Aim. Evaluation of the associations of allele variant of gene VEGFR2 rs2305948 with atherosclerotic lesion of coronary arteries in acute coronary syndrome (ACS) patients in the North (Surgut city) and big cities of the Siberian Federal District (SFD) (Novosibirsk, Irkutsk, Kemerovo). Material and methods. Totally, 258 consecutive ACS patients investigated, at admission to cardiological in-patient clinics of big cities of the North (Surgut, 78 patients) and SFD (180 patients). All patients underwent coronary arteriography and genetic test (the allele variant assessment VEGFR2 rs2305948). Results. In Surgut patients the allele variant VEGFR2*CC is directly linked with the lesion of proximal and intermediate part of three main arteries >70% (PTA) (χ2 = 4,68; p=0,031), PTA and left main stem stenosis >50% (χ2 = 7,02; p=0,008), and in patients from SFD VEGFR2 *CT + *TT is directly associated with hypercholesterolemia (HC) (χ2 = 8,53; p=0,003). Combination of allele variant VEGFR2*CC with HC directly influences PTA of stem stenosis >50% in ACS patients in Surgut (Exp (B) =4,441; 95% CI (1,351; 14,601); p=0,014). Combination of allele variant VEGFR2*CC with HC directly influences stenosis >70% existence in at least three coronary arteries, in Surgut patients (Exp (B): 3,697; 95% CI (1,304; 10,486); p=0,014), as in SFD patients Exp (B): 4,460; 95% CI (1,306; 15,236); p=0,017). Conclusion. Allele variant VEGFR2*CC does directly influence the existence of coronary atherosclerosis of various grade severity in patients with ACS in the North, and if combined with VEGFR2*CC and HC is also a risk factor for coronary atherosclerosis not only in the North but in SFD cities as well.