P2RY12 and Hyperglycemia: Patients with diabetes have had a more than 2-fold risk of coronary heart disease and stroke, and other vascular cause death.[11,12] Several mechanisms are demonstrated the prothrombotic state of diabetes; diabetes induces the platelet dysfunction by hyperglycemia, insulin resistance, upregulation of GP IIb/IIIa expression, P2Y12 signaling, increased platelet turnover, and excessive oxidative stress.[13–15] Therefore, acute coronary syndrome (ACS) patients with diabetes have a high thrombotic risk and need antiplatelet combination strategies involves pathways TXA2 and ADP-P2Y12.