How it's calculated
Each of 7 criteria scores 1 point, for a total of 0-7. Higher scores are associated with a higher 14-day risk of death, myocardial infarction, or urgent revascularisation, derived from the TIMI 11B and ESSENCE trial populations.
Score interpretation
| Score | 14-day risk |
|---|---|
| 0–1 | 4.7% |
| 2 | 8.3% |
| 3 | 13.2% |
| 4 | 19.9% |
| 5 | 26.2% |
| 6–7 | 40.9% |
Clinical use
- The TIMI score helps decide between a conservative (medical management, selective invasive strategy) versus early invasive approach (angiography) for unstable angina/NSTEMI.
- Higher-risk patients (score ≥3) generally benefit more from an early invasive strategy, per multiple randomised trials.
- TIMI was derived and validated specifically in UA/NSTEMI populations — the separate TIMI STEMI score exists for ST-elevation MI risk, and the two should not be used interchangeably.
- Like other risk scores, it supports rather than replaces clinical judgement, especially in patients with atypical presentations or comorbidities not captured by the score.
Frequently asked questions
What is the TIMI Risk Score used for?
It estimates the 14-day risk of death, myocardial infarction, or urgent revascularisation in patients with unstable angina or NSTEMI, helping guide the choice between conservative management and an early invasive strategy.
What does a TIMI score of 5 mean?
It corresponds to roughly a 26% risk of death, MI, or urgent revascularisation within 14 days — a risk level that generally supports an early invasive strategy (angiography) rather than conservative management alone.
Is the TIMI score the same for STEMI and NSTEMI?
No — this calculator implements the TIMI score for unstable angina/NSTEMI specifically. A separate TIMI risk score exists for STEMI, using different criteria, and the two are not interchangeable.
Does aspirin use in the past week increase or decrease risk?
It counts toward a higher TIMI score — patients who were already on aspirin and still developed an acute coronary event tend to represent a higher-risk population than those who weren't previously on aspirin.
References
- Antman EM, et al. The TIMI risk score for unstable angina/non-ST elevation MI. JAMA. 2000;284:835-842.
- Amsterdam EA, et al. 2014 AHA/ACC Guideline for the Management of Patients with Non–ST-Elevation Acute Coronary Syndromes. Circulation. 2014;130:e344-e426.
- Antman EM, et al. Enoxaparin prevents death and cardiac ischemic events in unstable angina/non–Q-wave myocardial infarction (ESSENCE). Circulation. 1999;100:1593-1601.