About the TIMI Score for UA/NSTEMI
The TIMI (Thrombolysis In Myocardial Infarction) risk score for unstable angina and non-ST elevation myocardial infarction is a bedside clinical score published by Antman and colleagues in 2000. It converts seven readily available pieces of history, exam, ECG, and lab data into a single integer from 0 to 7 that tracks the short-term risk of death, myocardial infarction, or the need for urgent revascularization.
How the score is built
Each of the following criteria contributes exactly 1 point when present, and 0 points when absent, with no weighting between them:
- Age 65 or older.
- Three or more coronary artery disease risk factors: family history of CAD, hypertension, high cholesterol, diabetes, or current smoking.
- Known coronary artery disease: a prior coronary stenosis of 50 percent or more.
- Aspirin use in the prior 7 days.
- Severe angina: two or more anginal episodes in the preceding 24 hours.
- ST-segment deviation of 0.5 mm or more on the presenting electrocardiogram.
- Elevated cardiac biomarkers, such as troponin or CK-MB.
Adding the seven point values gives the TIMI score, a whole number from 0 to 7.
Interpreting the result
In the original derivation cohort, the 14-day rate of death, myocardial infarction, or urgent revascularization rose with the score: about 4.7% at 0-1 points, 8.3% at 2, 13.2% at 3, 19.9% at 4, 26.2% at 5, and 40.9% at 6-7. Scores are often grouped into low risk (0-2), intermediate risk (3-4), and high risk (5-7) bands to support decisions about the intensity and timing of treatment.
When to consult a professional
This tool performs the standard TIMI UA/NSTEMI point count for education and reference. It is not a diagnosis and does not by itself direct treatment. Any decision about admission, monitoring, or invasive management should be made by the treating clinician, who weighs the score alongside the full clinical picture.