167. What is the TIMI risk score?

The TIMI risk score stands for “Thrombolysis In Myocardial Infarction” and is a scoring system to determine the likelihood that of death and the presence of an acute coronary syndrome in patients presenting with potential anginal symptoms. Each component of the score gives 1 point and is listed below:

1. Age > 65
2. Aspirin use in the prior 7 days
3. ST changes of at least 0.5 mm on the initial ECG (ST elevation or depression)
4. Elevated serum cardiac biomarkers
5. Two or more potential anginal symptoms in the last 24 hours
6. Previously diagnosed coronary artery disease with at least 50% stenosis
7. Three or more traditional risk factors for CAD

The risk at 14 days of all-cause mortality, acute coronary syndrome or severe ischemia requiring coronary revascularization is below:

1 point = 4.7%
2 points = 8.3%
3 points = 13.2%
4 points = 19.9%
5 points = 26.2%
6 or 7 points = 40.9%

Note that the TIMI score is different that TIMI grade coronary flow

TIMI 0 flow indicates no antegrade coronary flow past the obstruction (complete occlusion)
TIMI 1 flow is minimal antegrade flow past the coronary obstruction
TIMI 2 flow is partial antegrade flow past the obstruction with complete filling of the distal coronary vessel
TIMI 3 flow is normal flow filling the distal coronary artery