Clinical Resources

TIMI Risk Score

UA/NSTEMI — 14-Day Risk of Death, MI, or Urgent Revascularization

Check all criteria that apply. Score ranges from 0–7; higher scores indicate greater 14-day risk of adverse events.

Age ≥ 65 years

≥ 3 CAD risk factors

Family history of CAD · hypertension · hypercholesterolemia · diabetes · active smoker

Prior coronary stenosis ≥ 50%

Known CAD on prior angiography or prior revascularization (PCI or CABG)

ST-segment deviation on presenting ECG

≥ 0.5 mm of ST depression or transient ST elevation

≥ 2 anginal events in prior 24 hours

At least 2 episodes of chest pain/pressure at rest or with minimal exertion in the 24 hours before presentation

Aspirin use in prior 7 days

Suggests aspirin-resistant or refractory ischemia — associated with higher risk

Elevated serum cardiac markers

Troponin I or T, or CK-MB above the 99th percentile upper reference limit

TIMI Score

14-day event risk

0 / 7

Score	Risk	Event Rate	Strategy
0 – 1	Low	~4.7%	Conservative; early stress testing
2	Low	~8.3%	Conservative; early stress testing
3	Intermediate	~13.2%	Consider early invasive strategy
4	Intermediate	~19.9%	Early invasive strategy recommended
5	High	~26.2%	Urgent invasive strategy
6 – 7	Very High	~40.9%	Urgent invasive strategy + dual antiplatelet / anticoagulation

Score Interpretation

Low (0–2): Conservative management appropriate; stress testing before discharge.
Intermediate (3–4): Early invasive strategy (coronary angiography within 24–48 h) recommended.
High (5–7): Urgent invasive strategy. Benefit of GP IIb/IIIa inhibitors and LMWH is greatest at high scores.

Validated in UA/NSTEMI only — not applicable to STEMI. Event rates from the original TIMI 11B derivation cohort. Clinical judgment should always supersede the score.

Reference

Antman EM et al. (2000) — The TIMI Risk Score for Unstable Angina/Non–ST Elevation MI: A Method for Prognostication and Therapeutic Decision Making. JAMA. 284(7):835–842.

TIMI Risk Score

14-Day Risk Assessment

Score Interpretation

Reference