ABSTRACT Background: Myocardial infarction (MI) has an annual incidence rate of 600 occurrences per 100,000 people and affects over 1.5 million people. This study aimed to assess the major adverse cardiac events (MACE) in patients presenting with acute myocardial infarction (AMI). Patients and methods: A cohort study involved 180 patients with acute myocardial infarction attended to the coronary care unit at Department of Cardiology Zagazig University Hospitals and National Heart Institute. Patients were divided into: Group I: 155 patients with no MACE and Group II: 25 patients with MACE. All patients were subjected to full history taking, clinical examination and laboratory investigation. CHADS-VASc and GRACE scores were performed. Results: The mean age of the current study population was 56.2 (SD 9.9) years, 76.7% of them were males. The mean BMI was 27.9 (SD 3.1) kg/m2. About 56.1% of patients were smokers and 45% were hypertensives. CHADs-VASc score of the current study patients was ranging from 0 to 4. The mean GRACE score was 135 (SD 23) ranging from 64 to 187. GRACE score was 0-108 in 12.8%, 109-140 in 50.6% and > 140 in 36.7% of the studied patients. Death occurred in 3.3% of patients. Among the current study patients 2.2%, 2.2%, 3.3% and 3.9% had stroke, stent thrombosis, MI and heart failure, respectively. Conclusion: CHA2DS2-VASc and GRACE scores are simple and easily calculated scores that provides an additional consideration in predicting of MACE in patients with AMI. Keywords: MACE, CHA2DS2-VASc Score, MI, GRACE Score, Zagazig University Hospitals, National Heart