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Aim. To assess the implementation of international guidelines on coronary heart disease (CHD) treatment and secondary prevention into Russian clinical practice, by examining Moscow- population patients with myocardial infarction (MI). Material and methods. Five thousand out-patient medical cards of the individuals, who attended the Moscow City Cardiology Dispanser in 2001, were randomly selected. Among them, 623 patients had MI in anamnesis. According to medical documents data, the prevalence of CHD risk factors (RF), drug therapy administered, invasive CHD diagnostics and treatment, and CHD secondary prevention advice, were analyzed. Results. Among Moscow physicians, inadequate awareness on CHD RF was observed. International guidelines were not followed: in particular, under-treatment with statins, antiplatelet agents, effective doses of antihypertensives, as well as over-treatment with first-generation calcium antagonists, were registered. Invasive CHD diagnostics and treatment were still used rarely, comparing to developed countries in Europe and worldwide. Conclusion. In the area of CHD secondary prevention for MI patients, a huge gap between international guidelines and actual clinical practice was observed.