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Acute Coronary Syndrome

Cardiovascular
54
Pipeline Programs
30
Companies
50
Clinical Trials
3 recruiting
1
Approved Products

Pipeline by Development Stage

Preclinical
Phase 1
Phase 1/2
Phase 2
Phase 2/3
Phase 3
On Market
0
8
0
10
0
16
20
Early DiscoveryClinical DevelopmentMarket

Drug Modality Breakdown

Small Molecule
563%
Monoclonal Antibody
113%
Peptide
113%
RNA Therapeutic
113%
+ 115 programs with unclassified modality

Acute Coronary Syndrome is a $725M market dominated by a single peak-stage product with limited competitive diversity.

$0.725B marketMature→ Stable4 products10 companies

Key Trends

  • BRILINTA (ticagrelor) commands 95% of market spending, creating concentration risk
  • P2Y12 receptor antagonists represent 96% of spending; older mechanisms like GP IIb/IIIa inhibitors are declining
  • Significant patent cliff approaching 2035-2036 when BRILINTA loses exclusivity

Career Verdict

Moderate career bet: strong job availability and revenue base, but limited growth runway and high dependence on a single aging product make this a stabilizing rather than expanding opportunity.

AI-generated market analysis based on FDA, CMS, ClinicalTrials.gov, and hiring data

Market Leaders

#1BRILINTAStable
$0.692B
AstraZeneca·Peak10.2yr
#2PLAVIXDeclining
$0.007B
Sanofi·LOE Approaching
#3KENGREALStable
Chiesi·Peak9.2yr
#4INTEGRILINDeclining
Merck & Co.·LOE Approaching

Drug Class Breakdown

P2Y12 Receptor Antagonists
$0.699B(96%)

Dominates market; BRILINTA sole growth driver

GP IIb/IIIa Inhibitors (eptifibatide)
(0%)

Declining; niche acute care setting

Career Outlook

Stable

ACS is a mature, consolidated market with stable employment but limited upside. AstraZeneca's BRILINTA dominance creates job security through 2035-2036, but the approaching patent cliff and sparse pipeline mean professionals should expect layoffs and re-organization post-2035. This is a defensible career choice for early-to-mid career commercial talent seeking stability, but not for those seeking innovation exposure or rapid advancement.

Breaking In

Enter via AstraZeneca or Sanofi sales/marketing roles to build cardiology expertise and commercial fundamentals; avoid R&D roles given sparse pipeline.

For Experienced Professionals

Experienced professionals should seek Medical Affairs, clinical operations, or market access roles where salary premiums ($300K+) offset limited growth; plan exit strategy before 2034 patent cliff.

In-Demand Skills

Cardiovascular pharmacology and thrombosis mechanismsRegulatory and post-approval safety management (Phase 4)Commercial excellence in mature market maintenanceReal-world evidence generation and health economics

Best For

Brand Manager (Mature Asset)Medical Science Liaison (Cardiologist-facing)Clinical Safety OfficerCommercial Analytics / Market Access Manager

Hiring Landscape

$112K-$307K

AstraZeneca dominates hiring with 1,373 jobs tied to ACS portfolio, followed by Sanofi (1,121 jobs) and Takeda (1,335 jobs). Commercial roles represent 1,589 positions (67% of total identified ACS hiring), reflecting the mature, promotion-driven nature of the market. Clinical Operations and Medical Affairs roles command premium salaries ($307K and $302K respectively), signaling competition for regulatory and safety expertise.

7,779
Open Roles
3
Companies Hiring
3
Departments

Top Hiring Companies

1373Stable
1335Stable
1121Stable

By Department

Commercial(20%)
$257K
Clinical Operations(5%)
$307K
Medical Affairs(3%)
$302K

Hiring is concentrated at mature-stage companies managing established assets; growth opportunities are limited, and competition for high-paying clinical/medical roles is fierce.

