TIMI Risk Score Calculator (UA/NSTEMI)
Estimate 14-day risk in unstable angina or non-ST-elevation myocardial infarction (UA/NSTEMI) with the TIMI risk score. Seven findings each add one point, for a total of 0 to 7, and the score predicts the combined 14-day risk of death, new or recurrent MI, or severe ischaemia needing urgent revascularisation. Tick those that apply.
About the TIMI risk score
The TIMI risk score stratifies patients with unstable angina or NSTEMI to guide the intensity of treatment. Each of the seven findings scores one point. Source: Antman EM et al., “The TIMI risk score for unstable angina/non-ST elevation MI,” JAMA 2000;284(7):835–842.
How this is calculated
| Factor | Points |
|---|---|
| Age 65 or over | 1 |
| ≥ 3 risk factors for CAD | 1 |
| Known CAD (stenosis ≥ 50%) | 1 |
| Aspirin use in the past 7 days | 1 |
| Severe angina (≥ 2 episodes in 24 h) | 1 |
| ST deviation ≥ 0.5 mm | 1 |
| Elevated cardiac biomarker | 1 |
| Maximum | 7 |
Add one point for each finding present. Approximate 14-day risk of death, MI or urgent revascularisation: 4.7% (0–1), 8.3% (2), 13.2% (3), 19.9% (4), 26.2% (5), 40.9% (6–7). Source: Antman EM et al., JAMA 2000;284(7):835–842.
Frequently asked questions
What are the seven TIMI criteria?
Each of these adds one point: age 65 or over; three or more risk factors for coronary artery disease (hypertension, high cholesterol, diabetes, smoking, family history); known coronary artery disease with stenosis of 50% or more; aspirin use in the past 7 days; severe angina, meaning two or more episodes in 24 hours; ST-segment deviation of 0.5 mm or more on the ECG; and elevated cardiac biomarkers such as troponin. The total runs from 0 to 7. This version of the score was derived from the TIMI 11B and ESSENCE trial cohorts and published by Antman and colleagues in 2000, specifically for patients with unstable angina or non-ST-elevation myocardial infarction.
What does the TIMI score predict?
The TIMI score predicts the combined risk over 14 days of all-cause death, new or recurrent myocardial infarction, and severe recurrent ischaemia requiring urgent revascularisation. In the original derivation that composite risk rose from about 5% at a score of 0–1 to roughly 41% at 6–7, so a higher score identifies patients who benefit most from an early invasive strategy and more intensive antithrombotic therapy. A separate TIMI risk score, using different variables such as systolic blood pressure, heart rate and time to treatment, was later developed specifically for ST-elevation myocardial infarction to predict 30-day mortality.
What are the risk groups?
A common grouping is: 0–1 low, 2–3 intermediate, 4–5 high and 6–7 very high risk. The matching approximate 14-day event rates are about 4.7% (0–1), 8.3% (2), 13.2% (3), 19.9% (4), 26.2% (5) and 40.9% (6–7). Treat the group as the main output and the percentage as an approximate guide.
Is this the same as the STEMI TIMI score?
No — the TIMI score for unstable angina and NSTEMI is a simple count of seven equally weighted items. There is a separate, differently weighted TIMI score for ST-elevation MI (STEMI) that predicts 30-day mortality. Use this calculator only when the presentation is UA or NSTEMI, not STEMI.
When should the TIMI score not be relied on?
The TIMI score is a risk-stratification aid for acute coronary syndrome, not a diagnosis, and assumes the diagnosis of UA/NSTEMI has already been made from the history, ECG and troponin. It does not replace clinical judgement, and other tools such as the GRACE score are used alongside it. This is an educational reference, not medical advice.
This is a reference tool, not a diagnosis or medical advice. Results depend on the laboratory, assay and clinical context, and reference intervals vary between labs and by age and sex — always read your result against the range printed on your own report and discuss it with a qualified healthcare professional.
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