Currently, the choice of anti-platelet therapeutics in clinical practice is fairly limited to irreversible COX-1 inhibitor aspirin (ASA) for primary prevention of cardiovascular disease and dual anti-platelet therapy (ASA in combination with reversible (ticagrelor, cangrelor) and irreversible (clopidogrel, prasugrel) inhibitors of P2Y12) for secondary prevention of recurrent thrombotic events following acute coronary syndrome (ACS) or in patients with coronary stent implantation. This evidence concerns the gene P2RY12 and acute coronary syndrome.