Treatment of acute coronary syndrome is under rapid progress. Nevertheless, the early complication rate remains high. Standard antithrombotic treatment is Aspirin 100 mg/d. Patients with elevated risk should be treated with Aspirin and Clopidogrel if primary invasive strategy ist not intended. Independent of the cholesterol level, statins should be given in the early phase of acute coronary syndrome. Dose adaptation is recommended after three months corresponding to the national guidelines. Mainly in diabetes mellitus, additional treatment with an ACE inhibitor lowers the overall cardiovascular risk also in patients without arterial hypertension or congestive heart failure. Six months after the acute event, risk stratification should be adapted.