SUMMARY Acute coronary syndromes (ACS) remain a significant cause of disability and death in Australia. Following an initial acute coronary event, there is a significant risk of recurrence, particularly in the first 90 days. In April 2025, the National Heart Foundation of Australia and the Cardiac Society of Australia and New Zealand launched a new Australian clinical guideline for diagnosing and managing ACS. The guideline includes recommendations for the secondary prevention of ACS.