Secondary prevention of cardiovascular diseases: current state of the art.

Prevention strategies for cardiac events depend of the risk for such an event. A very high risk is defined by a risk >10% over 10 years. For example, a patient with known coronary artery disease has such a very high risk to die. However a patient with diabetes and severe hypertension without known coronary artery disease carries the same risk. Here, secondary prevention and primary prevention overlap. Prevention guidelines include a number of general recommendations such as changes in behavior, smoking intervention strategies, nutrition, body weight, and physical activity. Drug treatment-based prevention strategies address diabetes mellitus, hypercholesterinemia, platelet aggregation, and arterial hypertension. Following hospitalization for heart failure or ACS participation in a center-based or home-based rehabilitation program is recommended. There are a number of new treatment options with a promising potential to reduce events in patients with cardiovascular diseases and in patients with cardiovascular risk factors. Very recent treatment strategies include the PCSK9 inhibitors for hypercholesterinemia, the SGLT2 inhibitors for reduction of cardiovascular events in patients with Diabetes mellitus and increased CV risk.