The aim of the study was to investigate modern approaches to risk assessment in patients with acute coronary syndrome, based on the analysis of literature data of Russian and foreign authors, clinical guidelines. Material and methods. Analysis of literature in databases: Scopus, PubMed, CyberLeninka, etc. over the last 15 years is made. Results. The modern scales and markers allowing to estimate the prognosis of patients with acute coronary syndrome with the characteristic of each of them are described based on the literature review. For convenient use in practice, the presented models are divided into two groups, taking into account the assessment of the prognosis for the nearest and remote periods from the onset of the disease. The urgency of searching for a universal model of prognosis assessment in patients with acute coronary syndrome is indicated.