ANXA5 (Annexin A5) is a calcium-dependent phospholipid-binding protein that functions as an anticoagulant by inhibiting the thromboplastin-specific complex in blood coagulation 1. Beyond hemostasis, ANXA5 plays critical roles in multiple pathophysiological processes. In acute myocardial infarction, S100A12 interaction with ANXA5 enhances calcium influx to promote neutrophil extracellular trap formation, exacerbating myocardial injury; blockade of ANXA5 attenuates heart dysfunction 2. ANXA5 serves as a marker for apoptotic cells and participates in atherosclerosis development alongside other annexin family members through regulation of inflammation, cell adhesion, and apoptosis 1. The protein also functions in quality control mechanisms, with detection in extracellular mitochondria release pathways alternative to mitophagy 3. Therapeutically, ANXA5 is incorporated into fusion proteins like SSL5-AnxA5, which prevent pathological interactions between apoptotic endothelial cells and inflammatory cells in acute coronary syndrome by simultaneously binding apoptotic cells and blocking P-selectin interactions 4. ANXA5 elevation is associated with various cancers and serves as a biomarker in disease progression, though specific mechanistic roles in oncology require further investigation.