TIMI Risk Score for Unstable Angina or NSTEMI

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Rim Halaby, M.D. [2], Sadaf Sharfaei M.D.[3]

Overview

The TIMI risk score for unstable angina (UA) or Non ST-Segment Elevation MI (NSTEMI) was derived in the test cohort by selection of independent prognostic variables using multivariate logistic regression, assignment of value of 1 when a factor was present and 0 when it was absent, and summing the number of factors present to categorize patients into a level of risk.

TIMI Risk Score for Unstable Angina or NSTEMI

Calculation of the TIMI Risk Score for Unstable Angina or NSTEMI

The TIMI risk score for unstable angina (UA) or Non ST-Segment Elevation MI (NSTEMI) was derived in the test cohort by selection of independent prognostic variables using multivariate logistic regression, assignment of value of 1 when a factor was present and 0 when it was absent, and summing the number of factors present to categorize patients into a level of risk.[1]

TIMI Risk Score for Unstable Angina or NSTEMI
Variable Score
Age ≥ 65 1
Elevated serum cardiac enzymes 1
ST segment depression at presentation 1
Risk factors (at least three for coronary artery disease) 1
Ischemia (at least two anginal events in previous 24 hours) 1
Prior coronary artery stenosis of 50% or more 1
Aspirin use in previous 7 days 1
TIMI Risk Score for Unstable Angina or NSTEMI:
Risk of the all-cause mortality, myocardial infarction, or severe recurrent ischemia through 14 days:

Interpretation of the TIMI Risk Score for Unstable Angina or NSTEMI

The interpretation of the score is as follows:

  • Score 0-1: Risk of the all-cause mortality, myocardial infarction, or severe recurrent ischemia through 14 days is 4.7%
  • Score 2: Risk of the all-cause mortality, myocardial infarction, or severe recurrent ischemia through 14 days is 8.3%
  • Score 3: Risk of the all-cause mortality, myocardial infarction, or severe recurrent ischemia through 14 days is 13.2%
  • Score 4: Risk of the all-cause mortality, myocardial infarction, or severe recurrent ischemia through 14 days is 19.9%
  • Score 5: Risk of the all-cause mortality, myocardial infarction, or severe recurrent ischemia through 14 days is 26.2%
  • Score 6-7: Risk of the all-cause mortality, myocardial infarction, or severe recurrent ischemia through 14 days is at least 40.9%

References

  1. Antman EM, Cohen M, Bernink PJ, McCabe CH, Horacek T, Papuchis G; et al. (2000). "The TIMI risk score for unstable angina/non-ST elevation MI: A method for prognostication and therapeutic decision making". JAMA. 284 (7): 835–42. PMID 10938172.