What is the therapeutic ACT range for heparin during PCI?

• A. 100-200 seconds
• B. 200-250 seconds
• C. 300-350 seconds
• D. 400-450 seconds

Answer: (C)

In PCI, ACT monitoring is used to gauge how much heparin is in the blood so you balance preventing clots with avoiding bleeding. The target ACT is about 300 to 350 seconds because this level provides enough anticoagulation to prevent thrombus formation on catheters and stents without causing excessive bleeding. Values well below this range would leave the patient under-anticoagulated and at risk for catheter- or device-related thrombosis, while values well above it increase bleeding risk without added benefit in most PCI cases. If ACT is below target after the initial heparin bolus, additional dosing can be given to reach the range; if ACT overshoots the target, reversal with protamine can be used to temper the effect.