The 2012 ESC guidelines on atrial fibrillation recommend the use of the CHA2DS2-VASc score to assess stroke risk (IA) in patients with nonvalvular atrial fibrillation. The first step is to score stroke/bleeding risk according to the CHA2DS2-VASc and HAS-BIED.CHA2DS2-VASc ≥2 is considered a high stroke risk, while HAS-BIED ≥3 is considered a high bleeding risk. The English meaning of CHA2DS2-VASc: Congestive heart failure, Hypertension, Age ≥75 (doubled) (age >75 years scored 2 points), Diabetes, Stroke (doubled) (diabetes scored 1 point), Sascular disease (vascular disease). , Sascular disease (vascular disease (including heart attack, complex aortic plaque, PAD)), Age 65C74 (age 65-74 years), and Sex category (female). Lili Zhang, Department of Cardiovascular Medicine, Peking University Aerospace Clinical College 2, Components of the CHA2DS2-VASc scoring system (maximum value of 9 points) Major risk factors (2 points each): stroke or TIA , age ≥75 years. Clinically relevant non-major risk factors (1 point each): diabetes mellitus, age 65-74 years, hypertension, heart failure (LVEF£40%), vascular disease (including infarction, complex aortic plaque, PAD), female. Remarks (PAD-stenotic, occlusive, or aneurysmal dilatation disease of the aorta and its branch arteries other than coronary arteries). 3. The English meanings of HAS-BIED: Hypertension, Abnormal liver function/Abnormal renal function (one point each), Stroke, Bleeding, Liable INRs, Fluctuating INR values, Elderly. Fluctuating INRs), Elderly (age >65 years), Drugs or alcohol (one point each). Each item is worth 1 point and the maximum value is also 9 points. The ESC 2010 AF guidelines recommend that antithrombotic treatment strategies be chosen directly on the basis of risk factors, with the presence of one major risk factor or two or more clinically relevant non-major risk factors, i.e., a CHA2DS2VASc score of ≥2 requiring oral anticoagulant (OAC); the presence of one clinically relevant non-major risk factor, i.e., a CHA2DS2VASc score of 1 requiring OAC or aspirin. either OAC or aspirin, but OAC is preferred; those with no risk factors, i.e., a CHA2DS2VASc score of 0, may take aspirin or no antithrombotic therapy, with no antithrombotic therapy preferred. Caution should be exercised in patients at high risk of bleeding whether they receive OAC or aspirin therapy. In fact, such things as advanced age, hypertension, and a history of previous stroke are both risk factors for stroke and for bleeding, so while the guideline’s recommendations for antithrombotic therapy in high-risk patients are more comprehensive and actionable, the choice of antithrombotic therapy is still tricky in many cases. Conservative treatment of ACS combined with oral anticoagulant for atrial fibrillation: warfarin + aspirin + clopidogrel for 3-6 months (with gastric mucosal protectant), then warfarin + aspirin or clopidogrel up to 12 months. After 12 months, life-long anticoagulation with warfarin alone with INR 2.0-3.0. Treatment of acute non-ST-segment elevation myocardial infarction combined with oral anticoagulant for atrial fibrillation: perioperatively preferred warfarin for continuous Anticoagulation, preferred radial artery route, preferred bare stent, try to avoid the use of drug stents, postoperative warfarin + aspirin + clopidogrel for 6 months, prolonged course of triple antithrombotic therapy for those with a low risk of bleeding, triple antithrombotic therapy for 1 month for those with a high risk of bleeding, and no use of drug stents. Then warfarin + aspirin or clopidogrel until 12 months. after 12 months, life-long anticoagulation with warfarin alone, INR 2.0-3.0. Treatment of acute ST-segment elevation myocardial infarction combined with oral anticoagulant for atrial fibrillation: perioperative loading aspirin + clopidogrel, radial artery route is preferred, intraoperative normal heparin reduction (APTT250-300S), thrombus aspiration is preferred for those with heavy thrombus load. Thrombus aspiration catheter is preferred for heavy thrombus load, followed by consideration of combined IIb/IIIa receptor antagonists (GPIs). Pharmacological stenting is avoided, bare stenting is preferred, and postoperative antithrombotic treatment is the same as that for NSTEMI, but for those with high bleeding risk, the postoperative triple antithrombotic course is shortened as appropriate, and then switched to oral anticoagulant (OAC) monotherapy. Those with low risk of AF thrombosis: warfarin anticoagulation can be discontinued, following the perioperative antithrombotic regimen for PCI. Individuals at high risk of bleeding from AF (HAS-BIED ≥3): radial artery route is preferred, sodium sulfadoxinephedrine and enoxaparin can be used in patients with NSTACS in non-emergency interventions, but limited data are available in patients on anticoagulation therapy, avoiding pharmacologic stenting, and triple antithrombotic therapy for 2-4 weeks after implantation of a bare stent (BMS), followed by a single use of OAC monotherapy.