Abstract The features of the progression of carotid bed atherosclerosis were investigated in patients with stable coronary heart disease (CHD) after coronary artery bypass grafting (CABG). Material and methods. Seventy-four patients with CHD who had undergone on-pump (n=39) and off-pump (n=35) CABG. All the patients had carotid bed atherosclerotic lesions preoperatively and/or a new lesion in the long-term follow-up (the mean follow-up period was 62.4±8.0 months). All the patients had varying degrees of carotid bed atherosclerotic lesion in the preoperative period and/or a new lesion occurred in the long-term follow-up period. The patients’ mean age was 60.9±5.2 years; the mean follow-up period was 62.4±8 months. The criteria for progressive atherosclerosis were the appearance of de novo atherosclerotic plaques (ASPs) or an intima-media thickness of 0.5 mm or more, as well as an increasing degree of stenosis of the pre-existing ASP. Results. The investigators revealed the following important factors as possible causes of progressive atherosclerotic lesions in the extracranial segment of the brachiocephalic arteries: smoking addiction (p=0.04), diabetes mellitus (DM) with elevated glycated hemoglobin (more than 7.5%; p=0.04), the high values of high-sensitivity C-reactive protein (at least 16.0 mg/l; p<0.05) and endothelial dysfunction markers (matrix metalloproteinase-9 (at least 230.0 ng/ml; p=0.001), the hypoechoic type of internal carotid arterial ASP (Type II; p=0.04; Type IV; p=0.003). On-pump CABG also identified myocardial revascularization as a possible risk factor for pro-inflammatory reactions that could trigger the progression of carotid bed atherosclerosis (p<0.05). Conclusion. The progression of carotid bed atherosclerosis in patients after CABG depended on the following factors: concomitant insufficiently compensated DM, a higher level of inflammatory biomarkers, and the presence of hypoechoic internal carotid arterial plaques.