Safety of routine protamine in the reversal of heparin in percutaneous coronary intervention: A systematic review and meta-analysis

•Protamine is not routinely used in percutaneous coronary intervention.•There is a perceived risk of stent thrombosis in protamine use, deterring its use.•Routine protamine use in percutaneous coronary intervention is not associated with an increased risk of stent thrombosis nor mortality.•Protamine use in percutaneous coronary intervention is associated with fewer bleeding complications.•Protamine use in percutaneous coronary intervention is associated with shorter hospitalizations.