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Acute Heart Failure

Cardiovascular
19
Pipeline Programs
23
Companies
29
Clinical Trials
3 recruiting
4
Approved Products

Pipeline by Development Stage

Preclinical
Phase 1
Phase 1/2
Phase 2
Phase 2/3
Phase 3
On Market
0
0
0
5
0
8
6
Early DiscoveryClinical DevelopmentMarket

Drug Modality Breakdown

Small Molecule
2100%
+ 35 programs with unclassified modality

Cardiovascular is a $69.4B mature market dominated by anticoagulants and metabolic therapies with stable blockbuster portfolios.

$69.4B marketMature→ Stable30 products15 companies

Key Trends

  • FXa inhibitors (ELIQUIS, XARELTO) command 62% of market spending, creating limited room for new entrants
  • SGLT2 inhibitors gaining traction in heart failure indication, signaling expansion beyond traditional anticoagulation
  • Multiple patent cliffs (JANUVIA 2027, OPSUMIT 2029) create near-term revenue vulnerability but reinvestment pressure

Career Verdict

Strong choice for commercial, clinical operations, and device integration roles; limited opportunity for innovative pipeline development given market maturity.

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

Market Leaders

#1ELIQUISStable
$18.3B
Bristol Myers Squibb·Peak15.0yr
#2JARDIANCEGrowing
$8.8B
Boehringer Ingelheim·Peak8.6yr
#3XARELTOStable
$6.3B
Johnson & Johnson·Peak
#4FARXIGAGrowing
$4.3B
AstraZeneca·Peak15.4yr
#5JANUVIADeclining
$4.1B
Merck & Co.·LOE_Approaching1.1yr

Drug Class Breakdown

FXa Inhibitors (Apixaban/Rivaroxaban)
$42.8B(62%)

Mature, stable revenue base

SGLT2 Inhibitors
$13.1B(19%)

Growing in heart failure and renal indications

DPP4 Inhibitors
$4.1B(6%)

Declining as LOE approaches 2027

ARBs and Combination Therapies
$3.4B(5%)

Stable in heart failure management

Endothelin Receptor Antagonists and Prostacyclin Agonists
$1.8B(3%)

Niche pulmonary hypertension market

Career Outlook

Stable

Cardiovascular careers are stable but not expanding; the market is mature, dominated by blockbuster franchises with predictable commercial cycles and patent cliffs. Professionals entering this space should expect strong compensation (Commercial $210K avg, Medical Affairs $201K avg) but limited opportunity to drive breakthrough innovation. Device company roles offer better growth trajectories than pharma, particularly in remote monitoring, diagnostics, and patient engagement technologies.

Breaking In

Target device companies (Abbott, Medtronic) for growth potential; if joining pharma, focus on Commercial or Clinical Operations roles where hiring is active and compensation is competitive.

For Experienced Professionals

Leverage cardiovascular expertise to move into medical device strategy, digital health partnerships, or adjacent therapeutic areas; R&D opportunity is limited and may require lateral moves to access innovation-focused roles.

In-Demand Skills

Healthcare economics and payer management (anticoagulation safety monitoring, cost-effectiveness)Real-world evidence generation (postmarket surveillance for FXa inhibitors)Digital health and remote patient monitoring integrationClinical trial execution in large, established patient populationsRegulatory expertise in label expansions (SGLT2 inhibitor indications)

Best For

Commercial/Sales roles (mature market execution)Medical Science Liaisons (managing healthcare provider relationships on established therapies)Clinical Operations/Project Managers (managing large Phase 3/4 programs)Regulatory Affairs (label expansion strategy, patent cliff preparation)Health Economics and Outcomes Research (demonstrating value in competitive anticoagulation market)

Hiring Landscape

$130K-$210K

Cardiovascular hiring is concentrated in device companies (Abbott 337, Medtronic 317) rather than pharma, reflecting the therapeutic area's reliance on hardware solutions and patient management infrastructure. Pharma hiring (Johnson & Johnson 261, Bristol Myers Squibb 52) is heavily weighted toward Commercial (468 roles) and Clinical Operations (296 roles), with minimal R&D investment (14 roles). Medical device integration and remote patient monitoring expertise are increasingly valued as the market consolidates.

