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TIMI Risk Score Calculator for Unstable Angina and NSTEMI

Calculate the TIMI risk score for unstable angina or NSTEMI — seven criteria from age 65+ to positive cardiac markers — with the 14-day risk of death, heart attack or urgent revascularisation.

Age 65 or older

3 or more coronary risk factors

Known coronary artery disease (stenosis of 50% or more)

Aspirin use in the past 7 days

Severe angina (2 or more episodes in 24 hours)

ST deviation of 0.5 mm or more on the ECG

Positive cardiac marker (troponin or CK-MB)

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How it works

TIMI = 1 point each for: age ≥ 65; ≥ 3 CAD risk factors; known CAD (stenosis ≥ 50%); aspirin in the past 7 days; ≥ 2 anginal episodes in 24 h; ST deviation ≥ 0.5 mm; positive cardiac marker (0–7). 14-day all-cause death, new or recurrent MI, or severe recurrent ischaemia needing urgent revascularisation: 0–1 4.7% · 2 8.3% · 3 13.2% · 4 19.9% · 5 26.2% · 6–7 40.9%.

The TIMI risk score for unstable angina and non-ST-elevation myocardial infarction (Antman et al., JAMA 2000) was derived in the TIMI 11B trial and validated in ESSENCE. It sorts patients with an acute coronary syndrome by their short-term risk of death or ischaemic events using seven simple yes/no criteria. Higher scores also identify patients who benefit most from an early invasive strategy and more intensive antithrombotic therapy. For undifferentiated chest pain in the emergency department, the HEART score is now more commonly used.

Worked example

A 68-year-old with hypertension, diabetes and high cholesterol who took aspirin this week presents with unstable angina; ECG and troponin are normal: TIMI = 3 / 7, with a 14-day risk of death, MI or urgent revascularisation of 13.2% — intermediate risk.

Sources: Antman EM et al. The TIMI risk score for unstable angina/non-ST elevation MI. JAMA 2000

Frequently asked questions

What is a high TIMI score?

Scores of 5–7 are high risk (26–41% risk of an adverse event within 14 days), 3–4 intermediate and 0–2 low risk.

Why does taking aspirin increase the score?

Having an acute coronary syndrome despite recent aspirin suggests more aggressive or resistant disease, which was linked to worse outcomes in the derivation trial.

Is the TIMI score for STEMI?

No. This score is for unstable angina and NSTEMI. There is a separate TIMI risk score for ST-elevation myocardial infarction that uses different variables.

TIMI or HEART score for chest pain?

The HEART score was designed for undifferentiated chest pain in the emergency department and performs better there. TIMI was derived in patients already diagnosed with unstable angina or NSTEMI.

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Clinical decision tool for education and for use by trained clinicians alongside clinical judgement — not a diagnosis and not a substitute for medical assessment. Scores validated in specific populations may not apply to every patient.