Numerous teams are trying to find a genetic determination of individuals with high risk of myocardial infarction. Originally more attention was paid to candidate genes of atherosclerosis risk factors -hypercholesterolemia and hypertension. Out of several hundreds of potential genes involved, only effect of polymorphism of apolipoprotein E was reproduced in different settings and populations. Attention was focused to genes involved in monocyte behavior, arterial wall metabolism, and thromboembolic process more recently. Still the significant effect of few genes is low (OR 1.2-1.7), and in addition reproducibility is very low. Genome-wide scan has been used recently and most discriminative part was identified in chromosome 9 (but without any known protein function). Low reproducibility in different projects is probably related to low number of cases and controls. On the other hand, project with several thousands of individuals in compared groups suffered from inadequate characteristics of individuals, and gene environment interaction might also have substantial effect in reproducibility. Participation of high number of candidate genes with very small or negligible effect is supposed.