1,386
Open Roles
5
Companies Hiring
5
Departments

Top Hiring Companies

Abbott
337Growing
Medtronic
317Growing
Johnson & Johnson
261Stable
Bristol Myers Squibb
52Declining
Edwards Lifesciences
78Growing

By Department

Commercial(34%)
$210K
Clinical Operations(21%)
$180K
Engineering(13%)
$145K
Medical Affairs(1%)
$201K
Research & Development(1%)
$194K

Device companies offer more growth opportunities; pharma roles are high-paying but oriented toward mature market execution rather than innovation.

On Market (4)

Approved therapies currently available

AstraZeneca
FARXIGAApproved
dapagliflozin
AstraZeneca
oral2014
4.3B Part D
Otsuka
JYNARQUEApproved
tolvaptan
Otsuka
Vasopressin V2 Receptor Antagonist [EPC]oral2018
76M Part D
Otsuka
SAMSCAApproved
tolvaptan
Otsuka
Vasopressin V2 Receptor Antagonist [EPC]oral2009
12M Part D
Otsuka
TOLVAPTANApproved
tolvaptan
Otsuka
oral2025
3M Part D

Competitive Landscape

23 companies ranked by most advanced pipeline stage

Sandoz
SandozAustria - Kundl
6 programs
3
2
1
sacubitril/valsartanPhase 4Small Molecule1 trial
RLX030Phase 31 trial
SerelaxinPhase 31 trial
RLX030Phase 21 trial
SerelaxinPhase 21 trial
+1 more programs
Active Trials
NCT01543854Completed71Est. Jan 2013
NCT02002702Completed46Est. Aug 2014
NCT02151383Terminated12Est. Apr 2017
+3 more trials
Otsuka
OtsukaJapan - Tokushima
2 programs
1
1
TolvaptanPhase 31 trial
Tolvaptan 15 MGN/A1 trial
Active Trials
NCT04331132Unknown128Est. Jul 2023
NCT01733134Withdrawn0
AstraZeneca
AstraZenecaCAMBRIDGE, United Kingdom
1 program
1
DapagliflozinPhase 4Small Molecule1 trial
Active Trials
NCT04363697Completed2,401Est. Jun 2025
Abbott
AbbottABBOTT PARK, IL
3 programs
1
levosimendanPhase 3
Determining When Patients Hospitalized With Acute Heart Failure Can Be Safely Sent Home (The DECIDE N/A1 trial
Transthoracic EchocardiogramN/A1 trial
Active Trials
NCT00911703Completed835Est. Oct 2015
NCT02728739Completed500Est. Feb 2018
Orion Pharma
Orion PharmaUK - Reading
2 programs
1
levosimendanPhase 31 trial
Levosimendan Pharmacokinetics in ChildrenN/A1 trial
Active Trials
NCT01704131Unknown36Est. Sep 2019
NCT00348504Completed1,300Est. Jun 2005
Orion
OrionUK - Cambridge
2 programs
1
levosimendanPhase 3
Levosimendan Pharmacokinetics in ChildrenN/A
Idorsia
IdorsiaSwitzerland - Allschwil
2 programs
2
tezosentanPhase 31 trial
tezosentanPhase 31 trial
Active Trials
NCT00525707Completed735Est. Jan 2005
NCT00524433Completed713Est. Jan 2005
Bayer
BayerLEVERKUSEN, Germany
2 programs
2
CinaciguatPhase 21 trial
CinaciguatPhase 21 trial
Active Trials
NCT01065077Terminated12Est. Feb 2011
NCT01067859Terminated5Est. Nov 2010
Eppendorf
EppendorfGermany - Hamburg
2 programs
Characterisation of phenotYpes in aCute Heart faiLure patiEntsN/A1 trial
Venoarterial extracorporeal oxygenationN/A1 trial
Active Trials
NCT07508891Recruiting1,000Est. Dec 2030
NCT03508505Unknown1,000Est. Dec 2020
