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Background To investigate the possible association between insulin receptor substrate-1 (IRS-1) genotypes and clopidogrel resistance (CR) in Chinese patients with type 2 diabetes mellitus and coronary artery disease.Methods A total of 690 hospitalized patients with type 2 diabetes rnellitus and coronary artery disease in General Hospital of Shenyang command between April 2011 and April 2013 were enrolled.The residual platelet aggregation rate (RPA) induced by 20 μmol/L of adenosine diphosphate (ADP) was detected by optical nephelometry.Clopidogrel resistance was defined by RPA ≥70%.All the participants were divided into CR group and NCR group by RPA.The association between IRS-1 genetic variant and platelet function was assessed in patients with type 2 diabetes mellitus and coronary artery disease.