On Market (1)

Approved therapies currently available

AstraZeneca
BRILINTAApproved
ticagrelor
AstraZeneca
P2Y12 Platelet Inhibitor [EPC]oral2011
692M Part D

Competitive Landscape

51 companies ranked by most advanced pipeline stage

AstraZeneca
AstraZenecaCAMBRIDGE, United Kingdom
24 programs
3
3
7
TicagrelorPhase 41 trial
TicagrelorPhase 41 trial
TicagrelorPhase 41 trial
TicagrelorPhase 41 trial
Ticagrelor + ASA + BivalirudinPhase 41 trial
+19 more programs
Active Trials
NCT01490645Completed1,006Est. Aug 2014
NCT02615704Completed677Est. Mar 2019
NCT03823547Recruiting99,999Est. Jun 2050
+20 more trials
Abbott
AbbottABBOTT PARK, IL
9 programs
1
2
BS-DESPhase 41 trial
Triage CardioProfilERPhase 41 trial
ARCHITECT STAT High Sensitive Troponin I AssayPhase 31 trial
ESC 0/1 hour troponin pathwayN/A1 trial
High-sensitivity troponin I assayN/A1 trial
+4 more programs
Active Trials
NCT05322395Unknown3,536Est. Nov 2024
NCT01852123Completed48,282Est. Mar 2017
NCT01172990Terminated108Est. Feb 2014
+6 more trials
ViiV Healthcare
ViiV HealthcareNC - Durham
8 programs
2
1
2
1
fondaparinux background and standard dose UFHPhase 4
Darapladib 160 mgPhase 3
Losmapimod 7.5 mg twice dailyPhase 3
GW856553Phase 2
LosmapimodPhase 1
+3 more programs
Prevail Therapeutics
2
2
1
Modification of Prasugrel based on a biological assayPhase 41 trial
ClopidogrelPhase 31 trial
PrasugrelPhase 31 trial
PrasugrelPhase 21 trial
PrasugrelPhase 21 trial
+1 more programs
Active Trials
NCT01088503Completed12,227Est. Jan 2014
NCT01115738Completed282Est. Nov 2011
NCT00385944Completed56Est. Oct 2007
+3 more trials
UNION therapeutics
2
ColchicinePhase 41 trial
allopurinol sustained-release capsulesPhase 41 trial
Bleeding Risk Assessment System for Antithrombotic Therapy of ACSN/A1 trial
Active Trials
NCT04162808Unknown6,379Est. Dec 2023
NCT04848857Completed128Est. Oct 2023
NCT03745729Completed162Est. Jul 2022
Boston Scientific
1
BS-DESPhase 4
SYNERGY stentN/A1 trial
iMAPN/A1 trial
Active Trials
NCT02890589Completed22Est. Feb 2018
NCT01437553Completed100Est. Mar 2013
Sharp Therapeutics
1
1
EnoxaparinPhase 4
PantoprazolePhase 1Small Molecule
simvastatinN/ASmall Molecule
MSD
MSDIreland - Ballydine
3 programs
1
1
EnoxaparinPhase 41 trial
PantoprazolePhase 1Small Molecule1 trial
simvastatinN/ASmall Molecule1 trial
Active Trials
NCT00725829Unknown100Est. Dec 2009
NCT01358344Completed173Est. Dec 2010
NCT00790387Completed60Est. Dec 2006
Integrated Biosciences
1
Point of Care testingPhase 41 trial
Data CollectionN/A
Active Trials
NCT01563250Completed705Est. Dec 2011
Biocorp
1 program
1
ClopidogrelPhase 41 trial
Active Trials
NCT01572129Unknown240
Medtronic
MedtronicNJ - Phillipsburg
1 program
1
Same-day dischargePhase 41 trial
Active Trials
NCT01068119Terminated57Est. Mar 2012
Pfizer
PfizerNEW YORK, NY
3 programs
1
1
ApixabanPhase 3
ApixabanPhase 2
DalteparinN/A1 trial
Active Trials
NCT00922766Completed618Est. Sep 2010
Sandoz
SandozAustria - Kundl
2 programs
1
InclisiranPhase 3RNA Therapeutic1 trial
A Comparison of the TIMI, GRACE and HEART ScoresN/A1 trial
