This document discusses four clinical cases involving patients on antiplatelet and anticoagulant therapy: 1. A STEMI patient with LV thrombus found on echocardiogram who is currently on dual antiplatelet therapy (DAPT). The document recommends adding prophylactic anticoagulation with a vitamin K antagonist (VKA) or non-vitamin K oral anticoagulant (NOAC). 2. An NSTEMI patient currently on long-term DAPT who underwent PCI years ago. The document recommends continuing prasugrel as part of DAPT in this high thrombotic risk patient. 3. An NSTEMI patient who developed deep vein thrombosis while