape.

As research continues and clinical understanding advances, the refractory angina market is positioned for potential expansion and therapeutic innovation through 2034.

Table of Contents

1. Key Insights

2. Report Introduction

3. Refractory Angina Market Overview at a Glance

4. Refractory Angina Market: Future Perspective

5. Executive Summary of Refractory Angina

6. Key Events

7. Refractory Angina Background and Overview

8. Refractory Angina Market Epidemiology and Patient Population

9. Refractory Angina Market Patient Journey

10. Refractory Angina Marketed Products

11. Refractory Angina Emerging Drugs

12. Refractory Angina: Seven Major Market Analysis

13. Key Opinion Leaders’ Views

14. Refractory Angina Market Unmet Needs

15. SWOT Analysis

16. Reimbursement and Market Access

17. Appendix

18. DelveInsight Capabilities

19. Disclaimer

20. About DelveInsight

Related Reports

Refractory Angina Pipeline Insight

Refractory Angina pipeline insight provides comprehensive insights about the refractory angina pipeline landscape, pipeline drug profiles, including clinical and non-clinical stage products, and the refractory angina companies, including XyloCor Therapeutics, Inc., among others.

About DelveInsight

DelveInsight is a leading market research and consulting firm specializing in disease-specific insights and therapeutic market analysis. Their reports integrate real-world data, clinical trial findings, and expert interviews to deliver comprehensive industry intelligence.

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