Mehmet Cilingiroglu: Navigating Anticoagulation Choices in Acute Coronary Syndrome PCI
Mehmet Cilingiroglu, Clinical Professor of Medicine/Cardiology at the University of Hawaii John A. Burns School of Medicine, Cardiologist at Hawaii Pacific Health, shared a post on LinkedIn:
“Anticoagulation During ACS-PCI:
Which Agent Should We Choose?
The 2025 ACC/AHA and 2023 ESC guidelines support unfractionated heparin (UFH) as the standard procedural anticoagulant for patients undergoing PCI for acute coronary syndromes.
Bivalirudin and enoxaparin are appropriate alternatives in selected patients, while argatroban is an option when heparin-induced thrombocytopenia is present.
Fondaparinux may be useful in NSTE-ACS before PCI but must never be used as the sole anticoagulant during PCI because of catheter thrombosis risk.
Careful assessment of bleeding risk, renal function, platelet counts, and appropriate anticoagulation monitoring is essential.
The best anticoagulant is not necessarily the newest or most expensive—it is the one supported by evidence and appropriate for the individual patient!”
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