Objective - The objective of this study was to compare the clinical management of acute coronary syndromes (ACS) in 2016 with that in 2006 and to estimate the impact of these changes on 1-year mortality by calculating the prevention fraction (PF). Methods - The study included patients treated in 2006 and 2016 for an incident ACS in the three regions monitored by the French ACS registries. The PFR of the treatments was estimated. Results - The study included 2,023 patients in 2006 and 1,173 in 2016. In the acute phase, the rates of angioplasty, prescribing of new-generation antiplatelet agents, and statins increased over 10 years. Following a STEMI (ST-Segment Elevation Myocardial Infarction) episode, the prevalence of angioplasties with drug-eluting stent placement rose from 10% to 59% (+49%), and that of antiplatelet agents increased from 86% to 98% (+12%). Following a NSTEMI (Non-ST-Segment Elevation Myocardial Infarction) episode, the prevalence of angioplasties with drug-eluting stents increased during the period from 19% to 45% (+26%), and that of antiplatelet agents from 62% to 95% (+33%). At hospital discharge, prescription rates, which were already high in 2006, increased only slightly, with the exception of functional rehabilitation (+14% following an STEMI ACS). The prescription rate for antiplatelet agents increased from 57% to 78% in 2016 compared to 2006 following an ACS with STEMI, due to their beneficial effects on mortality. One-year mortality remained stable, at around 11%. Conclusion - Prescription rates for the main treatments increased in 2016 compared to 2006, without a notable benefit on 1-year mortality.