OBJECTIVES: This analysis aims to explore management of acute coronary syndromes (ACS) from acute event to hospital discharge in France. METHODS: This 12-month prospective, observational study recruited ACS patients undergoing percutaneous coronary intervention (PCI), January-August 2007, capturing practice patterns, resource use and quality of life. In France, all interventional cardiologists were invited to participate. RESULTS: 497 ACS-PCI patients (483 analyzed), enrolled by 59 interventional cardiologists from public university hospitals-36%, public non-university hospitals-45%, and private hospitals-19%, were: mean age 60.9+/-12.8, mean weight 79.7kg+/-14.8, 18% female, 16% diabetics and 12% prior myocardial infarction (MI). Index diagnosis was: unstable angina or non-ST-elevation MI (UA/NSTEMI)-53% and ST-elevation MI (STEMI)-47%. Almost all patients (96%) were implanted stents: 67% bare metal stents (BMS), 23% drug eluting stents (DES) and 11% both. Antiplatelet loading oral medications used were aspirin-91% and clopidogrel-95% (no use of ticlopidine). Antithrombotic agents were infused too: abciximab-16%, tirofiban-18%. eptifibatide-3%, and bivalirudin-3%. Clopidogrel loading dose (LD) was given in intensive care unit-32%, emergency room-24%, ambulance-21%, previous hospital-12%, catheter lab-6% and other ward-4%, and close to PCI (previous 6 hours, during or after) in 46% of cases. Total clopidogrel loading dose was over 300 mg in 34% of cases, and in-hospital maintenance dose (MD) was 150 mg in 26%, and 75 mg in 74% of cases. At time of hospital discharge, 96% of patients were receiving clopidogrel (discharge dose 150 mg in 23%) and EQ-5D QoL score was a median 0.85 (IQR 0.73-1.00). CONCLUSIONS: These data reflect contemporary real-life management of ACS patients in France. DES are implanted 3 times less than BMS. Variation in oral antiplatelet agent dosing pattern (LD and MD) and timing of administration is frequent.