OBJECTIVES: The aim of this study was to design a pilot study on pharmacoeconomic evaluation of the acute coronary syndromes therapy in the coronary care unit in Slovakia. METHODS: Literature review, design of criteria needed for patients selection on pharmacoeconomical analysis according to CURE study, retrospective “cost – effectiveness” analysis on acute coronary syndromes therapy. Study was set-in coronary care unit in internal medicine department of a university hospital. Main outcome measures was comparison pharmacotherapy with ESC Guidelines, in hospital costs evaluation. RESULTS: All patients of the 1st phase of the study with acute coronary syndromes diagnosis without ST-segment elevation (n = 15, age 60 ± 16,5 years) were treated following ECS Guidelines during hospitalization (ASA 86.6%; heparin or low molecular weight heparin 100%; ACE inhibitor 73.5%; beta-blocker 85%; calcium-channel blocker 93%; lipid-lowering agent 85%, intravenous nitrate 100%). Their pre-hospitalization medical history was hypertension (73.3%), diabetes (40%) and smoking (40%), myocardial infarction (20%). In-hospital costs were €1515 per 1 patient, including pharmacotherapy €60.5, interventions and investigations €1320.6 and overhead charges €133. Average length of stay in the hospital was 8.2 days. Subanalysis of evaluation showed higher hospitalization costs in women group (non-significant because of small number of patients). Post-hospitalization therapy was not observed and evaluated. CONCLUSION: The analysis showed: 1. Patients with acute coronary syndromes diagnosis were treated following ECS Guidelines in hospital; 2. The most financial resources were used for medical interventions and investigations; 3. The pilot pharmacoeconomical analysis study of the acute coronary syndromes showed the need of following studies they can compare using of various molecules and their effect on post-hospitalization quality of life.