The work specifies a combined histological, histochemical, histoenzymochemical and morphometric study of the relatively intact and affected by the atherosclerosis coronary arteries in 94 patients with ischemic heart
disease. The structural and functional condition of cellular elements and extracellular matrix was studied, as well as the level of the local cellular mechanisms of protective reaction at early stages of atherogenesis. The provided data indirectly prove the relation of the immune inflammation with atherogenesis. The pathological changes of the coronary arteries depended on the significance of the inflammatory reaction. The work specifies the possibility of preventing key mechanisms of the early atherosclerosis with systemic enzyme therapy.