TIMI risk score for NSTEMI/UA and STEMI

TIMI risk score for NSTEMI/UA

Age ≥65

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

Known CAD (stenosis ≥50%)

ASA use in past 7 days

Severe angina (≥2 episodes in 24 hrs)

EKG ST changes ≥0.5mm

Positive cardiac marker

TIMI risk score for STEMI

Age range, year

< 65 (0)

65 - 74 (+2)

≥ 75 (+3)

History of DM, HT or angina (+1)

SBP < 100 mmHg (+3)

HR > 100 mmHg (+2)

Killip class >1 (+2)

Weight < 67 kg (+1)

Anterior STEMI or LBBB (+1)

Time to reperfusion Rx> 4 h (+1)

GRACE ACS risk score

Age, years

Heart rate, beats/min

SBP, mmHg

Creatinine

mg/dl

µmol/L

Cardiac arrest at admission

Yes (39)

No

ST segment deviation

Yes (28)

No

Abnormal cardiac enzymes

Yes (14)

No

Killip class

No heart failure (I)

Rales and/or JVD (II)

Pulmonary edema (III)

Cardiogenic shock (IV)

Result

0 Points
5% risk at 14 days of: all-cause mortality, new or recurrent MI, or severe recurrent ischemia requiring urgent revascularization.

Reference

Antman EM, Cohen M, Bernink PJ, McCabe CH, Horacek T, Papuchis G, Mautner B, Corbalan R, Radley D, Braunwald E. The TIMI risk score for unstable angina/non-ST elevation MI: A method for prognostication and therapeutic decision making. JAMA. 2000 Aug 16;284(7):835-42. doi: 10.1001/jama.284.7.835. PMID: 10938172.

Morrow DA, Antman EM, Charlesworth A, Cairns R, Murphy SA, de Lemos JA, Giugliano RP, McCabe CH, Braunwald E. TIMI risk score for ST-elevation myocardial infarction: A convenient, bedside, clinical score for risk assessment at presentation: An intravenous nPA for treatment of infarcting myocardium early II trial substudy. Circulation. 2000 Oct 24;102(17):2031-7. doi: 10.1161/01.cir.102.17.2031. PMID: 11044416.

Granger CB, Goldberg RJ, Dabbous O, Pieper KS, Eagle KA, Cannon CP, Van De Werf F, Avezum A, Goodman SG, Flather MD, Fox KA; Global Registry of Acute Coronary Events Investigators. Predictors of hospital mortality in the global registry of acute coronary events. Arch Intern Med. 2003 Oct 27;163(19):2345-53. doi: 10.1001/archinte.163.19.2345. PMID: 14581255.