Calculator: check the 7 variables

TIMI UA/NSTEMI score variables (1 point each)

+1Age 65 years or older
Baseline cardiovascular risk rises with age; the 65-year threshold was an independent predictor in the original study\u2019s multivariate analysis.
+1At least 3 coronary heart disease risk factors
Counted: family history of CHD, hypertension, hypercholesterolemia, diabetes, or active smoking. Three or more indicates a greater atherosclerotic burden.
+1Known coronary stenosis of 50% or more
A history of previously documented obstructive coronary disease confirms established disease, not just a new lesion.
+1ST-segment deviation on the presenting ECG
Depresi maupun elevasi segmen ST (umumnya dipakai ambang 0,5 mm) indicate active ongoing myocardial ischemia. See also our ECG reading tool.
+1At least 2 angina episodes in the last 24 hours
Angina recurring within a day reflects an unstable coronary lesion and ongoing ischemia.
+1Aspirin use in the last 7 days
An informative paradox: symptoms appearing despite aspirin therapy indicate plaque rupture that remains progressive.
+1Elevated serum cardiac biomarkers
Elevated troponin or CK-MB indicates cardiac muscle cell necrosis — the strongest single predictor among the seven variables.

TIMI score

0 / 7

14-day composite risk

4.7%

Low risk

Selected variables

Educational tool — not medical advice. This calculator helps explain the TIMI score for UA/NSTEMI (Antman 2000) and does not replace physician judgment, ECG interpretation, diagnostic workup, or clinical monitoring of the patient. A score of 0–1 does not mean zero risk (4.7%) — clinical decisions still require physician evaluation.

14-day composite risk table by score

Outcome: all-cause mortality, new or recurrent myocardial infarction, or severe recurrent ischemia requiring urgent revascularization — within 14 days (TIMI 11B cohort, Antman 2000). The highlighted row follows the score calculated above.

TIMI score	14-day composite risk	Group
0–1	4.7%	Low risk
2	8.3%	Low risk
3	13.2%	Intermediate risk
4	19.9%	Intermediate risk
5	26.2%	High risk
6–7	40.9%	High risk

Stratification guide

The following groupings are a convention commonly used in the clinical literature — not part of the Antman 2000 publication — to help frame risk discussions:

Low risk (score 0–2): 14-day composite event rate 4.7–8.3% in the study cohort.
Intermediate risk (score 3–4): event rate 13.2–19.9%.
High risk (score 5–7): event rate 26.2–40.9%. In the TACTICS-TIMI 18 trial, the absolute benefit of an early invasive strategy appeared larger in patients with higher TIMI scores.

The 2014 ACC/AHA and 2020 ESC guidelines for acute coronary syndromes without persistent ST elevation list the TIMI score as one of several early stratification aids. This score is prognostic — it estimates risk, not therapy; treatment decisions rest entirely with the treating physician.

Comparison: TIMI vs GRACE vs HEART

Score	Population	Variables	Outcome & window	Strengths / limitations
TIMI UA/NSTEMI (Antman 2000)	Unstable angina / NSTEMI	7 variables, 1 point each	Composite (mortality, MI, severe ischemia → revascularization), 14 days	Very simple, bedside-calculable; from the older biomarker era
GRACE (2003)	Acute coronary syndrome spectrum	8 variables including vitals & labs	In-hospital & 6-month mortality	Generally better discrimination; more complex, needs lab data
HEART (2008)	Undifferentiated chest pain in the ED	5 components, total 0–10	6-week MACE	Practical for ED triage; not specific to confirmed UA/NSTEMI

TIMI STEMI vs TIMI UA/NSTEMI — don't mix them up

Two different instruments with similar names. TIMI STEMI (Morrow 2000): 8 weighted variables, total 0–14, predicts 30-day mortality in STEMI patients. TIMI UA/NSTEMI (Antman 2000, this page): 7 variables at 1 point each, total 0–7, predicts 14-day composite risk in unstable angina/NSTEMI. Their variables must not be mixed.

For STEMI patients, use our TIMI score calculator for STEMI.

Limitations

Derived from a clinical-trial population (TIMI 11B; validated in ESSENCE and other studies) — selected participants, may not represent all real-world patients.
The original study used older-era biomarkers (conventional troponin, CK-MB), before high-sensitivity troponin was widely available.
Each variable carries equal weight (1 point) as a simplification; predictive strength differs across variables.
Not designed for STEMI patients or undifferentiated chest pain (for the latter, the HEART score is generally more appropriate).
A score of 0–1 carries 4.7% risk — not zero.
In the original study, the risk gradient was slightly shallower in the enoxaparin arm — a reminder that this is a prognostic tool, not a therapy determinant.

