Dual antiplatelet therapy is the cornerstone of antithrombotic therapy in patients with acute coronary syndrome. Aspirin and P2Y12 receptor antagonists are commonly used antiplatelet drugs in clinic. At present, new P2Y12 receptor antagonists, especially ticagrelor monotherapy, are the subject of in-depth research in the field of antiplatelet optimization therapy. Studies have found that P2Y12 receptor antagonists can reduce thromboxane A2 receptor expression and thromboxane A2 production in platelets. Ticagrelor has broad-spectrum antiplatelet mechanism. This article summarizes the relevant research on the antiplatelet mechanism of new P2Y12 receptor antagonists, especially ticagrelor, and proposes new ideas for optimizing antiplatelet therapy.