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Background The early detection of high-risk patients with primary percutaneous coronary intervention (PPCI) is important in reducing the risk of death in patients with acute ST elevation myocardial infarction (STEMI).We aimed to compare the prognostic value of validated risk scores for in-hospital and one-year death.Methods This study enrolled a series of patients with acute STEMI who underwent PPCI.Thrombolysis in Myocardial Infarction (TIMI) risk score,Korea Acute Myocardial Infarction Registry (KAMIR) score,Canada Acute Coronary Syndrome (C-ACS) and Age,Glomerular filtration rate,and Ejection Fraction (AGEF) were calculated.The prognostic accuracy of the 4 scores for in-hospital and one-year death was assessed.Results A total of 489 patients with acute STEMI were retrospectively included in the present study.There were 16 (3.3％) patients died while in hospital.AGEF had higher predictive power for in-hospital death than KAMIR score (0.894 vs.0.816,P =0.048) and C-ACS (0.894 vs.0.728,P =0.038).No statistical significance was found when comparing with TIMI risk score (0.894 vs.0.795,P =0.124).There were 33 patients died in 459 (93.9％) included patients completed one-year follow up.The AUC of TIMI risk score,KAMIR score,C-ACS and AGEF in predicting one-year death was 0.728,0.718,0.681 and 0.772,respectively.They had similarly prognostic value for one-year mortality (P ＞ 0.05).Conclusion The AGEF risk scores appear to have slightly better prognostic value for the in-hospital and one-year mortality in patients with acute STEMI receiving PPCI.