Frequently asked questions

What is the TIMI score for UA/NSTEMI?

The TIMI score for unstable angina (UA) and non-ST-elevation myocardial infarction (NSTEMI) is a simple risk-stratification tool developed by Antman et al. and published in JAMA in 2000. It uses 7 clinical variables worth 1 point each, for a total of 0 to 7. Its purpose is to estimate the composite risk within 14 days of presentation — all-cause mortality, new or recurrent myocardial infarction, or severe recurrent ischemia requiring urgent revascularization. It was developed from the TIMI 11B clinical-trial cohort, and its rising pattern was confirmed in validation cohorts including the ESSENCE study.

What is the difference between the TIMI score for UA/NSTEMI and for STEMI?

They are different instruments and must not be mixed or interchanged. The TIMI score for STEMI (Morrow 2000) uses 8 weighted variables with a maximum of 14 points and predicts 30-day mortality in STEMI patients — available in our TIMI STEMI calculator. The TIMI score for UA/NSTEMI (Antman 2000, this page) uses 7 variables worth 1 point each with a maximum of 7 points, and predicts the 14-day composite outcome in patients with unstable angina or NSTEMI. The population, variables, weights, time window, and outcomes differ.

What are the 7 TIMI UA/NSTEMI score variables?

The seven variables, 1 point each: (1) age 65 years or older; (2) at least 3 coronary heart disease risk factors — family history of CHD, hypertension, hypercholesterolemia, diabetes, or active smoking; (3) previously known coronary stenosis of 50 percent or more; (4) ST-segment deviation on the presenting ECG; (5) at least 2 angina episodes in the last 24 hours; (6) aspirin use in the last 7 days; and (7) elevated serum cardiac biomarkers such as troponin or CK-MB.

Is the outcome window 14 days or 30 days?

14 days. Per Antman et al. (JAMA 2000), the predicted outcome is the composite event — all-cause mortality, new or recurrent myocardial infarction, or severe recurrent ischemia requiring urgent revascularization — within 14 days of randomization. The 30-day figure belongs to the TIMI score for STEMI (Morrow 2000), which predicts 30-day mortality; the two instruments are often confused because their names are similar.

How do I read the score result?

Add 1 point for each variable present. A score of 0 to 1 means a 14-day composite risk of 4.7 percent; score 2, 8.3 percent; score 3, 13.2 percent; score 4, 19.9 percent; score 5, 26.2 percent; and score 6 to 7, 40.9 percent. The full table is on this page and highlights automatically according to the calculated score.

Does a score of 0 mean no risk?

No. A score of 0 to 1 still carries a 14-day composite risk of 4.7 percent — risk is never zero. The score helps place the patient on a risk spectrum, but cannot be used alone to decide discharge; further clinical evaluation by a physician is still required.

Why does aspirin use add 1 point?

It seems paradoxical, but the reason is clinical: if angina symptoms appear even though the patient has taken aspirin in the last 7 days, it signals plaque rupture that remains progressive despite antiplatelet therapy — not a sign of protection. Symptoms breaking through therapy actually reflect a more unstable coronary lesion.

What kind of ST-segment deviation counts?

ST-segment deviation on the presenting ECG — either ST depression or elevation, commonly with a 0.5 mm threshold in practice — indicating active ongoing myocardial ischemia. This is one of the 7 variables and scores 1 point when present.

Which cardiac biomarkers are meant?

Elevated serum cardiac biomarkers, i.e. troponin or CK-MB in the original study's era. This variable indicates that cardiac muscle cell necrosis has occurred and is one of the strongest predictors among the seven. Note that the original study predates the high-sensitivity troponin era, so modern positivity thresholds may differ — see the limitations section.

How does the TIMI score compare with GRACE and HEART?

All three are stratification tools for acute coronary syndromes but differ in focus. The TIMI UA/NSTEMI score is simple (7 yes/no variables) and bedside-calculable. The GRACE score uses 8 variables including laboratory data and vital signs, with generally better discrimination for mortality, but is more complex. The HEART score (5 components, total 0 to 10) is designed for undifferentiated chest pain in the emergency department. The ACC/AHA and ESC guidelines list these scores as early stratification aids, not substitutes for clinical judgment.

What are the limitations of the TIMI UA/NSTEMI score?

