Objective To compare the prognostic value of clinical risk score and thrombolysis in myocardial infarction(TIMI)flow grade alone or combined on outcome of acute coronary syndrome(ACS).Methods A total of 206 eligible patients [135 males,mean age(67.57±9.88)years]were enrolled.The primary endpoints included cardiac death and non-cardiac death.The score,TIMI flow grade and combined risk score(all P＞0.05)for AUC and for primary end point and the secondary end point.Conclusion The result from this study suggests that the efficacy of predicting the total events based on clinical risk score,TIMI flow grade and combined risk score was similar.secondary endpoints included non-fatal stroke,reinfarction,heart failure and recurrent angiha.Receiver operating characteristic curve(ROC) established by using different endpoints and clinical risk score,TIMI flow grade or combined risk scores.The prognostic value for different endpoint expressed as the area under the curve(AUC).Results Eleven patients lost during the(11.41±5.33)months follow up and data were available for 195 patients,8 patients reached the primary endpoints,and 17 patients reached the secondary end-points at the end of follow up.The AUC was 0.67(95% CI=0.557～0.786),P=0.006;0.68(95% CI,=0.557～0.786),P=0.004 and 0.730(95% CI=0.691～0.815),P＜0.001,respectively for clinical risk score,TIMI flow grade and the combined risk score respectively.There were no significant differences among clinical risk score,TIMI flow grade and combined risk(all P>0.05)for ACU and for primaty end point and the secondary end point. Conclusion The result from this study suggests that the eppicacy of predicting the total events based on clinical risk score,TIMI flow grade and combined risk score was similar.