Antithrombotic therapy is the cornerstone of drug treatment for acute coronary syndrome,and perioperative anticoagulant therapy is crucial for preventing thrombosis and reducing the risk of ischemic events.Since the 1990 s,a large number of evidence-based studies have been conducted internationally on patients with a-cute coronary syndrome before,during,and after coronary intervention,and even in the stable and chronic pha-ses,laying a solid evidence foundation for guiding scientific and rational drug use.In-depth understanding of the pharmacological properties of anticoagulants,full understanding and correct evaluation of clinical research results,dynamic assessment of patients'ischemic and bleeding risks,and combined with coronary artery lesions,interven-tional procedures,and complications will help to timely adjust antithrombotic treatment plans,thereby achieving safe antithrombotic treatment and maximum benefit.