TIMI Risk Score

TIMI-IIB, ESSENCE trials found 7 variables to be independently predictive of outcome in patients with UA/STEMI

Age > 65

Presence of at least 3 risk factors for CHD
    HTN
    DM
    Hypercholesterolemia
    Smoking
    Male gender
    Age
    Fam Hx of Premature CAD
    PVD
    Obesity

Prior Coronary Stenosis > 50%

Presence of ST segment deviation on admission ECG

At least 2 anginal episodes in prior 24H

Elevated serum cardiac biomarkers

Use of ASA in prior 7 days

Score/ Event Rate (all-cause mortality, new or recurrent MI, severe recurrent ischemia requiring revascularization) at 14 days

0/1 - 4.7%
2 - 8.3%
3 - 13.2%
4 - 19.2%
5 - 26.2%
6/7 - 40.9%

TIMI Score also identifed patients most likely to benefit from particular therapies:

Score > 3 - early invasive strategy (TACTICS-TIMI)
Score ≥ 4 - benefit from addition of tirofiban to heparin (PRISM-PLUS)
Score ≥ 4, ≥ 5 - enoxaparin was associated with better 14-day and 6-week post discharge outcomes compared to unfractionated heparin (TIMI IIB, ESSENCE)

 TIMI Risk Index = (heart rate x [age/10]squared)/systolic pressure = correlates with mortality

0-10 - mortality 1%
> 80 - mortality 34.4%