Evidence for genetic polymophisms may contribute to the dependence on sex and age differences in biochemical phenotypes, clinical manifestation, severity and success in medical treatment of coronary artery disease (CAD) comes from a variety of studies. Two genetic polymorphisms, L55M and Q192R, in the human antioxidant system paraoxonase 1 gene (PON1) have been shown to be associated with increased risk of CAD. The aim of recent study was to investigate a possible association between polymorphic variants of PON1 and CAD in patients of different age and sex. The group of patients with CAD (323 men and 71 women) and the group of healthy (114 men and 84 women) randomly sampled from St Petersburg were investigated clinically, biochemically and genetically. We found out the genotype L55M and Q192R frequencies in the group of patients with CAD were different depending on sex and age (p = 0,057, p = 0,007). In women with CAD the frequency of 55MM genotype (ОR = 2,1311, 95 % CI 1,14-3,98) was significantly higher and the frequency of 192QR genotype (ОR = 0,59, 95 % CI 0,39-0,89) was significantly lower than in men with CAD who survived myocardial infarction (MI) under the age of 45. Our results suggest that both PON1 polymorphisms play the role in risk of CAD. Furthermore, PON1 polymorphisms act in various ways in patients of different age and sex.