Optimal Parenteral Antithrombotic Therapy for a Patient Admitted With NSTE-ACS | Patient Case Quiz

A 75-year-old female with a history of diabetes mellitus and hypertension presents to the emergency department with several episodes of chest pain in the previous two days. Initial physical examination reveals normal vital signs and is otherwise remarkable. Laboratories reveal normal renal function and elevated troponin and CK-MB levels. Electrocardiogram demonstrates normal sinus rhythm with 1.0-1.5 mm ST depression in II, AVF, and V4-V6 leads. She is hospitalized with the diagnosis of non–ST-elevation myocardial infarction (NSTEMI). At her admission, she is told that she will need to undergo a coronary angiography the following day, yet she wishes to wait for her daughter, who is out of town, in order to make the decision.

Based on current guidelines, which of the following parenteral anticoagulation regimens is most appropriate upon admission of this patient?

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