THE EFFECTS OF SECONDARY PREVENTION IN PATIENT WITH CORONARY HEART DISEASE (CHD): A LITERATURE REVIEW

Coronary Heart Disease (CHD) is the most common form of cardiovascular disease and one of the leading causes of death worldwide. Considering that CHD is chronic in nature, adherence to secondary prevention measures is needed to prevent the development of CHD in a worse direction, such as disability and disease recurrence. This study aimed to review the literature on secondary prevention and its effect on a patient with CHD. The search of literature used predefined keywords through several databases, namely Scopus, ProQuest, Science Direct and SAGE Journal. The inclusions are articles in full text, written in English, and published within the last five years from 2019 - 2023. The exclusions are non-experimental research literature and those that do not describe the impact of second prevention. The results show that there are fifteen articles that met the inclusion criteria. The second prevention can be given in various ways, and media can be used according to the patient's needs. This second prevention also provides many benefits for quality of life, self-efficacy, knowledge, adherence, self-care, health behavior, lifestyle, life orientation, optimism, physical activity, levels of anxiety and depression in patients controlling cholesterol levels and blood pressure. and reduce the occurrence of complications.


INTRODUCTION
Coronary Heart Disease (CHD) is the most common form of cardiovascular disease and one of the leading causes of death worldwide (Sigamani & Gupta, 2022). Approximately 9 million people died from CHD in 2019, representing 16% of all deaths from all causes globally (WHO, 2020). According to the American Heart Association, the prevalence of CHD will increase by 18% from 2013 to 2030 (Chiang et al., 2018). CHD can impair a person's physical and psychosocial functioning and affect the quality of life of CHD patients (Chiang et al., 2018). Furthermore, CHD patients remain at increased risk for subsequent adverse cardiac events and poor long-term outcomes (Patel et al., 2019).
Considering that CHD is chronic in nature, adherence to secondary prevention measures is needed to prevent the development of CHD in a worse direction such as disability and disease recurrence (Kähkönen et al., 2019). A key aspect of CHD care and secondary prevention is enabling patients to access and engage with evidence-based information and acquire knowledge related to their condition. With adequate and appropriate information, patients and relevant carers are better placed to make decisions and implement optimal behavioral changes (Zwack et al., 2023).
Secondary prevention of CHD is the prevention of recurrent coronary events after clinical diagnosis (Sigamani & Gupta, 2022). Secondary prevention focuses on preventing recurrent coronary events and prolonging life before symptoms appear (Antman, 2018).
There is strong evidence that secondary prevention by significantly modifying risk factors in CHD patients has beneficial effects, including reduced mortality, reduced heart attack recurrence, and improved quality of life (Gupta et al., 2018). With sufficient and relevant information, patients and relevant caregivers can make better decisions and implement optimal behavioral changes (Zwack et al., 2023). Therefore, this paper aimed to review the literature on secondary prevention and its effect on CHD patients.

METHOD
Search articles used the predefined keywords such as "Coronary Heart Disease" OR "Coronary Artery Disease" AND "Secondary Prevention" OR "Effect Secondary Prevention" through four online databases such as Scopus, ProQuest, Science Direct and SAGE Journal. The determination of inclusion and exclusion criteria was based on the PICOS format (Table 1). This format was used to gain the proper journal to review.  The review results show the secondary prevention and related outcomes in patients with CHD as presented in Table 2. The results showed that the intervention group had higher levels of knowledge, compliance, self-care, and comfort levels as well as lower levels of anxiety and depression compared to the control group.
Intervention group: daily care during hospitalization and follow-ups after discharge and The HCF (Hospital-Community-Family) Based Integrated Healthcare Model Services Control group: daily care during hospitalization and follow-ups after discharge Time: 12 months The results showed that the intervention group had lower recurrence and complication rates, as well as better treatment adherence, quality of life and risk factor control compared to the control group. 4 Shen et al., Intervention group: nursing intervention based on Cox's interaction model of client health behavior and daily health education. Control group: daily health education Time: 12 weeks The results showed that the intervention group had better health behaviors, higher levels of adherence and knowledge as well as better blood pressure and LDL levels compared to the control group. The results showed that the intervention group had lower levels of depression than the control group. The results showed that the intervention group had better levels of compliance, knowledge and social support compared to the control group. 13 Kuchi et al., Intervention group: took part in the empowerment program. The control group did not take part in the study.

Time: 8 weeks
The results showed that the intervention group had a better level of life orientation and optimism than the control group.
14 Zhang & Zhang, Intervention group: comprehensive nursing intervention based on self-disclosure (CNISD) Control group: usual care.

Time: 3 months
The results showed that the intervention group had better levels of sleep quality, quality of life, physical activity, levels of anxiety and depression as well as relapse and mortality rates compared to the control group. 15 Pitta et al., Intervention group: educational cardiac rehabilitation program, based on (Social Cognitive Theory) SCT. Control group: usual care.

Time: 3 months
The results showed that the intervention group had higher levels of physical activity and self-efficacy compared to the control group.  In this review, it was found that adding pecan nuts or extra-virgin olive oil to a healthy diet in CHD patients may also reduce atherogenicity and improve health among CHD patients (Weschenfelder et al., 2022). This is because pecans and olives have a cardioprotective effect (Campos et al., 2020