TIMI Risk Score for UA/NSTEMI
The TIMI Risk Score for Unstable Angina/NSTEMI can be used to help risk stratify patients with anginal symptoms, but is better-suited for patients with confirmed NSTEMI or unstable angina.
- Even with 0 or 1 risk factors, the TIMI Score still suggests a 4.7% risk of bad outcome (although risk of death or non-fatal MI was 2.9% in these lowest risk categories).
- TIMI is the first widely-used chest pain decision rule, and probably the most well known
- However it was developed in the late 1990s and published in 2000
- Newer risk scores using troponin-only have been developed (HEART, GRACE, EDACS) that provide better risk stratification
- For risk stratification of patients with confirmed acute coronary syndrome, most experts recommend the GRACE Score for risk stratification, with higher risk levels receiving more aggressive medical intervention and/or receiving early invasive management.
The TIMI Risk Score for Unstable Angina/NSTEMI is the best known chest pain risk score tool, however newer ones exist that provide better risk stratification for low vs non-low risk patients (for example, the GRACE Score).