TIMI Risk Score for UA/NSTEMI
What is the 14-day risk of death or ischaemic events in confirmed UA/NSTEMI?
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About this tool
Seven binary criteria estimating short-term adverse outcomes in unstable angina / non-ST-elevation MI.
Intended use
Patients with established UA/NSTEMI to estimate prognosis and the benefit of early invasive therapy.
Outcome
All-cause mortality, new or recurrent MI, or severe recurrent ischaemia requiring urgent revascularisation
Time horizon
14 days
Derivation population
Patients with UA/NSTEMI enrolled in the TIMI 11B and ESSENCE trials.
Limitations
- Derived in trial populations with confirmed ACS — less discriminating in undifferentiated ED chest pain.
- Aspirin use as a risk factor reflects the derivation era.
Clinical problems
Evidence
Evidence level
Strong evidence
Derived and externally validated in multiple cohorts (including prospective studies) and incorporated into major clinical guidelines. Methodology
Guideline status
Historically referenced in ACC/AHA NSTE-ACS guidance for risk stratification.
Validation studies
UA/NSTEMI trial patients
14-day event rates by score: 0–1, 4.7%; 2, 8.3%; 3, 13.2%; 4, 19.9%; 5, 26.2%; 6–7, 40.9%.
References
- Original publicationAntman EM, Cohen M, Bernink PJ, et al. The TIMI risk score for unstable angina/non-ST elevation MI. JAMA 2000;284:835-842. Find on PubMed (opens in a new tab)
Version history
| Version | Formula | Effective | Reviewer | Changes |
|---|---|---|---|---|
| v1.0.0 | Antman 2000 | 2026-10-03 | — | Initial implementation with reference test vectors. |
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