Active Trials
NCT01398631Completed2,440Est. Jul 2011
NCT04873934Completed400Est. Aug 2024
Angel Pharmaceuticals
Angel PharmaceuticalsChina - Zhejiang
2 programs
1
Guardian SystemPhase 32 trials
PMA P150009 AngelMed Guardian® SystemN/A1 trial
Active Trials
NCT05412927Recruiting500Est. Dec 2026
NCT04316481Terminated17Est. Jan 2022
NCT00781118Completed1,020Est. May 2017
DalCor Pharmaceuticals
2
DalcetrapibPhase 31 trial
dalcetrapibPhase 3
Active Trials
NCT05918861Recruiting2,000Est. Aug 2027
CSL Seqirus
1 program
1
Apolipoprotein A-I [human]Phase 3
Medpace
MedpaceCINCINNATI, OH
1 program
1
dalcetrapibPhase 31 trial
Active Trials
NCT02525939Completed6,147Est. Oct 2021
deCode Genetics
1
veliflaponPhase 31 trial
Active Trials
NCT00353067Suspended3,450
Kite Pharma
1 program
1
RanolazinePhase 21 trial
Active Trials
NCT01767987Terminated6Est. Apr 2014
Astellas
AstellasChina - Shenyang
1 program
1
YM150Phase 21 trial
Active Trials
NCT00994292Completed1,276Est. Mar 2011
AdvanceCOR
1 program
1
revaceptPhase 23 trials
Active Trials
NCT03312855Completed334Est. Mar 2020
NCT01645306Completed158Est. Sep 2019
NCT01042964Completed30Est. Oct 2007
Ildong Pharmaceutical
2
APD791Phase 11 trial
ClopidogrelPhase 11 trial
Active Trials
NCT02419820Terminated104Est. Apr 2016
NCT02034292Terminated16Est. Mar 2014
Chong Kun Dang Pharmaceutical
1
D578Phase 11 trial
Active Trials
NCT03671941Completed31Est. Jun 2018
CorVivo
1 program
1
Epicardial Infarct Repair with CorMatrix-ECMPhase 11 trial
Active Trials
NCT02887768Completed8Est. Oct 2017
Sanofi
SanofiPARIS, France
4 programs
A Comparison of the TIMI, GRACE and HEART ScoresN/A
Decision Support SystemN/A1 trial
LixisenatidePHASE_3Peptide1 trial
Percutaneous Coronary InterventionPHASE_31 trial
Active Trials
NCT05844566Completed1,139Est. Dec 2024
NCT01147250Completed6,068Est. Feb 2015
NCT01014273Completed7,021Est. Mar 2011
Daiichi Sankyo
Daiichi SankyoChina - Shanghai
4 programs
ADP receptor inhibitorsN/A
Immediate Invasive ManagementN/A
PrasugrelPHASE_3
30-day DAPTPHASE_41 trial
Active Trials
NCT04436978Recruiting2,000Est. Dec 2027
GSK
GSKLONDON, United Kingdom
4 programs
Quality Improvement ProgrammeN/A1 trial
fondaparinuxN/A1 trial
Losmapimod for single dosePHASE_11 trial
fondaparinux background and standard dose UFHPHASE_41 trial
Active Trials
NCT00716430Unknown3,500Est. Feb 2009
NCT01406301Completed1Est. Jul 2011
NCT01648192Completed20Est. Oct 2012
+1 more trials
Biotronik
BiotronikGermany - Berlin
3 programs
Percutaneous coronary interventionN/A1 trial
TicagrelorN/A1 trial
Colchicine 0.6 mgPHASE_41 trial
Active Trials
NCT03621501Active Not Recruiting1,525Est. Oct 2026
NCT02618733Completed120Est. Dec 2016
NCT06543082Recruiting490Est. Dec 2028
Heidelberg Pharma
Heidelberg PharmaGermany - Ladenburg
2 programs
TnThs Predicting Evolving Non-STEMIN/A1 trial
TnThs for Identification Myocardial InfarctionN/A1 trial
Active Trials
NCT00953251Completed115Est. Dec 2008
NCT00950469Completed94Est. Dec 2008
Merck & Co.
Merck & Co.RAHWAY, NJ
2 programs
PantoprazolePHASE_1Small Molecule
EnoxaparinPHASE_4

