Abstract Background : Coronary heart disease (CHD) mortality rates have decreased in most countries but increased in low and middle-income countries. Few studies have analyzed CHD mortality trends in Latin America, specifically trends in young-adults and the effect of correcting these comparisons for nonspecific causes of death (garbage codes).Objective: To describe and compare standardized, age-specific, and garbage-code corrected mortality trends for CHD from 1985 to 2015 in Argentina, Colombia and Mexico. Methods: CHD deaths were grouped by country, year of registration, sex and 10-year age bands to calculate age-adjusted and age and sex specific rates for adults aged ≥25. We corrected for garbage-codes using the Global Burden of Disease methodology. Finally, we fitted Joinpoint regression models.Results: In 1985, age-standardized mortality rates per 100,000 were 136.6 in Argentina, 160.6 in Colombia and 87.51 in Mexico. Compared to 2015, mortality fell in Argentina and Colombia (51% and 6.5% respectively) and increased by 61% in Mexico. The steepest decline was observed in Argentinian women, and the sharpest increment in Mexican men. There has been an upward trend in young Mexicans since 1985. Garbage-code corrections produced increases in mortality rates, particularly in Argentina: approximately 80 additional deaths per 100,000 (14 in Colombia and 13 in Mexico). Conclusions: Latin American countries are at different stages of the epidemic. The disease burdens are bigger after correcting for misclassification. Although CHD mortality is falling in Argentina, the modest falls in Colombia and substantial rises in Mexico highlight the region’s need for effective, population-wide prevention policies.