Synergy model gives nurses a common language for a definition and relation between patients and nurse's needs, so patient with acute coronary syndrome need immediate nurses knowledge in coronary care unit. Aim: the aim of this study is to investigate the impact of Synergy model application on patients with Acute Coronary Syndrome outcomes. Design: a quasi-experimental research design is used in this study. Setting: This study was carried out in the coronary care unit at Sohage University Hospital. Subjects: Sixty critically ill adult patients who are admitted to the previously mentioned setting, and 12 (twelve) number of nurses in coronary care unit. Tool: Synergy model tool which include two parts, Part I: Patients’ characteristics, (Stability, Resiliency and Resource availability ) Part two: Nurse-Competence (Advocacy moral agency, Caring practice and Clinical judgment). Results: Findings of the current study revealed statistical significance deference in both patient's needs and nurse's knowledge according to Synergy model for level I, level 3, level 5 which determine quality of nurses and the behavior toward the patient. In this study there are highly statistical significance different according to patients needs and nurses knowledge With (P=0.000*), (0.004)*. Conclusion: The synergy model outlines that when patients’ characteristics and nurses competencies synergize, optimal patient outcomes are achieved. As the patient is primary focus, optimal outcomes are defined as what patients themselves acknowledged as important.