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Free TIMI Risk Score Calculator for UA/NSTEMI (2026)
The TIMI Risk Score for unstable angina and non-ST-elevation myocardial infarction (UA/NSTEMI) is a seven-item point score that estimates the 14-day risk of death, myocardial infarction, or urgent revascularization in patients already diagnosed with UA/NSTEMI. Each of the seven criteria — age 65 or older, three or more coronary risk factors, known coronary artery disease, aspirin use in the past week, severe angina, ST-segment changes on the presenting ECG, and an elevated cardiac biomarker — contributes one point, for a score out of 7. Higher scores correspond to a steadily increasing risk of an adverse event within two weeks, and a score of 3 or more is generally used to favor an early invasive strategy over initial conservative management. Enter the seven criteria below to calculate a patient’s TIMI Risk Score instantly.
Clinical decision-support aid, not a substitute for clinical judgment. These tools implement published scoring criteria for education and workflow support. They are not a medical device and have not been reviewed by the FDA or any regulatory body. Every result should be interpreted by a qualified clinician in the context of the full clinical picture, not used as a standalone diagnostic or treatment decision.
UA/NSTEMI risk stratification
TIMI Risk Score
Estimates 14-day risk of death, myocardial infarction, or urgent revascularization in patients with unstable angina or NSTEMI, from seven yes/no criteria. Check the criteria that apply, then calculate.
Antman EM, Cohen M, Bernink PJ, et al. JAMA. 2000;284(7):835–842 (original TIMI 11B derivation and validation).
A fully worked example
Consider a 68-year-old woman with confirmed unstable angina. Her age of 68 meets the age-65-or-older criterion (+1). She has known coronary artery disease, with a prior coronary stenosis of 50% or more (+1). She has been taking aspirin within the past 7 days (+1). Her presenting ECG shows ST-segment changes of at least 0.5mm (+1). She does not have three or more additional risk factors for CAD beyond her known disease, she does not report severe angina with two or more episodes in the preceding 24 hours, and her initial cardiac biomarker is not yet elevated. Adding the four positive criteria gives a TIMI Risk Score of 4 out of 7 — approximately a 20% risk of death, myocardial infarction, or urgent revascularization within 14 days. Because her score is 3 or higher, current practice generally favors an early invasive strategy — catheterization and revascularization if indicated — over initial conservative management. Try the same four checked boxes in the calculator above to see the readout it produces.
Methods, assumptions, and when not to use the TIMI Risk Score
For a manuscript methods section, the TIMI Risk Score can be cited in a single sentence: “Risk in patients with unstable angina/NSTEMI was stratified using the TIMI Risk Score (Antman et al., JAMA 2000).” Because it is a fixed, seven-item point score derived and validated in the TIMI 11B trial, citing the original derivation is standard and sufficient.
The TIMI Risk Score applies to patients with an established diagnosis of unstable angina or NSTEMI — it is not intended for patients with ST-elevation myocardial infarction (STEMI), who require immediate reperfusion therapy regardless of any risk score, and it is not a substitute for serial troponins and repeat ECGs, which remain part of the diagnostic work-up alongside the score rather than replaced by it.
What does a TIMI score of 3 or higher mean?
A TIMI Risk Score of 3 or higher is the threshold most commonly used to favor an early invasive strategy — diagnostic catheterization with revascularization if indicated — over initial conservative management. The risk of death, myocardial infarction, or urgent revascularization within 14 days rises from roughly 5% at a score of 0–1 to about 13% at a score of 3, and continues to climb at higher scores, so the threshold reflects a point where the balance of risk and benefit generally favors moving toward an invasive approach.
Is the TIMI Risk Score used for STEMI?
No. The TIMI Risk Score described here, derived in the TIMI 11B trial, applies only to patients with unstable angina or NSTEMI. A separate, differently-weighted TIMI risk score exists for STEMI (derived from the InTIME-II trial population), and in any STEMI presentation the immediate priority is reperfusion therapy — primary PCI or fibrinolysis — not risk-score calculation.
Does calculating the TIMI score require any tests beyond the standard UA/NSTEMI work-up?
No. Two of the seven criteria — ST-segment changes on the presenting ECG and an elevated cardiac biomarker — are findings already generated by the standard UA/NSTEMI work-up. The remaining five criteria (age, risk factor count, known CAD, recent aspirin use, and severe angina) come from the history alone. Because the score only uses information already being collected, it can usually be calculated without ordering any additional tests.
Primary reference
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.
Running an ACS or cardiology outcomes registry study?
Risk scores like TIMI are only as useful as the outcomes data validating them. If your next project involves an acute coronary syndrome or cardiology outcomes cohort, Editverse’s NTDB/TQP Trauma Registry Study service handles registry access, cohort definition, risk-adjusted modelling, and a publication-ready manuscript. See the registry study service