Aim To explore the influence factors of high on-treatment platelet reactivity after coronary artery bypass grafting. Methods From May 2015 to May 2016, ninety patients accordance with the inclusion criteria were enrolled in this study, and were treated with aspirin enteric-coated tablets and clopidogrel tablets double antiplatelet in combination with thrombelastogram (TEG) detection. Archives were established by consulting the case system and followed-up for 1 year. The status of ischemic events and bleeding events had been recorded by telephone during the follow-up period.The patients were divided into high on-treatment platelet reactivity (HTPR) group and normal on-treatment platelet reactivity (NTPR) group. The collected data were analyzed to evaluate the correlation between TEG detected high on-treatment platelet reactivity and some factors in patients with coronary artery bypass grafting. Results Age, uric acid, alanine aminotransferase, aspartate aminotransferase, intraoperative blood transfusion, 24 h drainage, duration of operation, postoperative TEG (blood clotting K, blood clot strength MA_thrombin, coagulation syndrome CI, blood clot strength MAADP) were statistically different (P＜0.05). Multivariate Logistic regression analysis showed that uric acid elevation was positively correlated with occurrence of HTPR (OR＝1.1,5%CI was 1.003～1.019, P＜0.05). Conclusion Serum uric acid level may be a causal risk factor for a low response to anti-platelet drugs.