+21 more companies

Trial Timeline

Clinical trial activity over time

2021
2022
2023
2024
2025
2026
2027
2028
BiotronikColchicine 0.6 mg
Daiichi Sankyo30-day DAPT
UNION therapeuticsColchicine
UNION therapeuticsallopurinol sustained-release capsules
AstraZenecaTicagrelor
AstraZenecaticagrelor
AbbottBS-DES
AstraZenecaTicagrelor- Delayed Administration
AstraZenecaTicagrelor
AstraZenecaTicagrelor
AstraZenecaTicagrelor
AstraZenecaTicagrelor + ASA + Bivalirudin
Prevail TherapeuticsModification of Prasugrel based on a biological assay
BiocorpClopidogrel
Integrated BiosciencesPoint of Care testing

Showing 15 of 50 trials with date data

Clinical Trials (50)

Total enrollment: 92,516 patients across 50 trials

NCT06543082BiotronikColchicine 0.6 mg

MACT (Mono Antiplatelet and Colchicine Therapy) Prospective Multicenter Study

Start: Aug 2024Est. completion: Dec 2028490 patients
Phase 4Recruiting

What is the Optimal Antithrombotic Strategy in Patients With Atrial Fibrillation Undergoing PCI?

Start: Jan 2023Est. completion: Dec 20272,000 patients
Phase 4Recruiting

Colchicine for the Stability of Coronary Plaque in Acute Coronary Syndrome (COLOCT)

Start: May 2021Est. completion: Oct 2023128 patients
Phase 4Completed
NCT03745729UNION therapeuticsallopurinol sustained-release capsules

Allopurinol in Acute Coronary Syndrome

Start: Mar 2019Est. completion: Jul 2022162 patients
Phase 4Completed

Comparison of Ticagrelor vs. Prasugrel on Inflammation, Arterial Stiffness, Endothelial Function, and Circulating Endothelial Progenitor Cells in Diabetic Patients With Non-ST Elevation Acute Coronary Syndrome (NSTE-ACS) Requiring Coronary Stenting

Start: Jul 2015Est. completion: Jan 201760 patients
Phase 4Completed

Effects and Plasma Concentration of Ticagrelor, After Crushed and Non-crushed Intake, After Acute Coronary Syndrome

Start: Mar 2015Est. completion: Dec 201940 patients
Phase 4Completed

Harmonizing Optimal Strategy for Treatment of Coronary Artery Diseases Trial - Comparison of REDUCTION of PrasugrEl Dose & POLYmer TECHnology in ACS Patients (HOST REDUCE POLYTECH RCT Trial)

Start: Jul 2014Est. completion: Jan 20243,429 patients
Phase 4Completed
NCT01916902AstraZenecaTicagrelor- Delayed Administration

Effect of Pretreatment With Ticagrelor on Residual Thrombus After PCI in Patients Presenting With ACS in Comparison With Delayed Treatment at the Time of PCI: an OCT Study

Start: Feb 20140
Phase 4Withdrawn

Brilinta DaYu Study

Start: Jun 2013Est. completion: Sep 20152,004 patients
Phase 4Completed

Comparison of Ticagrelor Versus Clopidogrel on Residual Thrombus Burden During PCI: an OCT Study

Start: May 2013Est. completion: May 20140
Phase 4Withdrawn

Ad Hoc Percutaneous Coronary Intervention Study in Acute Coronary Syndrome Patients

Start: Jul 2012Est. completion: Jun 2014343 patients
Phase 4Completed
NCT01642238AstraZenecaTicagrelor + ASA + Bivalirudin

Antithrombotic Effects of Ticagrelor Versus Clopidogrel

Start: Jul 2012Est. completion: Apr 201315 patients
Phase 4Completed
NCT01538446Prevail TherapeuticsModification of Prasugrel based on a biological assay

Tailored Antiplatelet Therapy Versus Recommended Dose of Prasugrel

Start: Mar 2012Est. completion: May 2016880 patients
Phase 4Completed

Clopidogrel Reloading in Patients With NSTEACS Undergoing Percutaneous Coronary Intervention on Chronic Clopidogrel Therapy

