What is the TIMI Risk Score?
The TIMI (Thrombolysis in Myocardial Infarction) Risk Score for unstable angina/NSTEMI estimates short-term risk using seven equally-weighted clinical variables, deliberately kept simple enough to calculate at the bedside without a calculator. It was derived and validated by Antman and colleagues and published in JAMA in 2000. A separate TIMI score exists for STEMI risk stratification, using different criteria — this calculator is the UA/NSTEMI version.
How to calculate the TIMI Score
Seven criteria, each worth one point:
- Age ≥65
- ≥3 risk factors for coronary artery disease
- Known CAD (stenosis ≥50% on prior angiography)
- Aspirin use in the past 7 days
- Severe angina (≥2 episodes in 24 hours)
- ST changes ≥0.5mm on presenting ECG
- Elevated cardiac biomarkers
Interpretation
| Score | 14-day risk of death/MI/urgent revascularization |
|---|---|
| 0–1 | ~4.7% |
| 2 | ~8.3% |
| 3 | ~13.2% |
| 4 | ~19.9% |
| 5 | ~26.2% |
| 6–7 | ~40.9% |
Higher scores generally support an earlier invasive strategy and more intensive antiplatelet/anticoagulant therapy, per local ACS protocols.
References
Antman EM, Cohen M, Bernink PJ, et al. The TIMI risk score for unstable angina/non-ST elevation MI: a method for prognostication and therapeutic decision making. JAMA. 2000.
See also: ECG Interpretation Basics & STEMI Criteria.