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Free TIMI Score Calculator for UA/NSTEMI

Age ≥ 65 years

≥ 3 CAD risk factors (diabetes, hypercholesterolemia, family history of CAD, hypertension, current smoker)

Known CAD with stenosis ≥ 50%

Acetylsalicylic acid use in past 7 days

Severe angina (≥ 2 episodes in 24 hours)

EKG deviations (ST-segment depression ≥ 0.5mm)

Positive cardiac marker (elevated troponin or CK-MB)

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Select the TIMI risk factors present in your patient and click Calculate to assess the 14-day adverse event risk

The TIMI Score Calculator (Thrombolysis In Myocardial Infarction) is an online cardiac risk assessment tool designed specifically for patients with unstable angina (UA) or non-ST-segment elevation myocardial infarction (NSTEMI). It provides a quantitative estimate of the 14‑day composite risk of death, myocardial infarction, or urgent revascularization. This NSTEMI risk score is one of the most widely used prognostic instruments in emergency cardiology.

Founded on data from two international randomized double‑blind trials, the TIMI risk score was launched in 2000 and has since been validated in numerous patient populations. Its simplicity makes it particularly useful in busy clinical settings: the practitioner only needs to check whether each of seven predefined criteria is present. The total score directly correlates with the probability of an adverse outcome, enabling clinicians to allocate intensive monitoring and aggressive treatment to those at highest risk.

Important: The TIMI score is validated only for individuals presenting with at least three manifestations of acute coronary syndrome (ACS) and without persistent ST‑segment elevation. For ST‑elevation MI (STEMI), a separate scoring system should be employed.

How to Use the TIMI Risk Score

Using the calculator is straightforward – select “Yes” for each risk factor that applies to your patient. The tool instantly computes the TIMI score and displays the corresponding 14‑day risk percentage. Hovering over criteria or consulting the explanations below can help clarify any ambiguous definitions.

The Seven Risk Factors

Each of the following items contributes 1 point to the total TIMI score:

  1. Age ≥ 65 years.
  2. Multiple cardiovascular risk factors – at least three of the following must be present:
    • Diabetes mellitus
    • Dyslipidemia (elevated cholesterol or abnormal lipid profile)
    • Family history of premature coronary artery disease (CAD)
    • Hypertension
    • Current cigarette smoking (recent cessation does not count; recovery from smoking‑induced changes requires time)
  3. Known CAD – documented stenosis ≥ 50% in at least one coronary vessel on prior angiography, or history of myocardial infarction, percutaneous coronary intervention (stent), coronary artery bypass grafting (CABG), or prior angina.
  4. Acetylsalicylic acid (aspirin) use – the patient has taken aspirin within the past 7 days.
  5. Severe anginal symptoms – defined as at least two episodes of angina at rest in the preceding 24 hours.
  6. ST‑segment deviation – on the initial electrocardiogram, depression of ≥ 0.5 mm is considered positive. (If ST elevation is present, the STEMI‑specific TIMI score should be used instead.)
  7. Elevated cardiac biomarkers – a rise in cardiac troponin I or T (cTnI/cTnT) or creatine kinase‑MB (CK‑MB) above the upper reference limit. This factor carries the highest prognostic weight among the seven.

Scoring is additive: a patient with 0–1 points has very low risk, whereas a score of 5–7 indicates substantially increased risk. The 14‑day composite outcome (death, new MI, urgent revascularization) rises accordingly.

Caveats and Clinical Context

While the TIMI score is an evidence‑based unstable angina risk assessment tool, it should never replace a comprehensive clinical evaluation. Healthcare decisions must incorporate patient‑specific nuances, imaging, and laboratory results. The calculator is intended to support – not override – professional medical judgment.

For a broader perspective on cardiovascular risk, clinicians may consider tools that estimate 10‑year risk of CVD events (e.g., the Framingham‑based calculators). However, those address long‑term primary prevention, whereas the TIMI score focuses on short‑term prognosis in the acute setting.

FAQ

1. For which group of patients is the TIMI Score Calculator designed?

It is intended for patients with unstable angina (UA) or non-ST-segment elevation myocardial infarction (NSTEMI) who have at least three features of acute coronary syndrome. It is not for STEMI patients.

2. How many risk factors make up the TIMI score and what are they?

Seven: age ≥65 years, ≥3 cardiovascular risk factors (diabetes, dyslipidemia, family history of CAD, hypertension, current smoking), known CAD ≥50% stenosis, aspirin use in the past week, severe angina (≥2 episodes/24h), ST-segment depression ≥0.5 mm, and elevated cardiac biomarkers (troponin or CK-MB).

3. What does the total TIMI score predict?

The score stratifies the 14‑day composite risk of death, myocardial infarction, or urgent revascularization. Higher scores correspond to greater risk.

4. Can the TIMI score be used as the sole basis for treatment decisions?

No, it is a risk stratification aid and should be combined with full clinical evaluation, imaging, and laboratory data. It does not replace professional medical judgment.

How to Use

  1. Review each TIMI risk factor and select 'Yes' for any conditions that apply to your patient with UA/NSTEMI.
  2. Factors not selected are automatically considered absent - you only need to mark the positive findings.
  3. Click Calculate TIMI Score to see the total score, risk category, and 14-day adverse event rate with clinical recommendations.