Start: Nov 2011240 patients
Phase 4Unknown

Improving the Management of Acute Coronary Syndromes in the Emergency Department

Start: Jun 2011Est. completion: Dec 2011705 patients
Phase 4Completed
NCT01068119MedtronicSame-day discharge

Same-Day Discharge After Coronary Percutaneous Transluminal Coronary Angioplasty (PTCA)

Start: Feb 2010Est. completion: Mar 201257 patients
Phase 4Terminated
NCT00790907GSKfondaparinux background and standard dose UFH

Fondaparinux Trial With Unfractionated Heparin (UFH) During Revascularization in Acute Coronary Syndromes (ACS)

Start: Feb 2009Est. completion: May 20103,235 patients
Phase 4Completed
NCT00790387MSDEnoxaparin

Tirofiban and Enoxaparin in High Risk Coronary Intervention

Start: Jun 2004Est. completion: Dec 200660 patients
Phase 4Completed
NCT00206817AbbottTriage CardioProfilER

Rapid Assessment of Cardiac Markers for the Evaluation of Acute Coronary Syndrome (RACE-ACS)

Start: Oct 20030
Phase 4Withdrawn

Effect of Dalcetrapib on CV Risk in a Genetically Defined Population With a Recent ACS

Start: Oct 2023Est. completion: Aug 20272,000 patients
Phase 3Recruiting

Management of LDL-cholesterol With Inclisiran + Usual Care Compared to Usual Care Alone in Participants With a Recent Acute Coronary Syndrome

Start: Jun 2021Est. completion: Aug 2024400 patients
Phase 3Completed
NCT03473223CSL BehringApolipoprotein A-I [human]

Study to Investigate CSL112 in Subjects With Acute Coronary Syndrome

Start: Mar 2018Est. completion: Nov 202318,226 patients
Phase 3Completed

Effect of Dalcetrapib vs Placebo on CV Risk in a Genetically Defined Population With a Recent ACS

Start: Apr 2016Est. completion: Oct 20216,147 patients
Phase 3Completed
NCT01992523AstraZenecaTicagrelor mashed pills

Mojito Study (Mashed Or Just Integral Pill of TicagrelOr ? )

Start: Nov 2013Est. completion: Apr 201482 patients
Phase 3Completed
NCT01608100AbbottARCHITECT STAT High Sensitive Troponin I Assay

Evaluation of a New Cardiac Biomarker Assay

Start: Jun 2012Est. completion: Sep 20141,101 patients
Phase 3Completed

Study to Assess Safety and Efficacy of Ticagrelor (AZD6140) Versus Clopidogrel in Asian/Japanese Patients With Non-ST or ST Elevation Acute Coronary Syndromes (ACS)

Start: Feb 2011Est. completion: Jul 2012801 patients
Phase 3Completed
NCT01147250SanofiLixisenatide

Evaluation of Cardiovascular Outcomes in Patients With Type 2 Diabetes After Acute Coronary Syndrome During Treatment With AVE0010 (Lixisenatide)

Start: Jun 2010Est. completion: Feb 20156,068 patients
Phase 3Completed

A Comparison of Antiplatelet Therapies in Asian Subjects With Acute Coronary Syndrome

Start: Feb 2009Est. completion: Jun 2010720 patients
Phase 3Completed

AngelMed for Early Recognition and Treatment of STEMI

Start: Dec 2008Est. completion: May 20171,020 patients
Phase 3Completed

A Comparison of Prasugrel and Clopidogrel in Acute Coronary Syndrome Subjects

Start: Jun 2008Est. completion: Apr 20129,326 patients
Phase 3Completed

A Comparison of Ticagrelor (AZD6140) and Clopidogrel in Patients With Acute Coronary Syndrome

Start: Oct 2006Est. completion: Mar 200918,624 patients
Phase 3Completed
NCT01014273SanofiPercutaneous Coronary Intervention

A Trial of Trans-radial Versus Trans-femoral Percutaneous Coronary Intervention (PCI) Access Site Approach in Patients With Unstable Angina or Myocardial Infarction Managed With an Invasive Strategy

