Objective To systematically evaluate the effectiveness and safety of bivalirudin for the treatment of no⁃reflow/slow⁃flow after percutaneous coronary intervention (PCI). Methods Relevant literature of randomized controlled trials related to bivalirudin for the treatment of no⁃reflow/slow⁃flow after PCI was retrieved from databases such as PubMed, The Cochrane Library, Embase, Web of Science, China Biomedical Literature Service System, Wanfang Data Knowledge Service Platform, and China National Knowledge Infrastructure. After literature screening, data extraction, and quality assessment, Meta⁃analysis was performed by using the RevMan 5.4 and Stata 18 softwares. Results A total of 21 literature was included. The Meta⁃analysis results revealed that compared with the control group, the experimental group exhibited decreased incidence rate of thrombolysis in myocardial infarction (TIMI) flow grade≤2, corrected TIMI frame count, and incidence rate of TIMI myocardial perfusion grade≤2, whereas elevated proportion of electrocardiogram ST⁃segment resolution>70%, left ventricular ejection fraction at 7 days, 1 month, and 3 months after PCI, and reduced major adverse cardiovascular events at 1 and 3 months after surgery (P<0.05). However, no statistically significant difference was observed in myocardial blush grade after PCI between the two groups (P>0.05). Conclusion Bivalirudin is effective for treating no⁃reflow/slow⁃flow after PCI, ameliorating myocardial reperfusion, and reducing the occurrence of major adverse cardiac events.

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