Novartis
NovartisBASEL, Switzerland
2 programs
Global Non-interventional Heart Failure Disease RegistryN/A
SerelaxinPHASE_2
Colorado Therapeutics
Colorado TherapeuticsCO - Louisville
1 program
6 Minute Walk TestN/A1 trial
Active Trials
NCT02350114Completed51Est. Jul 2015
Montis Biosciences
Montis BiosciencesBelgium - Leuven
1 program
Continuous Furosemide InfusionN/A1 trial
Active Trials
NCT02638142Recruiting370Est. Jan 2028
Inovise Medical
Inovise MedicalOR - Beaverton
1 program
Determining When Patients Hospitalized With Acute Heart Failure Can Be Safely Sent Home (The DECIDE N/A
Revamp Medical
Revamp MedicalIsrael - Netanya
1 program
Doraya catheterN/A1 trial
Active Trials
NCT03234647Completed9Est. Apr 2021
Servier
ServierFrance - Suresnes
1 program
Gulf Acute Heart Failure RegistryN/A1 trial
Active Trials
NCT01467973Completed5,005Est. Nov 2013
Medtronic
MedtronicNJ - Phillipsburg
1 program
Intensive insulin infusionN/A1 trial
Active Trials
NCT00922402Withdrawn0Est. Sep 2011
Rhythm Pharmaceuticals
1 program
Intensive insulin infusionN/A
Martin Pharmaceuticals
1 program
Multilevel Guided Discharge PlanningN/A1 trial
Active Trials
NCT03696875Unknown1,260Est. May 2022
Roche
RocheSTAVANGER NORWAY, Norway
1 program
Registry Of Best Up-titration STrategies in Acute Heart FailureN/A1 trial
Active Trials
NCT05865665Not Yet Recruiting5,000Est. Dec 2027
Magenta Medical
Magenta MedicalIsrael - Kadima
1 program
TRVD TherapyN/A1 trial
Active Trials
NCT03621436Terminated13Est. May 2019
Innogene Kalbiotech
Innogene KalbiotechSingapore - Singapore
1 program
0.5M Sodium lactatePHASE_21 trial
Active Trials
NCT01981655Completed41Est. Aug 2013
Boehringer Ingelheim
Boehringer IngelheimINGELHEIM, Germany
1 program
Empagliflozin 10 MGPHASE_31 trial
Active Trials
NCT05392764Recruiting444Est. Dec 2027
Thermo Fisher Scientific
1 program
TolvaptanPHASE_3

Trial Timeline

Clinical trial activity over time

2021
2022
2023
2024
2025
2026
2027
2028
2029
2030
AstraZenecaDapagliflozin
Sandozsacubitril/valsartan
Boehringer IngelheimEmpagliflozin 10 MG
SandozSerelaxin
SandozRLX030
Idorsiatezosentan
Idorsiatezosentan
Orion Pharmalevosimendan
SandozSerelaxin
SandozSerelaxin
SandozRLX030
BayerCinaciguat
BayerCinaciguat
Innogene Kalbiotech0.5M Sodium lactate
RocheRegistry Of Best Up-titration STrategies in Acute Heart Failure

Showing 15 of 28 trials with date data

Clinical Trials (29)

Total enrollment: 29,350 patients across 29 trials

NCT04363697AstraZenecaDapagliflozin

Dapagliflozin and Effect on Cardiovascular Events in Acute Heart Failure -Thrombolysis in Myocardial Infarction 68 (DAPA ACT HF-TIMI 68)

Start: Sep 2020Est. completion: Jun 20252,401 patients
Phase 4Completed
NCT02554890Sandozsacubitril/valsartan

Comparison of Sacubitril/Valsartan Versus Enalapril on Effect on NT-proBNP in Patients Stabilized From an Acute Heart Failure Episode.