First, it was derived from a clinical-trial population (TIMI 11B, validated in ESSENCE and other studies), so participants were selected and may not represent all real-world patients. Second, the original study used older-era biomarkers (conventional troponin and CK-MB), before high-sensitivity troponin was available. Third, each variable is given equal weight (1 point) as a simplification, though their predictive strength is not identical. Fourth, the score was not designed for STEMI patients or for undifferentiated chest pain. Fifth, a score of 0 to 1 does not mean zero risk.

Can this score be used for STEMI patients?

No. For patients with ST elevation (STEMI), use the TIMI score for STEMI, which was developed and validated for that population. Mixing the two instruments' variables produces an invalid number. See our TIMI STEMI calculator for that purpose.

Who may use this calculator?

This calculator is an educational tool intended for healthcare professionals, medical students, and learners who want to understand how the TIMI UA/NSTEMI score works. It is not medical advice and does not replace physician judgment, serial ECG interpretation, diagnostic workup, and clinical monitoring of the patient. Treatment decisions rest entirely with the patient's treating physician.

Related terms

In the English literature, this instrument is called the TIMI UA/NSTEMI calculator, TIMI risk score UA/NSTEMI calculator, TIMI score UA/NSTEMI calculator, or abbreviated as TIMI NSTEMI score calculator and TIMI NSTEMI score. Other names in use: TIMI risk score for unstable angina/NSTEMI, TIMI score unstable angina calculator, and TIMI UA score calculator.

Related search terms include TIMI UA/NSTEMI calculator, TIMI UA/NSTEMI risk score, TIMI NSTEMI score calculator, TIMI NSTEMI calculator, and unstable angina risk calculator. Common questions include: what is the TIMI UA/NSTEMI score, how to calculate the TIMI NSTEMI score, TIMI NSTEMI score interpretation, TIMI NSTEMI risk table, the 7 TIMI NSTEMI score variables, NSTEMI 14-day risk score, UA/NSTEMI risk stratification, and TIMI NSTEMI score limitations.

This score comes from the Antman TIMI score JAMA 2000 (TIMI NSTEMI Antman 2000), developed from the TIMI 11B ESSENCE clinical trial, with the outcome of TIMI score recurrent ischemia revascularization within 14 days (TIMI NSTEMI 14-day risk). Frequently compared: TIMI NSTEMI vs STEMI, TIMI NSTEMI vs TIMI STEMI, TIMI UA/NSTEMI vs GRACE score, and TIMI vs GRACE vs HEART score. Component terms: TIMI NSTEMI aspirin paradox, TIMI score aspirin use 7 days, TIMI NSTEMI ST deviation criteria, TIMI NSTEMI biomarker troponin, TIMI NSTEMI age 65 risk factors. Interpretation: TIMI NSTEMI score 0-7 interpretation, TIMI NSTEMI low intermediate high risk, TIMI NSTEMI 4.7 percent risk, TIMI NSTEMI 40.9 percent risk. For those looking for a TIMI NSTEMI MDCalc alternative, this page provides equivalent functionality.

Referensi

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. PMID 10938172.
Anderson JL, Adams CD, Antman EM, et al. ACC/AHA 2007 Guidelines for the Management of Patients With Unstable Angina/Non–ST-Elevation Myocardial Infarction. Circulation. 2007;116:e148-e304. (Tabel 34-1 memuat tabel risiko 14 hari yang sama.)
Amsterdam EA, Wenger NK, Brindis RG, et al. 2014 AHA/ACC Guideline for the Management of Patients With Non–ST-Elevation Acute Coronary Syndromes. J Am Coll Cardiol. 2014;64(24):e139-e228.
Collet JP, Thiele H, Barbato E, et al. 2020 ESC Guidelines for the management of acute coronary syndromes in patients presenting without persistent ST-segment elevation. Eur Heart J. 2021;42(14):1289-1367.
Cannon CP, Weintraub WS, Demopoulos LA, et al. Comparison of early invasive and conservative strategies in patients with unstable coronary syndromes treated with the glycoprotein IIb/IIIa inhibitor tirofiban (TACTICS-TIMI 18). N Engl J Med. 2001;344(25):1879-1887.

TIMI Risk Score Calculator for UA/NSTEMI

Calculator: check the 7 variables

Selected variables

14-day composite risk table by score

Stratification guide

Comparison: TIMI vs GRACE vs HEART

TIMI STEMI vs TIMI UA/NSTEMI — don't mix them up

Limitations

Frequently asked questions

Related terms

Referensi

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