Background Clopidogrel is an antiplatelet drug, which requires the efflux pump P-glycoprotein(multidrug resistance-1, MDR1) encoded by the ABCB1 gene for intestinal absorption. However, recent studies evaluating the relationship between ABCB1 genetic polymorphisms and clopidogrel response have shown conflicting results due to both genetic and non-genetic factors. This study aimed to analyze the risk factors of clopidogrel response in a Han Chinese population undergoing percutaneous coronary intervention(PCI). Methods A total of 520 Han Chinese patients with coronary artery disease undergoing planned drug-eluting stent placement and receiving dual-antiplatelet therapy were sequentially recruited and followed up for 1 year. The effects of clinical risk factors and ABCB1 genetic polymorphisms on major adverse cardiovascular events(MACE) within 1 year or bleeding within 6 months after PCI were assessed. Results The patients were comprised of 82% men and 40% smokers. Diabetes, hypertension and low ejection fraction were associated with higher risk of MACE within 1 year after PCI. The hazard ratios [HR] and 95% confidence intervals [CI] were 3.15 [1.46-6.78], 2.78 [1.51-5.10] and0.98[0.95-1.00], respectively. Diabetes and female were also significantly associated with bleeding risk within 6months(odds ratio [OR] [95%CI]: 1.96 [1.11-3.44] and 2.20 [1.20-4.05]. Use of angiotensin-converting enzyme inhibitors(ACEIs) was associated with a low risk of bleeding events(OR [95%CI]: 0.53 [0.31-0.91]). There was no significant impact of ABCB1 c.1236 C>T, ABCB1 c.2677 G>T/A, or ABCB1 c.3435 C>T on the risk of MACE within 1 year or occurrence of bleeding within 6 months after PCI. Conclusions These results suggest a lack of association between ABCB1 genetic variants and adverse cardiovascular outcomes. However, diabetes,hypertension and low ejection fraction are high risk factors of MACE. In addition, diabetes and female are a high risk of bleeding, which can be reduced by use of ACEIs. Background Clopidogrel is an antiplatelet drug, which requires the efflux pump P-glycoprotein (multidrug resistance-1, MDR1) encoded by the ABCB1 gene for intestinal absorption. However, recent studies evaluating the relationship between ABCB1 genetic polymorphisms and clopidogrel response have shown conflicting results Due to both genetic and non-genetic factors. This study aimed to analyze the risk factors of clopidogrel response in a Han Chinese population undergoing percutaneous coronary intervention (PCI). Methods A total of 520 Han Chinese patients with coronary artery disease undergoing planned drug- eluting stent placement and receiving dual-antiplatelet therapy were frequently recruited and followed up for 1 year. The effects of clinical risk factors and ABCB1 genetic polymorphisms on major adverse cardiovascular events (MACE) within 1 year or bleeding within 6 months after PCI were assessed. Results The patients were comprised of 82% men and 40% smokers. Diabetes, hypertension and low ejection fraction were associated with higher risk of MACE within 1 year after PCI. The hazard ratios [HR] and 95% confidence intervals [CI] were 3.15 [1.46-6.78], 2.78 [1.51-5.10] and 0.98 [0.95 -1.00], respectively. Diabetes and female were also significantly associated with bleeding risk within 6months (odds ratio [OR] [95% CI]: 1.96 [1.11-3.44] and 2.20 [1.20-4.05]. Use of angiotensin-converting enzyme inhibitors (ACEIs) was associated with a low risk of bleeding events (OR [95% CI]: 0.53 [0.31-0.91]). There was no significant impact of ABCB1 c.1236 C> T, ABCB1 c.2677 G> T / A, or ABCB1 c.3435 C> T on the risk of MACE within 1 year or occurrence of bleeding within 6 months after PCI. Conclusions These results suggest a lack of association between ABCB1 genetic variants and adverse cardiovascular outcomes. However, diabetes, hypertension and low ejection fraction are high risk factors of MACE. In addition, diabetes and female are a high risk of bleeding, which can be reduced by use of ACEIs.