Background: Contrast-induced nephropathy (CIN) is characterised by a rise in serum creatinine of at least 0.5mg/dL or a relative increase of more than 25% from admission baseline to 48-72 hours after intravascular iodinated contrast media exposure. The aim of this study was to evaluate the predictive value of the PRECISE DAPT score for the development of contrast induced nephropathy (CIN) in acute coronary syndrome patients undergoing percutaneous coronary intervention (PCI) and compare its predictive power to the Mehran score. Methods: One hundred patients with acute coronary syndrome had percutaneous coronary intervention at Zagazig University Hospitals and Nasr City health Insurance as part of this prospective observational cohort study. Of the included 100 acute coronary syndrome patients, 13 has developed contrast induced nephropathy and 87 didn't develop CIN. Results: Mehran score has 76.9% sensitivity , 64.4% specificity, and 70.65% accuracy at a cutoff value >6, making it a significant predictor of the development of CIN (AUC: 0.746, p <0.001). The AUC of 0.929, p <0.001, indicates that the Precise-DAPT score is a significant predictor of the development of CIN. With cutoff value greater than 23, the score has 92.3% sensitivity, 83.9% specificity, and 88.1% accuracy. Compared to the Mehran score, the precise-DAPT score is a more reliable indicator of CIN (difference between both AUCs = 0.183, p = 0.005). Conclusion: In addition to early CIN prediction, PRECISE-DAPT may be helpful in selecting treatment approaches.