Start: Apr 2016Est. completion: Jul 2018887 patients
Phase 4Completed
NCT01733134OtsukaTolvaptan

Acute Heart Failure Patients With High Copeptin Treated With Tolvaptan Targets Increased AVP Activation for Treatment (ACTIVATE)

0
Phase 3Withdrawn
NCT05392764Boehringer IngelheimEmpagliflozin 10 MG

Early Treatment With a Sodium-glucose Co-transporter 2 Inhibitor in High-risk Patients With Acute Heart Failure

Start: Sep 2022Est. completion: Dec 2027444 patients
Phase 3Recruiting
NCT02007720SandozSerelaxin

Efficacy, Safety and Tolerability of Sexelaxin When Added to Standard Therapy in AHF

Start: Mar 2014Est. completion: Jun 2017876 patients
Phase 3Terminated
NCT01870778SandozRLX030

Efficacy, Safety and Tolerability of Serelaxin When Added to Standard Therapy in AHF

Start: Oct 2013Est. completion: Feb 20176,600 patients
Phase 3Completed
NCT00524433Idorsiatezosentan

Tezosentan in the Treatment of Acute Heart Failure

Start: Apr 2003Est. completion: Jan 2005713 patients
Phase 3Completed
NCT00525707Idorsiatezosentan

Tezosentan in Acute Heart Failure

Start: Apr 2003Est. completion: Jan 2005735 patients
Phase 3Completed
NCT00348504Orion Pharmalevosimendan

Survival of Patients With Acute Heart Failure in Need of Intravenous Inotropic Support: a Multicentre, Parallel-Group, Randomised, Double-Blind, Double-Dummy Study of Levosimendan Versus Dobutamine in Patients With Acute Heart Failure.

Start: Mar 2003Est. completion: Jun 20051,300 patients
Phase 3Completed
NCT02151383SandozSerelaxin

Pharmacokinetics & Safety of Serelaxin on Top of Standard of Care Therapy in Pediatric Patients With Acute Heart Failure

Start: Sep 2014Est. completion: Apr 201712 patients
Phase 2Terminated
NCT02002702SandozSerelaxin

Study of Safety, Tolerability and Pharmacokinetics of Serelaxin in Japanese Acute Heart Failure (AHF) Patients

Start: Jan 2014Est. completion: Aug 201446 patients
Phase 2Completed
NCT01543854SandozRLX030

Hemodynamic Responses to RLX030 Infusion in Subjects With Acute Heart Failure

Start: Mar 2012Est. completion: Jan 201371 patients
Phase 2Completed
NCT01065077BayerCinaciguat

BAY58-2667 Dose Finding Trial Investigating Fixed Doses in Patients With Acute Decompensated Chronic Congestive Heart Failure (ADHF)

Start: Mar 2010Est. completion: Feb 201112 patients
Phase 2Terminated
NCT01067859BayerCinaciguat

A Phase IIb Study to Investigate the Efficacy and Tolerability of Lower Doses Cinaciguat (25 µg/h, 10 µg/h) Given Intravenously to Patients With Acute Decompensated Chronic Congestive Heart Failure (ADHF)

Start: Mar 2010Est. completion: Nov 20105 patients
Phase 2Terminated
NCT01981655Innogene Kalbiotech0.5M Sodium lactate

0.5M Na Lactate Solution in Acute Heart Failure (AHF)

Start: Dec 2009Est. completion: Aug 201341 patients
Phase 2Completed
NCT05865665RocheRegistry Of Best Up-titration STrategies in Acute Heart Failure

