Review Question - QID 210704

A 70-year-old woman with a history of coronary artery disease status post coronary artery bypass graft presents with a stroke due to an infarction in the right middle cerebral artery territory. She is admitted to the intensive care unit for neurological monitoring following a successful thrombectomy. Overnight, the patient complains of difficulty breathing, chest pain, and jaw pain. Her temperature is 98.6°F (37°C), blood pressure is 160/80 mmHg, pulse is 100/min, respirations are 30/min, and oxygen saturation is 90% on 2L O2 via nasal cannula. Rales are heard in the lower lung bases. Electrocardiogram reveals left ventricular hypertrophy with repolarization but no acute ST or T wave changes. Troponin is 2.8 ng/mL. A chest radiograph reveals Kerley B lines. After administration of oxygen, aspirin, carvedilol, and furosemide, the patient improves. The next troponin is 3.9 ng/mL. Upon further discussion with the consulting cardiologist and neurologist, a heparin infusion is started. After transfer to a general medicine ward floor 4 days later, the patient complains of a headache. The patient's laboratory results are notable for the following:

Hemoglobin: 11 g/dL
Hematocrit: 36%
Leukocyte count: 11,000 /mm^3 with normal differential
Platelet count: 130,000 /mm^3

On admission, the patient's platelet count was 300,000/mm^3. What medication is most appropriate at this time?