Summary:

The TIMI risk score is an easy bedside calculation mostly based on the patient's medical history and a few initial tests (ECG and initial labs) in patients presenting to the emergency department (ED) with unstable angina or NSTEMI when trying to assess their risk for cardiac related ischemic events and death within the first 14 days after presenting to the ED.

• TIMI Risk Scores of 0 - 1 have a 4.7% risk
• TIMI Risk Scores of 6 - 7 have a 40.9% risk
• All groups showed an increase in event rates with higher TIMI risk scores
• Patients with higher TIMI risk scores also had better outcomes if treated with enoxaparin versus unfractionated heparin
• Note: 
• It is worth pointing out that even patients with the lowest TIMI risk score (0 - 1) are still at concerning risk within the first 14 days of presentation.  This highlights the importance of further admission and testing, or very close follow up. 
• The 2014 AHA/ACC Guidelines for NSTEMI say that risk scores should be used to assess the prognosis in patients and give this a Class IA, Level of Evidence A recommendation

Editor(s): 
    Anthony J. Busti, MD, PharmD, FNLA, FAHA
    Dylan Kellogg, MD
Date Last Reviewed: September 2015