Abstract: AIM The study was performed to compare the predictive value between thrombolysis in myocardial infarction (TIMI) scores and global registry for acute coronary events (GRACE) scores in patients with ST-Elevation Myocardial Infarction (STEMI). METHODS 280 consecutive STEMI patients who had undergone percutaneous coronary intervention (PCI) were enrolled in the current study. According to the two scores system, the patients were divided into low risk, moderate risk, and high risk groups, respectively. All the patients were followed up for 12 months to learn the major adverse cardiac events (MACE) rate. The receiver operating characteristic (ROC) curve was depicted for the two score system to evaluate and to compare the predictive capability. RESULTS The patients with high risk group of GRACE and TIMI scores had higher incidence of MACE at 12 months (P<0.01). Moreover, the high risk group of TIMI score had significantly higher incidence of MACE than that in high risk group of GRACE score (P<0.05). However, there was no significant difference between the area under ROC of GRACE score and TIMI score. The GRACE score predicted MACE with the sensitivity of 87%, specificity of 58% and Youden index of 0.45. The TIMI score had the sensitivity of 54%, the specificity of 90%and the Youden index of 0.44. Compared with TIMI score, GRACE score had higher sensitivity (87% vs. 54%, P<0.01) and lower specificity (58% vs. 90%, P<0.01). There were no difference in the Youden index (0.45 vs. 0.44) between the two groups. CONCLUSION The two risk scores show similar predictive capacity of MACE for the overall patient cohort at 12 months. GRACE score has a high sensitivity, while TIMI score has a high specificity.