Aim To study the characteristics of aspirin and clopidogrel pharmacogenomic testing results in Chinese patients, and to evaluate the clinical application using this technology as an individualized medication guidance after coronary artery bypass grafting. Methods Eight hundred fourty six patients who underwent coronary artery bypass grafting were included. All patients underwent preoperative aspirin and clopidogrel gene detection. The characteristics of the two drugs' testing results were counted respectively. Postoperative individualized antiplatelet therapy was implemented according to the genetic testing results and the evidence-based suggestions. The postoperative inpatients' arterial thrombosis events and the hemorrhage rate associated with antiplatelet drugs application were analyzed. The thrombelastogram (TEG) was used to verify the antiplatelet efficacy randomly. Results The platelet endothelial aggregation receptor 1 (PEAR1) gene was detected for patients with aspirin medication, including 321 cases of wild type (GG) (37.9%), 407 cases of heterozygous mutation (GA) (48.1%), and 118 cases of homozygous mutation (AA) (14%). The aluminium,magnesium and aspinin tablets (Ⅱ) (114 mg/ day) for antiplatelet therapy was applied for the wild type patients over 70 years old, or with a history of peptic ulcer or subtotal gastrectomy. For the remaining patients, aspirin enteric-coated tablets with routine dose (100 mg/ day) was used. Clopidogrel's detected genes were CYP2C19 and PON1. The genotype combination of GG+GG, GG+GA and GA+GG indicates a good response to clopidogrel or a low risk of resistance. Such patients, a total of 429 cases (50.7%), were given a conventional dose of clopidogrel (75 mg/day). On the contrary, genotype combination of AA+AA, AA+GA, AA+GG, GA+AA, GA+GA and GG+AA indicates a high risk of clopidogrel genetic resistance. For these patients, a total of 417 cases (49.3%), the dose of clopidogrel for antiplatelet therapy should increase at least by 50%～70%. Ticagrelor 180 mg/day (two doses) was used for those that were not suitable. In the postoperative hospital-stay period, there were 4 cases of myocardial infarction, 3 cases of cerebral infarction, and 3 cases of bleeding associated with antiplatelet drugs (2 cases of epistaxis and 1 case of gingival bleeding). There were 109 cases received the platelet function test of TEG on 3～5 days after oral antiplatelet therapy randomly. The inhibition rate of AA was (63.48±8.85)%; the inhibition rate of ADP was (53.43±14.10)%; and the MAADP value was 36.67±6.25 mm.Conclusions For the dual antiplatelet therapy after coronary artery bypass grafting, single center results showed that Chinese people had high probability of clopidogrel gene resistance. Gene detection technology has important reference value in the selection of clopidogrel and ticagrelor. For patients with high risk factors for gastrointestinal bleeding, the results of aspirin gene detection can be used as an important basis for drug reduction.