OBJECTIVES: This analysis aims to explore management of acute coronary syndromes (ACS) from acute event to hospital discharge in Germany, and to measure Quality of Life (QoL) at discharge. METHODS: This 12-month international prospective, observational study recruited ACS patients undergoing percutaneous coronary intervention (PCI), April 2008 – March 2009, capturing practice patterns, resource use and QoL. RESULTS: 500 ACS-PCI patients (out of the 508 recruited) were eligible:  median age 63 yrs (IQR 53-72), median weight 82 kg (IQR 74-92), 23% female, 24% Type II diabetics, and 27% 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%) received stents: 68% bare metal stents (BMS) only, 29% drug eluting stents (DES) only and 3% both. Time from start of ACS symptoms to PCI was 3 days or less   in 91% of UA/NSTEMI patients and 1 day or less  in 97% of STEMI patients. Oral antiplatelet  medications with  loading dose (LD) used: aspirin-86% and clopidogrel-93%. Clopidogrel LD was administered in the ambulance-7%, previous  hospital-8%, emergency room-32%, CCU or ICU-23%, catheterization lab-25%, other ward 5%.  LD was administered just before or direct after PCI in 79% of cases. The  clopidogrel LD was 600 mg in 68% and 300 mg  in 24% of cases and in-hospital maintenance dose (MD) was 75 mg in 98%. At time of hospital discharge, 92% of discharged patients were receiving clopidogrel (discharge dose 75 mg in all cases). QoL in discharged patients was good: median EQ-5D health state index at 0.85 (IQR 0.73-1.00). CONCLUSIONS: These real life data reflect treatment patterns among ACS patients managed by PCI in Germany in 2008-2009. Timing and place of antiplatelet loading differ between patients. The QoL of patients at discharge was high.