In a patient who has developed heparin-induced thrombocytopenia (HIT), which anticoagulant is the best option during PCI?

Study for the Board Certified Cardiology Pharmacist Exam. Utilize flashcards and answer multiple-choice questions with detailed explanations. Prepare efficiently for your certification!

In cases of heparin-induced thrombocytopenia (HIT), bivalirudin is the preferred anticoagulant during percutaneous coronary intervention (PCI). Bivalirudin is a direct thrombin inhibitor which does not cross-react with heparin, making it a safe choice for patients who have experienced HIT. It provides effective anticoagulation while minimizing the risk of further complications associated with heparin exposure.

Additionally, bivalirudin offers the advantage of a rapid onset of action and is also reversible, which is particularly beneficial in the context of PCI where timely anticoagulation is crucial. Its use has been associated with lower rates of bleeding compared to some other anticoagulant options, making it a suitable choice in these high-risk situations.

The other options such as enoxaparin, eptifibatide, and fondaparinux are not ideal in this scenario due to their mechanisms or association with heparin. Enoxaparin is a low molecular weight heparin and poses a significant risk of cross-reactivity in patients with HIT. Eptifibatide is a glycoprotein IIb/IIIa inhibitor, which, while useful in managing acute coronary syndromes, does not provide the

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