Acute coronary syndromes (ACS) without ST elevation (which include unstable angina [UA] and non ST elevation MI [NSTEMI]) are caused by dynamic changes in the atherosclerotic plaque and coronary blood flow. To determine characteristics, in-hospital outcome and management of patients with ACS without ST elevation. The total of 502 patients were enrolled. Inclusion criteria were: rest angina within the last 24 hours, ST-segment deviation (>0,05 mV), T-wave inversion (>0,1 mV) in at least two leads, positive serum cardiac markers. There were 63,3% of patients with Braunwald's IIIB UA and 6,8% with IIIC UA, 29,9% of patients were diagnosed with NSTEMI. All patients were diagnosed invasively with subsequent revascularization (PCI-73,1% or CABG-16,7%) if apprioppriate. 1,6% of patients underwent PCI and elective CABG and 16,7% of patients were treated conservatively. Overall mortality was 2,98%--PCI subgroup (N = 367) 1,36%, CABG subgroup (N = 84) 8,33% and conservative subgroup (N = 43) 6,07%. Non-fatal myocardial infarction (MI) complicated the hospital course in 0,99%, 0,27%, 3,57%, and 2,32% of patients respectively. 1,4%, 0,54%, 6% and 0% of patients respectively had fatal MI. Early invasive strategy in patients with ACS without ST elevation is efficacious method of treatment.