TIMI Risk Score for UA/NSTEMI

About the TIMI Risk Score

Derived from the TIMI 11B trial, this risk stratification tool helps clinicians determine the appropriate management strategy for patients presenting with Unstable Angina (UA) or Non-ST Elevation Myocardial Infarction (NSTEMI).

Scoring Criteria

The score assigns 1 point for each of the following independent predictors:

• Age ≥ 65 years
• ≥ 3 CAD Risk Factors (Hypertension, Hyperlipidemia, Diabetes, Smoker, Family History)
• Known CAD (Stenosis ≥ 50%)
• Aspirin use in past 7 days
• Severe angina (≥ 2 episodes in 24 hrs)
• EKG ST changes ≥ 0.5mm
• Positive cardiac markers

Interpretation & Management

Higher scores correlate with increased risk of adverse events.

• Low Risk (0-2): 5-8% event rate. May be candidates for early discharge or stress testing.
• Intermediate Risk (3-4): 13-20% event rate. Generally admitted for observation and risk stratification.
• High Risk (5-7): 26-41% event rate. Strong benefit from early invasive strategy (angiography within 24-48h) and aggressive antiplatelet/antithrombotic therapy.