Among patients with treatment-naive ITP and concurrent ACS who are either corticosteroid-dependent or corticosteroid-poor responders, we suggest using TPO-RA (avatrombopag, or once weekly subcutaneous injection romiplostim) as a second-line ITP therapy to target platelet count > 50 × 109/L, permitting the use of DAPT, to a maximum platelet count of 200 × 109/L to reduce the risk of TPO-RA-associated thrombosis. Here, TPO is linked to autoimmune thrombocytopenic purpura.