OBJECTIVE: To investigate the effects of bivalirudin on the disorders of coronary microcirculation as compared with heparin sodium, and to observe the function of bivalirudin responsive gene HIF-1α in myocardial cells. STUDY DESIGN: Detection of activated clotting time (ACT) was employed in a rat model. HIF-1α mRNA and protein levels in myocardial cells were determined by qRT-PCR and Western blotting. MTT assay was employed to monitor the proliferation of myocardial cells. SPSS version 13.0 was used for statistical analyses. RESULTS: Bivalirudin decreased the incidence of myocardial injury in patients and prolonged ACT in rats. It reduced coronary microcirculation obstruction. Bivalirudin induced HIF-1α in myocardial cells, and HIF-1α enhanced the proliferation of myocardial cells. CONCLUSION: Appropriate manipulation of bivalirudin may be a better treatment for the disorders of coronary microcirculation. © Science Printers and Publishers, Inc.