What are the seven TIMI risk criteria?

Age 65 or over; at least three coronary risk factors; known coronary stenosis of 50% or more; ST-segment deviation on ECG; at least two anginal episodes in the last 24 hours; aspirin use in the prior 7 days; and elevated cardiac markers. Each scores one point for a maximum of 7.

Why does prior aspirin use add risk?

Recent aspirin use marks a patient whose symptoms persisted despite antiplatelet therapy, which signals more aggressive disease. It is a counter-intuitive but validated component of the original TIMI 11B and ESSENCE derivation.

How does the TIMI score map to outcome?

The 14-day risk of all-cause death, new or recurrent MI, or severe ischaemia needing urgent revascularisation rises with the score: roughly 5% at 0–1, 8% at 2, 13% at 3, 20% at 4, 26% at 5, and about 41% at 6–7.

When should an early invasive strategy be considered?

Higher TIMI scores (3 or more) identify patients who benefit most from an early invasive strategy with angiography and revascularisation. Lower scores may be managed with an initial conservative approach, guided by local protocol and other findings.

Is my data stored anywhere?

No. The calculation runs entirely in your browser and nothing you enter is transmitted or saved on any server.

TIMI Risk Score for UA/NSTEMI

The TIMI risk score for unstable angina and NSTEMI condenses seven simple yes/no findings into a single number that predicts short-term cardiac events and helps decide whether a patient benefits from an early invasive strategy.

How it works

One point is added for each of the seven criteria that is present, giving a total from 0 to 7:

Age 65 years or over.
At least three coronary risk factors (hypertension, diabetes, smoking, hyperlipidaemia, family history).
Known coronary stenosis of 50% or more.
ST-segment deviation of 0.5 mm or more on the presenting ECG.
At least two anginal episodes in the prior 24 hours.
Aspirin use in the prior 7 days.
Elevated cardiac markers (troponin or CK-MB).

The total maps to the 14-day risk of all-cause death, new or recurrent myocardial infarction, or severe recurrent ischaemia requiring urgent revascularisation:

0-1 -> ~4.7%   2 -> ~8.3%   3 -> ~13.2%
4   -> ~19.9%  5 -> ~26.2%  6-7 -> ~40.9%

Example and notes

A 68-year-old (1) with diabetes, hypertension, and a smoking history (1), known 60% stenosis (1), a positive troponin (1), but a normal ECG and only one anginal episode scores 4 — about a 20% 14-day event rate, favouring an early invasive approach.

The TIMI score is derived for UA/NSTEMI populations and should not be applied to STEMI or non-cardiac chest pain. It complements, rather than replaces, the GRACE score and bedside judgement.