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TIMI Risk Score for UA/NSTEMI

The TIMI score for unstable angina/NSTEMI (0–7) predicts 14-day all-cause death, new/recurrent MI or urgent revascularization, from 4.7% (score 0–1) to 40.9% (score 6–7). Scores ≥3 favour an early invasive strategy.

  • Age (years)
  • ≥ 3 CAD risk factors (family history, HTN, hypercholesterolemia, DM, current smoker) (yes/no, +1)
  • Known CAD (stenosis ≥ 50%) (yes/no, +1)
  • Aspirin use in the past 7 days (yes/no, +1)
  • Severe angina (≥ 2 episodes in 24 h) (yes/no, +1)
  • ST deviation ≥ 0.5 mm (yes/no, +1)
  • Elevated cardiac markers (yes/no, +1)
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Interpretation

ResultMeaning
0–14.7%
28.3%
313.2%
419.9%
526.2%
6–740.9%

Formula

One point each: age ≥ 65 · ≥ 3 CAD risk factors · known CAD (stenosis ≥ 50%) · aspirin in past 7 days · ≥ 2 anginal episodes in 24 h · ST deviation ≥ 0.5 mm · elevated cardiac markers

Clinical pearls

  • Derived in UA/NSTEMI trial populations (TIMI 11B, ESSENCE); GRACE discriminates better for mortality.
  • Aspirin use is a marker of more advanced disease, not a harmful exposure.

Examples

timi score 68M on aspirin with st depression and positive troponinTIMI UA/NSTEMI for a 55 year old with known CAD and 2 episodes of angina todaytimi nstemi 72F 3 risk factors, no st changes, trop negative

FAQ

What is a high TIMI score?

Scores of 5–7 are high risk (26–41% 14-day events); 3–4 intermediate; 0–2 low.

Is TIMI used for STEMI?

No. STEMI has its own TIMI risk score with different variables predicting 30-day mortality.

Evidence

  1. Antman EM et al. The TIMI risk score for unstable angina/non-ST elevation MI. JAMA 2000;284:835–42.

Cardiology · Reviewed 2026-10-14 · Methodology