Aim. To study blood insulin level in patients with coronary heart disease (CHD) with and without metabolic syndrome (MS) and its relation to cardiovascular risk factors. Materials and methods. We examined 127 patients with stable coronary heart disease (mean age 59.4±5.7 yr) including 63 with MS and 64 without it. The control group consisted of 80 practically healthy subjects. Bloods insulin was determined by immunochemoluminescence, glycated hemoglobin (HbA) by immunoturbidimetry, total cholesterol, HDLP cholesterol, and triglycerides by enzymatic colorimetric method, oxidized LDLP, IL-1β, IL-6, and tumour necrosis factor-a by enzyme immunoassay. The degree of depression was estimated using the Zung scale. Results. Blood insulin level in healthy subjects, CHD patients with and without MS was 6.3 (6.20;6.62), 15.5 (13.96, 16.3) and 9.5 (9.2, 10.1) mcIE/ml respectively (p<0.001). HOMA-IR directly correlated with MBI, waist circumference, HbA total cholesterol, triglyceride, oxidized LDLP, IL-1β, IL-6, and tumour necrosis factor-a levels and negatively with the HDLP cholesterol level. Conclusion. In patients with CHD, metabolic syndrome is associated with a set of additional cardiovascular risk factors, viz. hyperinsulinemia, insulin resistance, increased HbA level, dyslipidemia, oxidative modification of LDLP, activation of proinflammatory cytokines, and depressive disorders. Close correlation of HOMA-IR with certain pathogenetic factors of CHD allow to use it as an indicator of cardiovascular risk in patients with CHD and MS.