TIMI

The TIMI Risk score

Part of our discussion this morning was about the prognosis of those individuals admitted with Acute Coronary Syndromes. This TIMI score came up in conversation. This score estimates mortality of your ACS patient in the next 14 days. Each item is worth a point for a total score out of 7. 0-2 points is low risk with a 14 day mortality of less than 3%. 5 points and above is high risk, with estimated 14 day mortality rates over 12%.

1.Age greater than or equal to 65 years
2. Presence of at least three risk factors for CHD (hypertension, diabetes, dyslipidemia, smoking, or positive family history of early MI)
3. Prior coronary stenosis greater than or equal to 50%
4. ST segment changes on admission ECG
5. Two or more anginal episodes in the preceding 24 hours
6. Elevated serum cardiac biomarkers
7. Use of ASA in the past 7 days

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 Aug 16;284(7):835-42.

Taking a History for Acute Coronary Syndromes:

Below is a link to the JAMA article that discuses which components of the cardiac history are important for Acute Coronary Syndromes:

http://jama.ama-assn.org/cgi/content/full/294/20/2623