[Therapeutic innovations in secondary prevention of cardiovascular risk].

New lipid-lowering therapies (injectable and oral PCSK9 inhibitors, inclisiran, bempedoic acid) allow more intensive LDL-C reduction, including in statin-intolerant patients.Lipoprotein(a) is emerging as a specific target, with ASO/siRNA agents (pelacarsen, olpasiran, lepodisiran) achieving marked reductions while outcome data are pending.Antithrombotic strategies are now tailored to ischemic and bleeding risks, using shortened dual antiplatelet therapy (DAPT), P2Y12 monotherapy and de-escalation approaches. On the inflammatory side, low-dose colchicine offers a simple, low-cost option for selected coronary patients, though recent results are mixed.Remote monitoring, hybrid cardiac rehabilitation and personalized care pathways help to further reduce residual cardiovascular risk.