TIMI Risk Score Calculator for Unstable Angina / NSTEMI (14-day risk)

Understanding the TIMI risk score for unstable angina and NSTEMI — concept and principle

The TIMI risk score for unstable angina and non-ST-elevation myocardial infarction (NSTEMI) adds one point for each of seven features at presentation and estimates the 14-day risk of death, heart attack or urgent revascularisation. It helps clinicians gauge risk and decide how aggressively to treat.

Seven yes/no items: with the default inputs the result is 4 → 19.9% (14-day events · intermediate).

How it is calculated

TIMI score (0–7) = one point each for:

Age 65 or older
Three or more coronary risk factors
Known coronary stenosis of 50% or more
Aspirin use in the past 7 days
Severe angina (two or more episodes in 24 hours)
ST deviation of 0.5 mm or more
Raised cardiac markers

14-day risk: 0–1 4.7%, 2 8.3%, 3 13.2%, 4 19.9%, 5 26.2%, 6–7 40.9%. Groups: 0–2 low, 3–4 intermediate, 5–7 high.

The principle

Antman and colleagues (2000) tested candidate predictors in the TIMI 11B trial and validated the score in ESSENCE. Each feature reflects either a vulnerable coronary system (known disease, aspirin use despite which symptoms occur, risk factors) or an active unstable event (repeated angina, ST changes, raised markers). Equal weights keep it simple.

Worked example

Default inputs: age 65+, three or more risk factors, recent aspirin, ST deviation; other items no.

Points = 1 + 1 + 1 + 1 = 4.
14-day risk (death, MI, urgent revascularisation) = 19.9%.
Risk group = Intermediate (3–4).

How to read the result

Where does your result fall?

Higher scores identified patients who benefited more from aggressive treatment such as early invasive strategy and stronger antithrombotic therapy. Newer tools (such as GRACE) and high-sensitivity troponin have changed practice, but TIMI remains a quick bedside summary.

Common mistakes

Counting risk factors incorrectly (family history, hypertension, high cholesterol, diabetes, current smoking).
Counting aspirin taken only after symptoms began in hospital.
Using the score for STEMI.

Keep in mind: This is a classification aid for clinicians, not a diagnosis. Chest pain needs emergency assessment.

Frequently asked questions

What counts as a coronary risk factor?

Family history of coronary disease, hypertension, high cholesterol, diabetes and current smoking.

Why does aspirin use add risk?

Symptoms despite aspirin suggest a more resistant or aggressive disease process.

What is a low TIMI score?

0–2 points.

Sources: Antman EM, Cohen M, Bernink PJ, et al., "The TIMI risk score for unstable angina/non-ST elevation MI: a method for prognostication and therapeutic decision making", JAMA 2000;284(7):835–842

Checked 9 Nov 2026. Antman EM, Cohen M, Bernink PJ, et al., “The TIMI risk score for unstable angina/non-ST elevation MI: a method for prognostication and therapeutic decision making”, JAMA 2000;284(7):835–842 — items and 14-day event rates as given in the MSD Manual Professional table “Risk of Adverse Events at 14 Days in Unstable Angina or NSTEMI” and its TIMI UA/NSTEMI calculator.

Your numbers