Prevention of cardiovascular events should involve an adequate control of the risk factors (diabetes, blood pressure, hyperlipidemia, etc). Once the thrombotic complications occur, the invasive approaches combined with potent antithrombotic agents appears to have some advantage over fibrinolytic therapy. A need for better and more efficacious antithrombotics is indicated by the high incidence of thrombotic complications. Among the new antothrombotic agents, the inhibition of the TF pathway (inhibitors of factors VIIa, Xa or oral thrombin inhibitors) seems to be more promising. Their efficacy should be demonstrated in large and controlled clinical trials.