The Thrombolysis In Myocardial Infarction or TIMI Study Group is an Academic Research Organization.
The TIMI Risk Score assesses the risk of death and ischemic events in patients experiencing unstable angina (UA) or a non-ST elevation myocardial infarction (NSTEMI).
With unstable angina (UA) or a non-ST elevation myocardial infarction (NSTEMI) the TIMI risk score is a prognostication scheme that categorizes a patient’s risk of death and ischemic events and provides a basis for therapeutic decision making.
TIMI Score Calculation-1 point for each):
Age ≥ 65
Aspirin use in the last 7 days
At least 2 angina episodes within the last 24hrs
ST changes of at least 0.5mm in contiguous leads
Elevated serum cardiac biomarkers
Known Coronary Artery Disease (CAD) (coronary stenosis ≥ 50%)
At least 3 risk factors for CAD, such as:
Hypertension -> 140/90 or on anti-hypertensives
Current cigarette smoker
Low HDL cholesterol (< 40 mg/dL)
Diabetes mellitus
Family history of premature CAD
Male first-degree relative or father younger than 55
Female first-degree relative or mother younger than 65
Score Interpretation:
% risk at 14 days of: all-cause mortality, new or recurrent MI, or severe recurrent ischemia requiring urgent revascularization.
Score of 0-1 = 4.7% risk
Score of 2 = 8.3% risk
Score of 3 = 13.2% risk
Score of 4 = 19.9% risk
Score of 5 = 26.2% risk
Score of 6-7 = at least 40.9% risk
TIMI risk estimates mortality following acute coronary syndromes.
The TIMI Risk Score for STEMI is useful for patients with known STEMI: though these patients have a clear protocol – normally thrombolysis or Percutaneous coronary intervention – and are already high risk for mortality,
TIMI Risk Score for STEMI provides risk stratification which helps treatment decisions after acute issues have been resolved.
TIMI Grade Flow is a scoring system from 0-3 referring to levels of coronary blood flow assessed during percutaneous coronary angioplasty.
TIMI 0 flow of no perfusion, refers to the absence of any antegrade flow beyond a coronary occlusion.
TIMI 1 flow is faint antegrade coronary flow beyond the occlusion, with incomplete filling of the distal coronary bed.
TIMI 2 flow is delayed or sluggish antegrade flow with complete filling of the distal territory.
TIMI 3 is normal flow which fills the distal coronary bed completely
TIMI Risks
points % risk of mortality, MI, or need for revascularization
0 5%
1 5%
2 8%
3 13%
4 20%
5 26%
6 41%