Acute Coronary Syndrome (ACS) remains one of the most significant causes of morbidity and mortality worldwide, posing a continuing challenge to global health systems. Despite substantial progress in early diagnosis, reperfusion strategies, and pharmacotherapy, long-term outcomes following an acute coronary event remain suboptimal. Many patients experience persistent myocardial dysfunction, recurrent ischemia, or the development of heart failure, arrhythmias, and chronic inflammatory responses. These clinical entities can be viewed as the successors of ACS—pathophysiological and clinical consequences that evolve from the initial ischemic injury. Understanding these successors is essential for improving post-ACS care, reducing complications, and enhancing survival. Recent advances in pharmacological therapy, regenerative medicine, and digital technologies have created new opportunities for secondary prevention and personalized management. This article examines the mechanisms and clinical manifestations of post-ACS conditions and highlights emerging trends that may define the future of coronary artery disease management. Chronic heart failure (HF) is one of the most common outcomes following ACS. Myocardial necrosis leads to structural remodeling, neurohormonal activation, and progressive ventricular dysfunction. Despite optimal therapy, nearly 25–40% of post-MI patients develop HF within 5 years.

Coronary angiography, heart failure, inflammation, left ventricular dysfunction; mortality predictors.

Thygesen K,. Fourth Universal Definition of Myocardial Infarction. Eur Heart J. 2018.

Timmis A. Global Burden of Ischaemic Heart Disease: 1990–2020. Eur Heart J. 2022.

Ridker P.M.Anti-Inflammatory Therapy with Canakinumab for Atherosclerosis. N Engl J Med. 2017.

Ibanez B.2017 ESC Guidelines for the Management of ACS in Patients Presenting Without Persistent ST-Segment Elevation. Eur Heart J. 2018.

Galli A. Lombardi F. Post-Infarction Ventricular Arrhythmias: Mechanisms and Management. Eur Heart J. 2020.