Start: Jun 2006Est. completion: Mar 20117,021 patients
Phase 3Completed

Veliflapon (DG-031)to Prevent Heart Attacks or Stroke in Patients With a History of Heart Attack or Unstable Angina

Start: May 20063,450 patients
Phase 3Suspended

PASSIvation of Vulnerable Plaque With AZD5718 in AcuTe Coronary syndromE

Start: Jul 2021Est. completion: Aug 2024243 patients
Phase 2Terminated

Intracoronary Stenting and Antithrombotic Regimen: Lesion Platelet Adhesion as Selective Target of Endovenous Revacept

Start: Nov 2017Est. completion: Mar 2020334 patients
Phase 2Completed

Comparison of Low-Dose, Standard-Dose Ticagrelor and Clopidogrel for Inhibition of Platelet Reactivity in Patients With Acute Coronary Syndromes

Start: May 2015Est. completion: Mar 201765 patients
Phase 2Completed

Ticagrelor and Eptifibatide Bolus-Only Versus Ticagrelor and Eptifibatide Bolus Plus Abbreviated Infusion

Start: Feb 2014Est. completion: Dec 201570 patients
Phase 2Completed

Revacept in Symptomatic Carotid Stenosis

Start: Mar 2013Est. completion: Sep 2019158 patients
Phase 2Completed

Ranolazine Cardioprotection in PCI

Start: Nov 2012Est. completion: Apr 20146 patients
Phase 2Terminated

Clopidogrel to Prasugrel in Acute Coronary Syndrome (ACS) Patients

Start: May 2010Est. completion: Nov 2011282 patients
Phase 2Completed

Study Evaluating Safety, Tolerability and Efficacy of YM150 in Subjects With Acute Coronary Syndromes

Start: Sep 2009Est. completion: Mar 20111,276 patients
Phase 2Completed

A Double-Blind Study of E5555 in Japanese Patients With Acute Coronary Syndrome

Start: Nov 2007240 patients
Phase 2Completed

Safety and Tolerability of E5555 and Its Effects on Markers of Intravascular Inflammation in Subjects With Acute Coronary Syndrome

Start: Oct 2007Est. completion: Aug 2009600 patients
Phase 2Completed

The Effect on Blood Cells, Known as Platelets, Using Prasugrel vs Clopidogrel in Patients With the Heart Problem Acute Coronary Syndrome (ACS)

Start: Mar 2007Est. completion: Oct 200756 patients
Phase 2Completed

Clinical Study to Compare the Pharmacokinetic Characteristics and Safety Between CKD-357 and D578 in Healthy Volunteers

Start: May 2018Est. completion: Jun 201831 patients
Phase 1Completed
NCT02887768CorVivoEpicardial Infarct Repair with CorMatrix-ECM

Epicardial Infarct Repair Using CorMatrix®-ECM: Clinical Feasibility Study

Start: Jan 2016Est. completion: Oct 20178 patients
Phase 1Completed

Dose-escalation, Repeated and Single Oral Dosing Study

Start: Mar 2015Est. completion: Apr 2016104 patients
Phase 1Terminated

Safety Study of APD-791 With Aspirin and/or Clopidogrel

Start: Feb 2014Est. completion: Mar 201416 patients
Phase 1Terminated
NCT01648192GSKLosmapimod for single dose

Phase I Study of GW856553 (Losmapimod)

Start: Jul 2012Est. completion: Oct 201220 patients
Phase 1Completed
NCT01358344MSDPantoprazole

A Bioequivalence Study of SCH 530348 2.5 mg Tablets (P06558)

Start: Aug 2010Est. completion: Dec 2010173 patients
Phase 1Completed

Related Jobs in Cardiovascular

Phase Legend

PreclinicalLab & animal studies
Phase 1Safety & dosing
Phase 2Efficacy testing
Phase 3Large-scale trials
On MarketApproved & available

Key Insights

16 late-stage (Phase 3) programs, potential near-term approvals
3 actively recruiting trials targeting 92,516 patients
30 companies competing in this space

The information on this page is for informational purposes only and should not be used as a substitute for professional medical advice. Drug information is sourced from FDA, DailyMed, and other government databases. Adverse event data from FAERS does not establish causation. Always consult a healthcare professional for medical decisions.