TIMI Score Calculator for UA/NSTEMI

Created by Aleksandra Zając, MD
Reviewed by Dominik Czernia, PhD and Jack Bowater
Based on research by
Antman EM, Cohen M, Bernink PJ, McCabe CH, Horacek T, Papuchis G, Mautner B, Corbalan R, Radley D, Braunwald E The TIMI risk score for unstable angina/non-ST elevation MI: A method for prognostication and therapeutic decision making JAMA (Aug 2000)See 1 more source
Scirica BM, Cannon CP, Antman EM, Murphy SA, Morrow DA, Sabatine MS, McCabe CH, Gibson CM, Braunwald E Validation of the thrombolysis in myocardial infarction (TIMI) risk score for unstable angina pectoris and non-ST-elevation myocardial infarction in the TIMI III registry The American Journal of Cardiology (Aug 2002)
Last updated: Oct 26, 2022

The TIMI score calculator (Thrombolysis In Myocardial Infarction score calculator) serves as a simple tool to determine the 14 day risk of death or major health complications in patients with UA (Unstable Angina) or NSTEMI (Non-ST-segment Elevation Myocardial Infarct). The TIMI score is intended for use only on those who have three or more manifestations of acute coronary syndrome). For patients with STEMI (ST-segment Elevation Myocardial Infarct), there is another scale designed - TIMI score for STEMI calculator. It contains different TIMI score risk factors.

We try our best to make our Omni Calculators as precise and reliable as possible. However, this tool can never replace a professional doctor's assessment. If any health condition bothers you, consult a physician.

What is the TIMI score?

In an emergency, it's all about evaluating the risk of severe outcomes. Acute coronary syndrome (or ACS for short) is a common disease, contributing massively to hospital admission in the USA and all over the world. Cases of ACS are not equally severe, so, although every patient needs close monitoring, the outcomes vary.

To help doctors spot the patients who are at the highest risk of severe health complications, the TIMI score (Thrombolysis In Myocardial Infarction) was made. The TIMI score is a result of two international, randomized, double-blind trials and was launched in 2000. Since then, it has been validated on thousands of patients in papers (e.g., in this American article) led by the TIMI Study Group. The research has proven that the TIMI score correlates with the risk of the adverse outcome, and is a valuable prognostic tool, and, in addition - a very simple one.

Assessing the TIMI score helps you to find those patients who may benefit from more a aggressive treatment, which implies, e.g., a need for transport to a more specialized hospital or ward.

Using the TIMI risk score calculator

Using the calculator is extremely simple - just select "Yes" next to those conditions that your current patient has. If you need help, hover the mouse cursor over the criteria or check the section below for more complex explanations.

Below the TIMI score calculator, you'll find your result - the likelihood (as a percentage) of major health complications after an episode of unstable angina pectoris or NSTE myocardial infarct. The percent value refers to all of the conditions at once - death, myocardial infarct, and an urgent need for revascularization.

TIMI score - risk factors

There are seven risk factors in the TIMI score calculator.

  • Age ≥ 65 years;

  • ≥ 3 risk factors for coronary artery disease - these factors include:

    1. Diabetes;
    2. Hypercholesterolemia and distorted cholesterol ratios;
    3. family history of CAD (Coronary Artery Disease);
    4. Hypertension; or
    5. Being a current smoker (quitting one minute ago doesn't count - smoking recovery takes time).

    Check this criterion positive if at least three of them are present.

  • Known CAD with stenosis ≥ 50% - this refers to patients with a history of coronarography. Remember to ask the patient about incidents like myocardial infarction, stent or CABG placement, or prior angina pectoris.

  • Acetylsalicylic acid use in the past seven days - get a recent medical history with a list of all the drugs the patient is currently taking. Some acetylsalicylic acid medicines are OTCs (Over-The-Counter drugs), don't forget to ask about that.

  • Severe angina - defined here as at least two episodes in the past 24 hours.

  • EKG deviations - in this case, we're looking for ST-segment depression (as in ST elevation we would be using another TIMI risk score). Look for changes of at least 0.5mm (0.5mV).

  • Positive cardiac marker - abnormally high levels of cardiac troponin I or T (cTnI or cTnT) or cardiac kinase - myocardial bands (CK-MB) are a bad sign, as they are a sign of heart damage. This parameter is considered the most prognostic of the TIMI score risk factors, and is associated with adverse outcomes.

Acute coronary syndrome is, in most cases, a result of long-lasting and neglected cardiovascular diseases (CVD), like obesity and hypertension. Find out more about CVD risk factors in our CVD 10-year risk calculator, which is based on the long-lasting - and still ongoing - Framingham Heart Study.

Aleksandra Zając, MD
Age ≥ 65 years
No
≥ 3 risk factors for CAD
No
Known CAD (stenosis ≥ 50%)
No
ASA use in the past 7 days
No
Severe angina (≥ 2 episodes within 24h)
No
EKG deviations
No
Positive cardiac marker
No
Result
Your risk at 14 days of:

- all-cause mortality,
- new or recurrent MI (Myocardial Infarcion),
- severe recurrent ischemia requiring urgent revascularization,

is 5%.
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