# TIMI Risk Score Calculator for UA/NSTEMI
> Free TIMI Risk Score calculator for unstable angina / NSTEMI. 14-day death + MI + urgent revascularisation risk. Based on Antman 2000. Clinician decision support.

## Overview

The TIMI Risk Score for unstable angina and NSTEMI predicts the 14-day composite of all-cause mortality, new or recurrent myocardial infarction, and severe recurrent ischaemia requiring urgent revascularisation. The score uses seven binary clinical and electrocardiographic variables and totals 0–7. It supports early risk stratification in the emergency department and inpatient telemetry settings. ESC NSTE-ACS guidelines and ACC/AHA NSTE-ACS guidelines reference TIMI alongside the GRACE score for risk stratification; higher scores often align with earlier invasive strategies in suitable patients.

## Who this is for

- Emergency physicians evaluating chest pain
- Internal medicine and cardiology residents on telemetry
- Hospitalists managing UA/NSTEMI

## How to interpret the result

| Score / band | Meaning |
|---|---|
| 0–2 | Low — 4.7–8.3% 14-day event rate. |
| 3–4 | Moderate — 13.2–19.9% event rate. |
| 5–7 | High — 26.2–40.9% event rate; early invasive strategy commonly considered. |

## Cited source

**ESC 2020 Guidelines for the Management of NSTE-ACS** (2020) — European Society of Cardiology

_Primary publication:_ Antman EM et al., JAMA 2000 (TIMI Risk Score derivation)

## FAQs

### TIMI vs GRACE — which should I use?

Both are validated. TIMI is faster (seven inputs); GRACE is more accurate for in-hospital and 6-month mortality and is commonly preferred where time permits. The ESC 2020 NSTE-ACS guideline references both.

### Does TIMI dictate cath lab timing?

No. TIMI supports an invasive strategy in higher-risk patients, but the decision integrates haemodynamics, ongoing ischaemia, comorbid burden, and bleeding risk.

### Is TIMI useful for STEMI?

There is a separate TIMI Risk Score for STEMI (Morrow 2000). Use that score for STEMI; this tool focuses on UA/NSTEMI.

### Can a TIMI of 0 safely be discharged?

TIMI 0 has the lowest event rate but is not by itself a discharge criterion — many centres pair it with HEART score or accelerated diagnostic protocols (ADAPT).

### What troponin threshold counts as 'positive'?

Use your institution's myocardial-injury threshold (often the 99th-percentile upper reference limit for high-sensitivity troponin assays). The original derivation used an older marker panel.

---
_Rounds AI is a citation-first clinical AI assistant. It supports clinical reasoning by surfacing cited information and is not a substitute for independent clinical judgement._