Acute coronary syndromes (ACS) are the most frequent cause of hospitalization in intensive cardiac care units and are associated with a high risk of early complications. As a consequence, medical attention and healthcare are mainly directed towards the treatment of the acute phase of ACS, when the risk is higher. However, the risk associated with ACS is not simply confined to the hospitalization period, but may persist for months or years because of the frequent recurrence of ischemic events and related outcomes. Although more aggressive invasive strategies and powerful therapies with anticoagulants and antiplatelet agents have strongly improved the acute prognosis of ACS, the prognosis still remains unfavorable. Notwithstanding this, cardiologists mostly focus on the acute phase of ACS, while adopting a less aggressive approach after patient discharge and during outpatient follow-up. However, secondary prevention measures are as important as acute therapy and should be largely applied, including accurate estimation of the residual risk for the individual patient, appropriate implementation of secondary prevention, and close monitoring of adherence to suggested treatments, such as dual antiplatelet therapy. In conclusion, adherence to therapy is a clinically relevant factor, and efforts towards its improvement should be actively pursued. Moreover, appropriate prescriptions may stimulate therapy adherence with favorable effects, resulting in better clinical outcomes and healthcare cost containment. This holds particularly true for patients with ACS undergoing percutaneous revascularization.