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The aim of the study was to investigate the prevalence of 8 haemostatic gene polymorphisms associated with thrombophilia in patients with acute coronary syndrome (ACS) with nonobstructive coronary atherosclerosis (NOCA). Material and methods: Investigation is nonrandomized, open, controlled: NCT02655718. We present the results of patients admitted to the emergency department of cardiology due to ACS in 2015-2016. Inclusion criteria comprised NOCA (normal coronary arteries/plaques <50%), confirmed by invasive coronary angiography, aged over 18 years at the time of randomization. Individuals who had previously undergone coronary artery revascularization were excluded from the study. For 29 patients were analyzed 8 haemostatic gene polymorphisms: F2 (20210 G> A), F5 (1691 G> A), F7 (10976G> A), F13 163 G> T), F1 (-455G> A), GP Ia-IIa (807C> T), GP IIb-IIIa (1565 T> C), PAI-I (-675 5G> 4G).The genotypes were determined by polymerase chain reaction methods. Results: Among 913 patients who were hospitalized with ACS, 44 (4.8%) had NOCA. Including 19 men (66%) and 25 (57%) women, the average age of patients was 54 ± 11 years. Among 29 patients in 28 (96.6%) individuals with NOCA had at least one homozygous or heterozygous for unfavorable alleles genotype of haemostatic system. The homozygous genotype for adverse allelic variants was registered in 13 (44.8%) patients by polymorphic variants of the following genes: FXIII, GP Ia-IIa, GP IIb-IIIa, PAI-1, including 2 unfavorable homozygous genotype for variants of GP IIb-IIIa and PAI-1 genes. One patient (3.4%) had unfavorable heterozygous genotypes according to 5 studied variants predisposing to the development of thrombophilia; seven (24.1%) have heterozygous genotypes of 4 SNP, ten (34.5%) have heterozygous genotypes of 3 SNP, seven (24.1%) have 2 SNPs, two (6.9%) - 2 SNP each; Only two (6.9%) individuals did not have adverse alleles in the heterozygous state. The frequency of registration of homozygous genotypes for alleles predisposing to thromboses for all the studied polymorphic variants in the survey sample is within the limits shown for the european population, and the frequency of heterozygotes registration for variants of the FV, FVII, FXIII, FI gene, it exceeds estimates of heterozygotes prevalence in european population. Conclusion: The proportion of patients with NOCA among patients with ACS in 2015-2016 was 4.8%. The prevalence of adverse allelic variants of clotting factor genes associated with risk of thrombophilia in patients with ACS and NOCA was 96.6%