TIMI Score for STEMI Calculator
Calculate the TIMI STEMI score as a bedside prognostic summary using the original fibrinolytic-era 30-day mortality framework.
TIMI Score for UA/NSTEMI Calculator
Calculate the TIMI UA/NSTEMI score as a bedside prognostic summary using the original 14-day composite event framework.
⚠️ Medical Disclaimer: This TIMI UA/NSTEMI page is a prognostic summary of the original 14-day composite event framework. It supports bedside risk framing but does not by itself determine cath timing, anticoagulation intensity, or discharge decisions.
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TIMI UA/NSTEMI Score
0
14-Day Event Context: ~5%
Low band in the original cohort
○ Age ≥65
○ ≥3 CAD risk factors
○ Known CAD (≥50% stenosis)
○ ASA use in past 7 days
○ ≥2 angina episodes in 24h
○ ST deviation ≥0.5 mm
○ Elevated biomarkers
TIMI Score⧉
0 / 7
Low
14-Day Event Context⧉
~5%
Original composite endpoint: death, MI, or urgent revascularization
Original Use Case⧉
UA/NSTEMI prognosis
Derived for early event stratification in the original TIMI UA/NSTEMI setting
Active Criteria⧉
0 of 7
Number of risk criteria present
Biomarker Status⧉
Not elevated
Interpret with the full ACS presentation rather than as a stand-alone label
Use in Practice⧉
One input into ACS planning
Do not let the score alone decide invasive timing, ICU placement, or antithrombotic regimen
| Score | 14-Day MACE | Risk | How To Read It |
|---|---|---|---|
| 0-1 | ~5% | Low | Lower short-term event band in the original TIMI cohort |
| 2 | ~8% | Low-Moderate | Still interpret with troponin trend, ECG, and overall ACS suspicion |
| 3 | ~13% | Moderate | Higher event band; pair with the rest of the modern NSTE-ACS workup |
| 4 | ~20% | Moderate-High | Meaningful early-risk signal, but not a stand-alone cath order |
| 5 | ~26% | High | Strong short-term risk context from the original derivation data |
| 6-7 | ~41% | Very High | Very high original event band; still apply the broader ACS pathway |
| Criterion | Rationale | Points |
|---|---|---|
| Age ≥65 | Advanced age predicts higher short-term event risk | 1 |
| ≥3 CAD risk factors | Traditional atherosclerotic burden marker | 1 |
| Known CAD (≥50% stenosis) | Established obstructive coronary disease | 1 |
| ASA use in past 7 days | Breakthrough event despite aspirin exposure | 1 |
| ≥2 angina episodes/24h | Active or recurrent ischemic symptoms | 1 |
| ST deviation ≥0.5 mm | Objective ischemic ECG change | 1 |
| Elevated biomarkers | Myocardial injury signal within the ACS evaluation | 1 |
Planning notes, formulas, and examples
About the TIMI Score for UA/NSTEMI Calculator
The TIMI Risk Score for UA/NSTEMI is a 7-item bedside score developed from the original TIMI UA/NSTEMI cohorts to estimate the 14-day composite risk of death, new or recurrent myocardial infarction, or urgent revascularization. Each criterion contributes 1 point, which makes the score easy to calculate from the initial history, ECG, and biomarker data.
The score is still useful as a compact prognosis summary, but its event rates come from the original derivation and early validation setting rather than from every modern NSTE-ACS pathway. The most defensible use is to frame short-term risk, not to pretend the number alone decides cath timing or antithrombotic intensity.
This page should be used as one bedside risk-stratification aid within the broader ACS evaluation.
When This Page Helps
The TIMI UA/NSTEMI score is helpful when you want a quick, standardized way to summarize short-term event risk at presentation. It captures several classic high-risk features without requiring a more complex calculator.
Its value is in bedside prognostic framing. Decisions about invasive evaluation, observation, antithrombotic therapy, and discharge still depend on troponin trend, ECG findings, bleeding risk, comorbidities, and the overall clinical picture.