Registry Of Best Up-titration STrategies in Acute Heart Failure

Start: Jun 2023Est. completion: Dec 20275,000 patients
N/ANot Yet Recruiting
NCT04331132OtsukaTolvaptan 15 MG

Tolvaptan add-on Therapy to Overcome Loop Diuretic Resistance in Acute Heart Failure With Renal Dysfunction

Start: Dec 2021Est. completion: Jul 2023128 patients
N/AUnknown
NCT03696875Martin PharmaceuticalsMultilevel Guided Discharge Planning

Discharge Planning in Emergency Department for Frail Older With AHF

Start: May 2019Est. completion: May 20221,260 patients
N/AUnknown
NCT07508891EppendorfCharacterisation of phenotYpes in aCute Heart faiLure patiEnts

Characterisation of phenotYpes in aCute Heart faiLure patiEnts

Start: Mar 2019Est. completion: Dec 20301,000 patients
N/ARecruiting
NCT03234647Revamp MedicalDoraya catheter

First In Human Study of the Doraya Catheter for the Treatment of AHF Patients

Start: Jan 2018Est. completion: Apr 20219 patients
N/ACompleted
NCT03508505EppendorfVenoarterial extracorporeal oxygenation

Postcardiotomy Venoarterial Extracorporeal Membrane Oxygenation

Start: Jan 2018Est. completion: Dec 20201,000 patients
N/AUnknown
NCT02728739AbbottTransthoracic Echocardiogram

Incidence of Significant Mitral Regurgitation in Acute Heart Failure Patients

Start: Jun 2016Est. completion: Feb 2018500 patients
N/ACompleted
NCT02638142Montis BiosciencesContinuous Furosemide Infusion

Loop Diuretic Therapy in Acutely Decompensated Heart Failure

Start: Dec 2015Est. completion: Jan 2028370 patients
N/ARecruiting
NCT03621436Magenta MedicalTRVD Therapy

Clinical Evaluation of the TRVD™ System in ADHF

Start: Aug 2015Est. completion: May 201913 patients
N/ATerminated
NCT02350114Colorado Therapeutics6 Minute Walk Test

An Observational Study of the Functional Capacity of Heart Failure

Start: Nov 2014Est. completion: Jul 201551 patients
N/ACompleted
NCT01704131Orion PharmaLevosimendan Pharmacokinetics in Children

Levosimendan Pharmacokinetics in Children

Start: Nov 2012Est. completion: Sep 201936 patients
N/AUnknown
NCT01467973ServierGulf Acute Heart Failure Registry

Gulf Acute Heart Failure Registry

Start: Feb 2012Est. completion: Nov 20135,005 patients
N/ACompleted
NCT00922402MedtronicIntensive insulin infusion

Heart & Diabetes - Feasibility Study

Start: Jun 2009Est. completion: Sep 20110
N/AWithdrawn
NCT00911703AbbottDetermining When Patients Hospitalized With Acute Heart Failure Can Be Safely Sent Home (The DECIDE

Determining When Patients Hospitalized With Acute Heart Failure Can Be Safely Sent Home (The DECIDE Study)

Start: Aug 2008Est. completion: Oct 2015835 patients
N/ACompleted

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Phase Legend

Preclinical— Lab & animal studies
Phase 1— Safety & dosing
Phase 2— Efficacy testing
Phase 3— Large-scale trials
On Market— Approved & available

Key Insights

8 late-stage (Phase 3) programs, potential near-term approvals
3 actively recruiting trials targeting 29,350 patients
23 companies competing in this space

Related Indications

Hypertension(936)Heart Failure(877)Coronary Artery Disease(769)Atrial Fibrillation(615)Pulmonary Arterial Hypertension(207)Acute Coronary Syndrome(140)Atherosclerosis(123)Aortic Valve Stenosis(121)Pulmonary Hypertension(111)Congestive Heart Failure(94)

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.