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TIMI Risk Score for UA/NSTEMI

The Thrombolysis in Myocardial Infarction (TIMI) Risk Score estimates the 14-day risk of all-cause mortality, new or recurrent MI, or severe recurrent ischemia requiring urgent revascularization in patients with UA/NSTEMI.

Risk Criteria

Select all that apply (+1 point each)

Result

TIMI Risk Score

0/ 7
Low Risk
5-8% Risk of Event*

*14-day risk of all-cause mortality, new or recurrent MI, or severe recurrent ischemia requiring urgent revascularization.

Clinical Significance

  • Low Risk (0-2): Consider early conservative strategy or discharge from ED with follow-up.
  • Intermediate Risk (3-4): Observe, consider early invasive strategy depending on other factors.
  • High Risk (5-7): Benefit from early invasive strategy (catheterization) and aggressive medical management (e.g., GP IIb/IIIa inhibitors, LMWH).
  • Source: Antman EM et al. (2000)

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.

Disclaimer: This tool is intended for educational and reference purposes only. It should not be used as a substitute for professional medical judgment. Always follow your institution's protocols and clinical guidelines.