How to Use the Inputs
- Assess each of the 7 binary criteria as present or absent.
- Enter the age, risk-factor, CAD-history, aspirin, angina-frequency, ECG, and biomarker items.
- Review the total score and the original 14-day event framework.
- Interpret the result as short-term prognosis context rather than a stand-alone management order set.
Formula used
TIMI UA/NSTEMI Score (7 binary variables, 0-7):
Age ≥65: 1 pt
≥3 CAD risk factors: 1 pt
Known CAD (≥50% stenosis): 1 pt
Aspirin use in past 7 days: 1 pt
≥2 anginal episodes in past 24h: 1 pt
ST deviation ≥0.5 mm: 1 pt
Elevated cardiac biomarkers: 1 pt
Original 14-day composite-event framework:
0-1 (~5%), 2 (~8%), 3 (~13%), 4 (~20%), 5 (~26%), 6-7 (~41%)Example Calculation
Result: TIMI 7/7 — 14-Day MACE ~41%, Very High Risk
All 7 criteria are present, placing the patient in the highest original TIMI UA/NSTEMI event band. The result should be read as a strong short-term risk signal within the broader NSTE-ACS assessment, not as a stand-alone directive for cath timing, ICU placement, or medication choice.
Tips & Best Practices
- Use the score to summarize risk, not to replace the rest of the ACS assessment.
- Remember that aspirin use adds a point because it represents a breakthrough event, not a protective effect.
- ST deviation ≥0.5 mm can include ST depression or other qualifying ischemic ST changes in the original rule.
- Consider GRACE alongside TIMI when you need a fuller prognosis estimate.
- Avoid turning a single TIMI cutoff into a stand-alone invasive or discharge rule.
- Document the result only if it adds real value to the clinical summary.
What the Score Is Good For
The TIMI UA/NSTEMI score is good at packaging several classic high-risk features into one easy bedside total. That makes it useful when documenting early risk or comparing two presentations.
What It Does Not Do
It does not replace serial troponins, ECG review, bleeding-risk assessment, hemodynamic assessment, or the full NSTE-ACS pathway. A higher score should strengthen clinical attention, not act like an automatic order set.
Best Use
Use the page as a short-term prognosis summary rooted in the original TIMI framework, then interpret it alongside modern ACS evaluation rather than in isolation.
Sources & Methodology
Last updated:
Methodology
This page applies the original TIMI UA/NSTEMI risk score by summing the seven published 1-point criteria into the standard 0-to-7 total. It then reports the original 14-day composite event framework of death, new or recurrent myocardial infarction, or urgent revascularization.
The page is meant to summarize short-term risk within the broader NSTE-ACS workup. It should not be used as a stand-alone decision rule for cath timing, antithrombotic intensity, ICU placement, or discharge.
Sources
- The TIMI risk score for unstable angina/non-ST elevation MI: a method for prognostication and therapeutic decision making (JAMA)
- TIMI Study Group (TIMI Study Group) — Study-group reference for the TIMI family of cardiovascular risk scores.
Frequently Asked Questions
The point reflects a breakthrough event despite aspirin exposure, which was associated with higher short-term event risk in the original cohort. It does not mean aspirin is harmful.
The original TIMI work used the standard traditional CAD risk factors such as hypertension, diabetes, smoking, dyslipidemia, and family history. Having 3 or more of those factors adds 1 point.
GRACE uses a broader variable set and is often more discriminating for overall ACS prognosis, while TIMI is simpler and easier to calculate at the bedside. They are complementary risk tools rather than interchangeable rules.
Any elevated cardiac biomarker counts, including troponin or CK-MB. The result still has to be interpreted with the broader ACS presentation and assay context.
No. A higher TIMI band is one argument for closer evaluation, but invasive timing still depends on the rest of the ACS workup, bleeding risk, comorbidities, hemodynamic status, and the local pathway.
No. STEMI has its own TIMI score with different variables and a different derivation setting.
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